In a follow-up to reports earlier this year, Health Protection Scotland (HPS) says the botulism outbreak linked to people who inject drugs is ongoing , in fact, they says that dozens of people have been hospitalized with confirmed or probable wound botulism.
To date, 47 people in Scotland have been admitted to hospitals between 21 December 2014 and 5 June 2015, with illness where botulism has been suspected.
In five of the 47 cases botulism was thought not to be the cause of the illness, these cases having now been discounted. Of the remaining 42 cases, 17 have been confirmed microbiologically to be botulism and 14 have been confirmed as type B.
In 23 cases, there is clinical evidence to support a diagnosis of wound botulism, these cases having been classified as probable cases. The remaining two cases are under investigation and have been classified as possible cases. Five of the 42 cases have died, with botulism being considered a contributory factor in four.
Botulism is caused by botulinum toxin, a poison produced by the bacterium Clostridium botulinum. The organism is can be found in soil, dust, and river or sea sediments and can survive in these environments as a resistant spore.
The bacteria themselves are not harmful, but they can produce highly poisonous toxins when they are deprived of oxygen (such as in closed cans or bottles, stagnant soil or mud, or occasionally the human body).Symptoms often begin with blurred or double vision and difficulty in swallowing and speaking.
There may be local inflammation at an injection site in cases associated with intravenous drug use. If the condition is not treated quickly the disease can progress to a paralysis that can affect the arms, legs, and eventually the muscles that control breathing. The way in which the condition is treated depends on the type ofbotulism you have, but treatment will usually involve neutralising the toxins with injections of special antibodies while the functions of the body (such as breathing) are supported. Most cases make a full recovery, but the recovery period can be many months. Death can occur in between 5 and 10 per cent of cases.