In a follow-up to reports of a wound botulism outbreak in Scotland in intravenous drug users, Health Protection Scotland says from 21 December 2014 to 9 February, 21 people in Scotland have been admitted to hospital (seven since 1 February 2015), with illness where botulism has been suspected.

Scotland map/CIA
Scotland map/CIA

Two of the 21 cases have been discounted. Of the remaining 19 cases, six have been confirmed microbiologically as botulism and three as type B. In nine cases, there is clinical evidence to support a diagnosis of wound botulism and laboratory results are either pending (six cases) or negative (three cases); these cases have been classified as probable cases. The remaining four cases are under investigation, being classified as possible cases.

The source of the infection is believed to be heroin contaminated with Clostridium botulinum spores.

In all the cases where information is available, the individuals had obtained their drugs in, or sourced them via, Glasgow.

While further cases of botulism have been reported in Norway , there is no information at this point to suggest a link with the Scottish cases.