Scotland health officials are investigating two suspected cases of wound botulism in injecting drug users.

Public domain photo/Psychonaught
Public domain photo/Psychonaught

Both individuals are receiving hospital treatment. One of the patients is from the NHS Greater Glasgow and Clyde area while the other is from the NHS Lanarkshire area.

The cause of these infections is being investigated with the focus on injecting heroin users.

Dr Gillian Penrice, NHS Greater Glasgow and Clyde Consultant in Public Heath Medicine, said: “I urge all drug injecting heroin users to be extremely alert.

“They should seek urgent medical attention from Accident and Emergency if they experience any early symptoms such as blurred or double vision, difficulty in swallowing and speaking and/or inflammation at the injection site.

“It is important for injecting drug users to engage with the wide range of services we offer designed to help them tackle their addictions. However for those who continue to inject, it is extremely important that they seek urgent medical help if they show these early symptoms.

“Heroin users should avoid injecting heroin into their muscles. Injecting heroin into a vein or smoking can reduce the risk of botulism, although not using heroin at all is by far the best course of action.”

We are not aware of any other cases in Scotland at this time.

What is Botulism?

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 of botulism 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.