Case of anthrax confirmed in Lanarkshire heroin user

webbykevin

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http://www.bbc.co.uk/news/uk-scotland-glasgow-west-18981196

A case of anthrax has been confirmed in an injecting drug user in Lanarkshire.

The area's health authority said the patient was being treated at one of its hospitals and was in a critical but stable condition.

NHS Lanarkshire believes the patient could have contracted the anthrax bacteria from a contaminated batch of heroin circulating in the area.

Anthrax is an acute bacterial infection most commonly found in hoofed animals such as cattle, sheep and goats.

It normally infects humans when they inhale or ingest anthrax spores, but cannot be passed from person to person.

Blood poisoning
Symptoms can include a raised, itchy, inflamed pimple which turns into a blister with extensive swelling.

The lesion is usually painless, and will later turn into a black eschar.

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If there is any pain or swelling around an injection site drug users should seek urgent medical attention”

David Cromie
NHS Lanarkshire
If left untreated the infection can spread to cause blood poisoning.

It can take up to a week for symptoms to develop after a person comes into contact with anthrax.

David Cromie, consultant in public health medicine at NHS Lanarkshire, said: "It is possible that heroin contaminated with anthrax may be circulating in Lanarkshire and potentially other parts of Scotland.

"There have been recent reports of anthrax from contaminated heroin in other western European countries, the most recent reported outbreak being in Germany.

"It is important that drug users are aware of the particular dangers involved when they are injecting heroin."

Mr Cromie said injecting drug users known to Lanarkshire addiction services were being contacted to alert them to the problem.

"The advice to drug users is to avoid all heroin use, which we recognise may be very difficult for drug users to follow," he said.

"Muscle-popping, skin-popping, and injecting when a vein has been missed are particularly dangerous.

"Smoking heroin carries much less risk than injecting it. If there is any pain or swelling around an injection site drug users should seek urgent medical attention."

The worst outbreak of anthrax in the UK for 50 years occurred among drug users in Scotland between 2009 and 2010.

A total of 119 cases were recorded with a total of 14 deaths during the outbreak.
 
The area's health authority said the patient was being treated at one of its hospitals and was in a critical but stable condition.

If he's in critical condition, then he can't be stable. If he is stable then he can't be critical.

Pet peeve.
 
If he's in critical condition, then he can't be stable. If he is stable then he can't be critical.

Pet peeve.

Hehe. He's brain dead, but breathing on his own, eh?

Mr Cromie said injecting drug users known to Lanarkshire addiction services were being contacted to alert them to the problem.

That's awfully nice of them. That might just save a life or two. My methadone clinic would never call me... ever. Some of us do have phone numbers.
 
From here, "Boiling water for >10 minutes, for example, can reduce B. anthracis spore counts by at least 10^6 (Table 1)." It's the most practical thing I can come up with, don't know if anyone would bother doing it though.
 
just for reference: I have no idea if this is safe:

Decontaminating mail

In response to the postal anthrax attacks and hoaxes the US Postal Service sterilized some mail using a process of gamma irradiation and treatment with a proprietary enzyme formula supplied by Sipco Industries Ltd.[58]

A scientific experiment performed by a high school student, later published in The Journal of Medical Toxicology, suggested that a domestic electric iron at its hottest setting (at least 400 °F (204 °C)) used for at least 5 minutes should destroy all anthrax spores in a common postal envelope.[59]

http://en.wikipedia.org/wiki/Anthrax

Bear in mind that a mass of evaporated heroin is potentially as dangerous as anthrax.
 
From here, "Boiling water for >10 minutes, for example, can reduce B. anthracis spore counts by at least 10^6 (Table 1)." It's the most practical thing I can come up with, don't know if anyone would bother doing it though.

Wouldn't that destroy the heroin as well though? iirc heroin breaks down below boiling point.
 
Heroin should be reasonably stable in water provided there's not too much acid around. Boiling water for 10 minutes is probably pushing it, but even then the worst that will happen is hydrolysis to morphine & 6-MAM.

If memory serves the Toronto harm reduction services recommend boiling possibly unsafe (bacterially contaminated) drugs for 15 minutes in as close to a sterile environment as you can find. It's important you boil it for quite some time because most bacteria can resist temporrary heating.

As to the saying "critical but stable condition", perhaps he's in a condition where one or more organs are not functioning properly, rendering him hospital-bound (critical) but for the most part the doctors have it controlled and are keeping him supervised until improvement is seen (stable). As opposed to a currently deteriorating critical condition, being dead, or being able to walk away.
 
Heroin should be reasonably stable in water provided there's not too much acid around. Boiling water for 10 minutes is probably pushing it, but even then the worst that will happen is hydrolysis to morphine & 6-MAM.

If memory serves the Toronto harm reduction services recommend boiling possibly unsafe (bacterially contaminated) drugs for 15 minutes in as close to a sterile environment as you can find. It's important you boil it for quite some time because most bacteria can resist temporrary heating.

As to the saying "critical but stable condition", perhaps he's in a condition where one or more organs are not functioning properly, rendering him hospital-bound (critical) but for the most part the doctors have it controlled and are keeping him supervised until improvement is seen (stable). As opposed to a currently deteriorating critical condition, being dead, or being able to walk away.
Anthrax spores can survive boiling easily.
 
Did you not see skillet's post suggesting otherwise? A millionfold reduction in spore count seems pretty good to me for a 10 minute boil.
 
it's not a millionfold reduction. It's a million fewer spores.

How populous is your average contaminated specimen? I seem to remember from high school microbiology that boiling isn't an effective neutralizer of anthrax.
 
Well technically speaking the best result from the paper is boiling for 5 mins at 100C will kill a population of 750 million anthrax spores. (sample was sterile afterwards). I would call that effective decontamination.

I guess it depends on the concentration of anthrax present and how long you cook it for.
 
it's not a millionfold reduction. It's a million fewer spores.

I'd say it's a millionfold too, it's not like a sample containing a million spores would be completely sterilised, but a sample containing 2 million spores would only be reduced to 1 million...
 
Yeah I suppose going from 1 million spores to 1 (or from a trillion to a thousand) would be a millionfold reduction, but 1 million spores to zero would be an infinityfold reduction, or something (divide by zero).
 
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