Anthrax alert for heroin users in London

The Health Protection Agency (HPA) and NHS London can confirm that a drug injecting heroin user has tested positive for anthrax and is being treated in a London hospital.

This is the first case of anthrax seen in an injecting drug user in England since similar cases were first seen in Scotland in December 2009. Nineteen cases have so far been confirmed in Scotland. Similarities to the cases in Scotland suggest that the heroin, or a contaminated cutting agent mixed with the heroin, is the likely source of infection.

Dr Brian McCloskey, Director of the Health Protection Agency in London, said:
“We are working closely with NHS London to monitor the situation. There is no evidence of person to person transmission in this case and I’d like to reassure people that the risk to the general population, including close family members of the infected patient, is negligible. It is extremely rare for anthrax to be spread from person to person and there has been no evidence of a significant risk of airborne transmission associated with the current situation in Scotland.

“While public health investigations are ongoing, it must be assumed that all heroin in London carries the risk of anthrax contamination. Heroin users are advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. Heroin users in London are strongly encouraged, as soon as possible, to find out more about the support services in their area. They can be put in touch with local drug services and receive advice by contacting Talk to Frank.”

Professor Lindsey Davies, Regional Director of Public Health from NHS London, said:
“I urge all heroin users in London to be extremely alert to the risks and to seek urgent medical advice if they experience signs of infection such as redness or excessive swelling at or near an injection site, or other symptoms of general illness such a high temperature, chills or a severe headache or breathing difficulties, as early antibiotic treatment can be lifesaving. This is a very serious infection for drug users and prompt treatment is crucial.

“Drug injecting is an extremely risky and dangerous practice and users are vulnerable to a wide range of infectious diseases, both from the action of piercing the skin, as well as contaminants in the drugs that they use.

“Health professionals and drug action teams in England had already been alerted to the situation in Scotland in December and we will continue to work closely with colleagues who work with drug users to monitor probable cases and raise awareness of the risks.”

ENDS

Notes to Editors:

1. Further information about the cases of anthrax in Scotland is available at:
   www.hps.scot.nhs.uk/anthrax
2. Heroin users in London are strongly encouraged to find out more about the support services in their area. They can find drug services or seek advice from Contact Talk to Frank for local drug services and advice:
   24-hour helpline: 0800 77 66 00 / website: www.talktofrank.com
3. The outbreak in Scotland began with the identification of cases in NHS Greater Glasgow & Clyde in December 20009, with cases now having been identified in six NHS board areas across the country, and represents the first known outbreak of anthrax to have occurred in conjunction with drug use. It is important to note that there is no evidence of person-to-person transmission in this outbreak.
4. The Health Protection Agency has produced advice for injecting drug users and guidelines on the clinical evaluation and management of people with possible cutaneous anthrax in England. These are available at: http://www.hpa.org.uk/HPA/Topics/InfectiousDiseases/InfectionsAZ/1191942145749/
5. Recent public health alerts issued by the Department of Health through the Central Alerting System are available at: https://www.cas.dh.gov.uk/Home.aspx

Media enquiries:

Health Protection Agency:
020 7759 2834
020 7759 2824
020 8327 6647
020 8327 7750

NHS London:
020 7932 3911. Out of office hours, please call 0844 822 2888 and ask for pager number LON01.