Lessons for control of heroin-associated anthrax in Europe from 2009-2010 outbreak case studies, London, UK

Aula Abbara, Timothy Brooks, Graham P. Taylor, Marianne Nolan, Hugo Donaldson, Maribel Manikon, Alison Holmes*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009-2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012-13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community.

Original languageEnglish
Pages (from-to)1115-1122
Number of pages8
JournalEmerging Infectious Diseases
Volume20
Issue number7
DOIs
Publication statusPublished - Jul 2014

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