By NewsDesk  @infectiousdiseasenews

County health officials in Butte County, California report investigating a case of wound botulism in a Butte County resident who injected drugs, including black tar heroin.


Laboratory test results to confirm the diagnosis are pending. The source of the heroin is unknown at this time. Black tar heroin has been linked to other wound botulism cases and outbreaks in injection drug users, so there is concern that locally available black tar heroin may be contaminated.

California has the highest rate of wound botulism in the United States. This is the third case reported in Butte County this year.

Since 2016, there have been 22 to 59 cases of wound botulism annually in California. Wound botulism occurs when a wound becomes infected with Clostridium botulinum (the cause of foodborne botulism) or a closely related Clostridium bacterium. The bacteria multiply in the wound and create a toxin that acts on the nerves. Most, but not all, people with wound botulism will have a visibly infected wound. Persons injecting black tar heroin into their muscles (“muscling”) or under their skin (“skin popping”) are at highest risk of wound botulism. Persons with wound botulism cannot transmit the illness to others.

Symptoms of wound botulism occur within days or weeks of injecting contaminated drug and may be mistaken for drug overdose. Symptoms can include weak or drooping eyelids, blurred or double vision, dry mouth, sore throat, slurred speech, trouble swallowing, difficulty breathing, and a progressive symmetric paralysis that begins at the face and head and travels down the body.

If left untreated, symptoms may progress to paralysis of the respiratory muscles, arms, legs, and trunk with subsequent death. Prompt diagnosis and treatment is critical to decreasing the severity and duration of illness. Any injection drug users with symptoms of wound botulism should seek medical attention immediately at the nearest emergency room.