The Norwegian Institute of Public Health (NIPH), or Folkhelseinstitutet (computer translated) has reported an additional two wound botulism cases linked to contaminated heroin, bringing the total in Norway to 10 cases since the first case was recorded in late December.
The individual drug users injected heroin outside the blood vessel, health officials note. In all cases the heroin was obtained in the drug environment in Oslo.
In addition, Scotland’s total botulism cases remain unchanged at 15, making the total in the two European countries to 25. Four patients remain under investigation, with botulism as a possible cause but are not counted in the total cases.
The hypothesis that these cases are the result of a single batch of heroin contaminated with C. botulinum spores remains to be positively confirmed.
The European Centre for Disease Prevention and Control (ECDC) botulism in people who inject drugs has been reported in recent years in several European countries and the USA.
Given the complex international distribution chain of heroin, the exposure of people who inject drugs in other EU Member States cannot be excluded.