People who use heroin are potentially at risk of infection with anthrax, and also other diseases such as botulism and tetanus, that are caused by organisms found in the environment. The bacteria that cause these infections produce hardy spores that can survive in the environment for very long periods. Heroin can become contaminated with these spores whilst it is being trafficked.
An outbreak of anthrax among heroin users in Scotland, England and Germany occurred in 2009 and 2010. During 2012 cases of anthrax have been reported in a number of European countries, including the UK.
A high proportion of heroin users who become ill with anthrax will die from their infection.
Anthrax can be cured if treatment is started at an early stage
This guide aims to provide staff working with heroin users in specialist and non-specialist settings with key information on:
signs and symptoms of anthrax infection in heroin users
what staff can do to help.
What is anthrax?
Anthrax is a bacterium that produces spores that can infect the body. It also produces harmful toxins that damage the body and can lead to death.
The infection of drug users by contaminated heroin is most likely to be acquired through:
- heroin injection, with the spores entering the skin or entering the tissues under the skin (such as fat or muscle) or
- heroin smoking or inhalation, with the spores entering the lungs.
Who is anthrax affecting?
People who use heroin.
Most of those who have become infected have injected heroin. However, some of those who have developed anthrax had smoked heroin. It is likely that heroin use by any route will carry a risk of infection if the heroin is contaminated with anthrax spores.
No heroin can be considered safe.
Can you spot the contaminated heroin?
No. The spores are too small to be seen by the human eye.
Heroin powder normally varies in colour, texture and how well it dissolves – depending on the batch and how much it‟s been cut. Heroin that was used by those who developed anthrax has varied in appearance.
Contaminated heroin cannot be identified by appearance and therefore all heroin has to be considered potentially dangerous.