Investigators still stymied by European heroin-anthrax link

Anthrax-laced heroin has been responsible for the deaths of 16 people over the last nine months in the United Kingdom.

The recent outbreak is the largest the United Kingdom has seen for decades and the first reported in intravenous drug users. There are many questions about the outbreak, but few answers, according to Epidemiologists are uncertain as to how long the infections will persist in the population and how the heroin became infected in the first place.

A link to terrorist groups has been largely dismissed, although epidemiologists have not ruled the possibility out entirely.

Since December 2009, there have been 47 confirmed cases of anthrax in Scotland, and hundreds of potential cases investigated, reports. Cases in England began appearing in February 2010, and three people there have died. Two more cases related to those in England have been recorded in Germany.

During the current outbreak, 15 patients in Scotland were treated with an experimental drug, anthrax immunoglobulin. It was taken from the Centers for Disease Control and Prevention in the United States. Tests for its effectiveness are ongoing.

Before December 2009, the there had only been one confirmed case of anthrax being contracted intravenously, which was in Norway in 2000. Scientists there coined the term “injectional anthrax” to describe the appearance and transmission of the disease, reports.

Since the outbreak in the United Kingdom, injectional anthrax has become a recognized term. Both the route of transmission and the symptoms differ from the other three forms of the disease, which are gastrointestinal, cutaneous and inhalation anthrax.

Colin Ramsay, a consultant epidemiologist at the U.K. Health Protection Agency, told that the known cases represent a minor portion of the damage done by the contamination. He believes that it seems probable that the first case was actually from before December 2009.

Officials are busy testing the blood serum of addicts around the country for anthrax antibodies, which would identify exposure to the disease.

Under normal circumstances, heroin flows from England to Scotland, so it seems unusual that the there would be such a discrepancy in the number of cases in both regions. Not all drug users seem to run the same risk of contracting the disease.

“We have found that it has mostly affected older drug users, who may have a more drug-related pathology than younger ones,” Ramsey told

Results of testing the anthrax bacteria found in the contaminated heroin have proven that they come from the same source and are genetically indistinguishable. Investigators believe that one rogue batch might be the culprit, though this goes against previously held beliefs that the drug is distributed and used immediately on its arrival.

The newest case, however, which appeared in August, has prompted speculation that there may be chronic contamination in the nation’s heroin supply. Ramsay believes it is too early to say for certain.

There is still no concrete theory as to how the batch could have become contaminated. The latest theory is that the suspect heroin was smuggled in an infected animal hide at some point along its trip to the United Kingdom.