Health officials in Butte County, CA report investigating a suspected case of wound botulism in a resident who injected themselves with black tar heroin.

Confirmation testing is ongoing.

Public domain photo/Psychonaught
Public domain photo/Psychonaught

The source of the heroin is unknown at this time and the patient remains hospitalized and on a ventilator.

Black tar heroin has been an issue in the US and Europe for years and in addition to California, Washington state has seen outbreaks in recent years.

Mexico is frequently the source of black tar heroin which is a thick gummy substance and because of this it needs to be diluted. Many experts believe the source of the botulism is in the “cutting agent” which is believed to be things like dirt and honey.

Wound botulism is one of five types of botulism (foodborne, infant, Adult intestinal toxemia and  iatrogenic botulism are the other four).

Wound botulism occurs when spores of Clostridium botulinum contaminate a wound, germinate and produce botulinum neurotoxin in the body. Most wound botulism cases have been among intravenous drug users.

The symptoms of botulism include muscle weakness that starts in the head and neck muscles and then moves down the body to involve the arms and then legs; slurred speech; double or blurry vision; and trouble swallowing.  In severe illness respiratory muscles are involved and respiratory failure may occur.

Persons with botulism need to be hospitalized for treatment.  Severe illness and death can occur in persons whose disease is not recognized early in its course. The only specific treatment for botulism is botulism antitoxin, which should be given as early as possible to ease symptoms.