waarschuwing aanwezigheid anthrax in heroine
From: Dbsyd@aol.com [mailto:Dbsyd@aol.com]
Sent: Tuesday, May 30, 2000 9:14 AM
Dear Judit and Ton
This looks like some important information for heroin users. It's about the
recent spate of unexplained deaths of drug users in Scotland and Norway.
Anthrax is very scary stuff. Please ensure it gets circulated.
>From New Scientist 20 May 2000
Vital Signs - Editorial
ANTHRAX and heroin. Could there be a more sensational mix of modern-day
nightmares? Yet there really are anthrax spores in some heroin in Norway.
They have killed at least one man and could be to blame for the worst year
the country's seen for deaths among addicts. Anthrax may also be killing
Scottish drug users(p 4). And, since virtually all Europe's supplies come
from Asian countries where anthrax is endemic, spore-laced heroin might be
scattered right along the drug's trade routes.
And yet some will say, so what? Junkies die young anyway. Anthrax is not
communicable, so the addicts are only harming themselves.
Try telling that to the six-year-old orphaned by the latest death in
Scotland. All these deaths are personal tragedies. But there is another
reason to care about them: they tell us whether we are alert to new
diseases, and yes, even biological weapons. So the news is not all bad. We
caught this outbreak.
South-West Asia has been supplying Europe with heroin for more than a
decade. Why should anthrax only appear now? Most heroin comes from
Afghanistan, home to some of the Western world's arch-enemies. Maybe they
have suddenly started infecting their prime export, even if killing addicts
does seem a bizarre form of terrorism.
More likely, pure heroin was cut with a powder that included some material
from infected animals, which means this could have been happening for years.
But who bothers to autopsy dead addicts? Every few months there is a surge
in deaths which is blamed on overdosing with unusually pure heroin, and no
one looks further.
Except that this time someone did. Norwegian doctors decided to autopsy a
heroin addict who had died of a strange septicaemia, and were surprised at
what they found. Next came a series of events outside official channels. In
an informal Internet newsletter one doctor asked if anyone else had found
anthrax in heroin. At the same time, Glasgow hospitals noticed more dead
addicts than usual--with similarly strange symptoms. The penny dropped.
Otherwise, no one would have suspected anthrax.
So let us have more openness between people with information about
infectious diseases. True it's not always easy to share details when the
police call for silence while they track down suppliers and traffickers. But
as events over the past few weeks show, the more people talk, the easier it
is to spot patterns of disease.
Other European countries should check for infection. And let us continue to
investigate. Samples should be sent to American labs with the wherewithal to
tell us precisely where the anthrax strain came from. Maybe it was an
escapee from a weapons lab.
Paying more attention to what addicts die of will help to show which
pathogens are moving around the world, and how. Next time it might be
something even more malevolent.
>From New Scientist 20 May 2000 (Page 4)
Lethal Injection by Debora MacKenzie
The deaths of heroin addicts have sparked an anthrax scare
ANTHRAX is now a prime suspect in a spate of deaths among heroin addicts in
Europe. Tests at Britain's lab for dangerous pathogens at Porton Down have
found signs of anthrax infection in two Scottish victims. Nine more Scots
are ill, and doctors fear the disease--which is hard to monitor among drug
users--may be far more widespread.
"Heroin can contain almost anything in small amounts," says Les King of the
Forensic Science Service, which analyses seized heroin in Britain. But no
one checks it for infectious agents, he notes. "There could be a long
history of this, and we just haven't observed it till now."
Ten addicts in Glasgow and Aberdeen have died over the past few weeks after
injecting the drug into muscle, rather than their veins. They developed a
painless, pus-free lesion at the injection site, then died hours after the
appearance of more general symptoms including severe oedema, leakage of
fluids around the heart and lungs, and soaring white blood cell counts.
No one knew of a possible contaminant in heroin that could be to blame. But
now the spotlight is on anthrax, following the appearance of an anthrax case
history on ProMED, the Internet forum for emerging diseases. Per Lausund of
the Norwegian Army Medical School posted details of an Oslo addict who died
in April after injecting heroin into muscle. He developed an abscess, then
fell into a coma 10 days later. After antibiotics failed to save him, tests
showed anthrax bacilli in his spinal fluid, which was confirmed by DNA
Now scientists at Porton Down have tested blood samples from five Scottish
victims. Two tested positive for "protective antigen", the main anthrax
toxin. "Nothing else would give that result," says Phil Hanna, an anthrax
expert at the University of Michigan at Ann Arbor, who says the symptoms are
also typical of anthrax.
Anthrax bacilli have not shown up in any of the blood samples, but that does
not rule out infection. "Antibiotics can wipe out circulating anthrax
bacilli, making diagnosis very difficult," says Martin Hugh-Jones of
Louisiana State University, who investigated a 1979 anthrax outbreak in
Russia. The circulating toxins can still kill patients, even though the
bacteria have gone.
Chris McGuigan of the Greater Glasgow Health Board adds that at least one
sufferer in Scotland, who is still alive, has the black scab typical of
localised anthrax infection.
The link with injecting into muscles, rather than veins, is also consistent
with an anthrax diagnosis, says Hanna. Infection spreads only when anthrax
spores are consumed by macrophages, the roving white blood cells that eat
bacteria. They do this much more effectively in muscle than in blood. Hanna
adds that intravenous users may succumb later if spores encounter
macrophages in the spleen.
As New Scientist went to press, the Glasgow Health Board was still
undecided. "We do not discount anthrax, but we have so far failed to find
the bacilli," says Syed Ahmed of the Health Board. It is also considering
necrotising fasciitis, or "flesh-eating disease", as some of its symptoms
are similar. While investigations continue, addicts have been advised to
smoke heroin rather than inject it. No one else is at risk, as neither
disease passes from person to person.
Anthrax is endemic in Pakistan, Afghanistan and Iran, where most of Europe's
heroin originates. Hugh-Jones says animal-derived material from the region,
such as gelatin or bone meal, may well be contaminated with spores. Such
material could have found its way into heroin.
The National Institute of Public Health in Oslo warns that further cases may
occur elsewhere. But addicts might not come forward for treatment, says
Hugh-Jones. Many cases may not even be noticed, he adds, because deaths
among heroin users are relatively commonplace.
Vanaf vijf juni tweeduizend (16:20):