Anthrax link to deaths of 11 Scottish heroin addicts

James Meek, science correspondent
Thursday May 18, 2000

Government analysts said yesterday that evidence of anthrax had been found in
victims of a mysterious disease that has killed 11 Scottish heroin addicts in
recent weeks and left 15 more in hospital.
Scientists at Porton Down, Wiltshire, confirmed a report in the forthcoming
issue of New Scientist magazine that antibodies against anthrax spores have
been found in blood samples from two of the victims. The anthrax theory is
expected to be confirmed or ruled out by the end of the week after further
tests.

If confirmed, the deaths suggest that a consignment of heroin contaminated
with the deadly bacterium is loose on the streets of Europe.

However, Glasgow health officials yesterday played down the theory, saying
the Porton Down findings were only weak, indirect evidence.

"I'm very sceptical," said Laurence Gruer, consultant in public health
medicine on Greater Glasgow health board. "I can't 100% rule it out, but I
would have expected a lot more evidence for anthrax."

Cases of dead and dying heroin users with similar and unusual symptoms began
to pile up on Dr Gruer's desk at the end of last month. The 11th victim died
on Tuesday.

All had injected the drug into their muscles, rather than their veins, either
by accident or because scars from overuse of a needle meant that free-flowing
blood could no longer be found in surface veins. Many of the victims have
been women, whose veins tend to be less accessible than men's.

The anthrax connection was first mooted by scientists at the centre for
applied microbiology and research, which is alongside the Ministry of
Defence's biological warfare lab at Porton Down but is run by the Department
of Health.

They noticed a report from Norway, posted on the internet, of an Oslo addict
who died in April after injecting heroin into his muscle. A postmortem showed
anthrax bacilli in his spinal fluid. Aware of the deaths in Scotland, CAMR
asked the Glasgow health board to send some samples.

A CAMR spokesman, Phil Luton, said: "We got two very weak positives, which is
not conclusive evidence of anthrax, but we can't rule it out and are
continuing to test."

The victims' symptoms were indicative of anthrax, he said. Phil Hanna, an
anthrax specialist at the University of Michigan at Ann Arbor, made the same
observation in the New Scientist report.

The Scottish victims - 10 from Glasgow, one from Aberdeen - all died in a
similar way: several hours after injecting they had accumulated symptoms
including a heavy build-up of fluid, leakage of fluids round the heart and
lungs, and rapidly rising white blood cell counts as their metabolism rallied
to fight a major infection.

Dr Gruer said he hoped to get the further test results from CAMR today or
tomorrow.

Besides the Porton Down tests, he said, Glasgow specialists had been
culturing blood and tissue samples from the victims to see if anthrax spores
could be detected through a microscope, but with negative results.

Other theories have included necrotising fasciitis, known as flesh-eating
disease, or alternative contaminants in heroin, or the citric acid used by
addicts to dissolve heroin in water to make an injectable solution.

The muscle-injecting addicts have complained that lately they have had to use
more acid than usual, causing a burning sensation and, doctors speculate,
severe muscle damage.

Dr Gruer said one possibility was that the muscle damage had combined with
minor bacterial infections to cause the addicts' deaths.

Anthrax is not passed from person to person, so there is no risk of an
epidemic outside the heroin-injecting community even if it turns out to be
the cause.

It is not clear how it may have contaminated heroin, although the bacterium
is endemic in livestock in prime heroin poppy growing regions such as
Afghanistan.

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