An inquiry has opened in Glasgow into the deaths of two heroin users who died as a result of using contaminated heroin in May 2000.
The illness which killed the Scottish heroin users also resulted in the deaths of eight users in the Republic in the summer of last year.
Forty people were killed by the illness, identified as being caused by an anaerobic bacterium called clostridium noviae type A, in Dublin as well as in north-west England and parts of Scotland. A spokeswoman for the Eastern Regional Health Authority said last night no inquiry was planned here.
Dr Penelope Reading, a consultant microbiologist at Victoria Infirmary in Glasgow, yesterday told how she was one of the first people to identify a bacterium which led to the deaths of the 18 known drug-users in Scotland.
She was speaking on the opening day of a fatal accident inquiry into how staff at her hospital first became aware of a possible bacteria outbreak among drug-users.
The inquiry heard how an outbreak management team was set up after two Glasgow women were admitted to the hospital with similar symptoms. Both were known heroin users and were admitted to the intensive care ward within days of each other.
Dr Reading said: "To have two deaths like this in such a short period of time was something which the clinicians felt was unusual. By the time we had acted on this, a third patient had been admitted showing similar symptoms."
Specialists at the hospital became increasingly concerned when the patients failed to respond to measures regularly known to help treat heroin users.
She said: "The patients had infections of the skin, something not unusual in this group of people, but they remained extremely unwell and death came very quickly.
Tests later identified the bacterium, clostridium noviae, as a probable cause of death after samples were taken from two users who survived the illness.
Dr Reading said the bacteria contained a group of organisms which grew in the absence of oxygen, often in the bowels, which could contaminate a wound and cause gangrene-like symptoms.
The inquiry heard a number of similar cases had been discovered about the same time in north-west England and Dublin. Health authorities treating the infected patients had liaised about the infections.
A number of recommendations were made, including improving communications between doctors and hospitals dealing with such outbreaks.