Mysterious illness killing heroin users

31 deaths in Britain, Ireland in last month spur global probe

June 03, 2000|By Bill Glauber | Bill Glauber,SUN FOREIGN STAFF

GLASGOW, Scotland - A mysterious illness among heroin users in Britain and Ireland has led to as many as 31 deaths, triggering an international medical investigation.

From Glasgow to Dublin, England and Wales, the trail of death has been charted by health officials who have called in American experts to attempt to pin down the illness.

Since the outbreak was discovered last month, there have been 31 reported cases in Glasgow, with 14 deaths.

Health officials in Dublin reported 15 cases, with eight deaths.

Two deaths in the north Scotland city of Aberdeen may also be linked to the illness. Fourteen suspected cases, including seven deaths, were found in England and Wales, officials from the Public Health Laboratory Service said yesterday. It won't be known until later next week if the cases are linked.

Similar symptoms of abscess or swelling have been reported in the cases, in which it appears an infection produces a toxin that damages vital organs, including the heart. In all the cases, it appears the users inject heroin into tissue or muscle, instead of veins. Victims suffer a septicemia-type illness.

A spokeswoman for the Greater Glasgow Health Board said yesterday that microbiologists suspect the illness could be caused by an anaerobic bacteria. "We're not at this stage sure that it can be pinpointed to one particular organism," the spokeswoman said.

Previously, investigators ruled out anthrax after tests were undertaken at a chemical weapons research center.

The unusually high number of deaths became so serious that Glasgow public health officials assembled an international medical team that included the Atlanta-based Centers for Disease Control and Prevention. Two CDC investigators were dispatched last week to Glasgow and Dublin to help local teams, and specimens of tissue were sent to Atlanta.

Health officials also provided advice to addicts, warning that "it is much safer to smoke heroin than inject it."

"Our focus is on a common supply of heroin within which there are rare or unusual contaminants, a microorganism that can develop infection," said Dr. Laurence Gruer of the Greater Glasgow Health Board. "All the signs are that it is not spread from person to person. It's not like HIV."

Gruer, a consultant in public health medicine, is leading the local medical investigation, walking a careful line between raising public awareness and causing panic.

"The general population isn't at risk," he said. "It's not even a problem that is putting a great majority of drug injectors at risk."

But the cases are casting light on Scotland's - and Glasgow's - struggle with drugs. They're also causing concern among veterans of Scotland's bleak drug culture.

"We don't know what happened," said Thomas Mougen, who is 38, looks 70 and displays the scars of two decades of heroin addiction. "We don't know if it will stop. There is panic."

Heroin is this old industrial city's silent killer and dirty secret. Experts claim there are at least 12,000 intravenous drug users among Glasgow's population of 610,000. Last year, 148 people died of drug overdoses in the Strathclyde area, which includes Glasgow.

Many of the same reasons that account for hard drug use in America can be seen here, according to Netta Maciver, head of Turning Point Scotland, a health and social charity.

"The people we see using heroin come from areas of great deprivation, poor education and little opportunity," she said. "If you look at social deprivation, it intensified here in the 1970s and 1980s."

Their parents may have used alcohol and tranquilizers, Maciver says, but some in the younger generation moved on to harder drugs.

As the death toll climbed from drug overdoses in recent years, public concern and outrage also rose. The death two years ago of a 13-year-old Glasgow girl compelled a woman named Gaille McCann to take action, founding a local organization, Mothers Against Drugs.

McCann's initial goal was simple: Get the pushers off the streets of an east-side neighborhood, Cranhill. Now, McCann, a member of the Glasgow City Council, has taken her anti-drug message to the next level, with the planned opening in September of a drug treatment center.

"In Glasgow, there is a real shortage of treatment centers," she said. "Demand outstrips supply, 10 to 1."

For many here, the city's drug problem was out of sight, out of mind.

But that attitude began to change early last month, when two young women, heroin users, arrived at a local hospital emergency room with abscesses. Despite being treated with antibiotics, their conditions deteriorated, they suffered multiple organ failure and they died within hours.

Other cases - and deaths - quickly popped up.

"The first two cases we came across on May 5," Gruer said. "By the 8th, we got a number more. We went public May 9."

"It was an unprecedented problem that we had never come across before," he added. "We've scoured the published literature."

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