The answer to the medical mystery behind the rash of deaths among heroin users here and in Britain would appear to have come in Cardiff yesterday. A team lead by Prof Brian Duerden at the Public Health Laboratory Service unit (PHLS) in the Welsh capital identified the bug that has killed heroin users in Britain as clostridium novaea, a member of the clostridium family.
Clostridium is an anaerobic bacterium, meaning it flourishes in the absence of oxygen. It can exist, however, in a kind of "suspended animation" as spores in dust or soil. If heroin is cut with soil or dust containing the bacterium, once injected into the oxygen-free environment of body muscle, it can multiply and produce potentially fatal toxins which attack the body. However, a spokeswoman for the Eastern Regional Health Authority here said its department of public health was still trying to establish the cause of the illness here.
"The particular type of clostridium confirmed in the three cases in Glasgow has not been isolated in any case in Dublin," she said.
But Dr Laurence Gruer, of the Greater Glasgow Health Board (GGHB), said the illnesses here and in Scotland were "almost certainly linked". He said there was still some way to go in isolating the bacterium from heroin samples. "So far, the tests have been negative. We are at a serious disadvantage because we cannot be sure that the heroin we are testing is the same heroin that the patients had been injecting." The identification of clostridium novaea (type A) is not therefore a definitive answer to the mystery behind the heroin deaths.
Another case of the illness among heroin users was confirmed in Dublin yesterday, bringing the total here to 16. Anti-drugs workers welcomed the probable identification of the bacterium behind the illness, which has killed 26 IV drug users in this State and Britain since April 26th.
The The Cardiff announcement would appear to confirm a report in Wednesday's Irish Times, which identified the clostridium strain. The PHLS has been working with the Centre for Disease Control in the United States. Doctors there are urging anyone with symptoms to get to hospital quickly - but warn that the infection is hard to treat, even with modern antibiotics. The novaea (type A) strain has been known to cause severe infection in domestic animals but was rarely seen in humans, said Prof Duerden at a press conference convened by the GGHB yesterday.
"It is commonly found in soil and may be present in animal faeces," he said. "As far as we know, this is the first time this bacterium has ever caused an infection in drug injectors."
Mr Tony Geoghan, director of the Merchant's Quay Centre in Dublin, said he was glad the probable cause had been identified but said "it doesn't hold out much hope" for the majority of users.
"What they need desperately is a better network of services and a better range of services," he said.