By NewsDesk  @bactiman63

The Los Angeles County Health Department is reporting an increase in wound botulism cases linked to heroin injection in recent months.

Public domain photo/Psychonaught

Since June 1, 2020, six suspected cases of wound botulism associated with heroin injection have been reported in Los Angeles County (one case a month June through August and three cases in October).

The cases are apparently unknown to each other. The sources of the heroin remain unknown.

Five of the six cases presented with wound infections or abscesses and a recent history of injecting heroin. Symptoms included diplopia, ptosis, dysphagia, slurred speech, facial paralysis, difficulty breathing, and muscle weakness.

Five cases required intensive care treatment and had respiratory failure requiring intubation. All patients were treated with Botulism Antitoxin Heptavalent (BAT®).

In 2020 to date, there has been a total of 9 reported cases of wound botulism, more than twice the annual average.

Between 2015-2019, twenty confirmed cases of wound botulism occurred in Los Angeles County, all of which were associated with drug use. Of these twenty, 11 cases were associated with black tar heroin, 7 with heroin and 2 were associated with injection/inhalation of cocaine and/or methamphetamine.

Botulism is a rare, potentially fatal paralytic illness caused by the neurotoxins produced by Clostridium botulinum. Wound botulism occurs when a wound is contaminated by C. botulinum spores that germinate and produce toxin inside the wound. Wound botulism in drug abusers occurs in dermal abscesses from subcutaneous or intramuscular injection (skin or muscle “popping”).