In a follow-up on the wound botulism situation linked to heroin use in Los Angeles County, Los Angeles County Department of Public Health (Public Health) has identified three additional suspect cases of botulism associated with the use of black tar heroin, bringing the total to six cases.

Public domain photo/Psychonaught
Public domain photo/Psychonaught

Public Health is warning that black tar heroin in Los Angeles may be contaminated with bacteria that can cause wound botulism, a serious illness that can cause death. Injection drug users are at greatest risk, especially if injecting contaminated heroin under their skin (“skin-popping”) or into their muscle (“muscling”).

“We normally see two to three cases of botulism among heroin users per year, so this is a significant increase,” said Muntu Davis, MD, MPH, Los Angeles County Health Officer. “We are asking community providers and partners, particularly those serving people that use heroin such as substance use providers, to inform patients and colleagues about the increased risk.”

Contaminated drugs look the same as drugs that do not contain bacteria. “Cooking” or heating drugs will not kill the bacteria that cause botulism. Botulism is not contagious from person to person, but if you share contaminated heroin or equipment (“works”) with another person, both of you might get botulism.

Symptoms of wound botulism include drooping eyelids, blurred or double vision, difficulty speaking, difficulty swallowing, trouble breathing, and shortness of breath. Symptoms may be mistaken for drug overdose and may occur within days or weeks of injecting the contaminated drug. Any injection drug user who is suspected of experiencing these symptoms should go to the nearest emergency room immediately. Symptoms can be life threatening and require immediate medical attention.