Case of Wound Botulism in Ireland
The National Disease Surveillance Centre has been notified of a case of botulism, which has been identified in the Eastern Regional Health Authority. This case is under investigation by the ERHA. It has arisen in an injecting drug user. In February 2002 three cases of botulism were reported in injecting drug users in the UK.
The NDSC and the Department of Health and Children have asked public health doctors and other health professionals to be alert to possible cases of botulism.
Botulism is a rare condition that is caused by botulinum toxin, a poison produced by the bacterium Clostridium botulinum. The bacterium is common in the soil in the form of spores. It usually takes about 12-36 hours to start to develop symptoms once you have been exposed to the toxin. More than 90% of cases are treated successfully but some prove fatal.
Persons with botulism may complain of symptoms such as blurred vision, difficulty swallowing, difficulty in speaking, paralysis and breathing problems. Treatment is with a special botulism antitoxin antidote and antibiotics.
It is possible that this case may be associated with injecting drug use. The advice to those who inject drugs is:
- Never, ever share needles, syringes, cookers/spoons or other 'works' with other users.
- Smoking heroin is less harmful than injecting
- If you must inject, do not inject into muscle or under the skin: make sure you hit the vein - blood kills bugs better than muscle.
- Use as little citric acid as possible to dissolve the heroin. Too much damages skin and muscle and gives bugs a better chance to grow and cause infection.
- If you inject more than one type of drug, don't inject them all in the same place. This is important because some drugs, like cocaine could give any bacteria in heroin a better chance to grow.