A consultant in Glasgow has said he hopes to have found a cause by next week for the mysterious deaths and illnesses among heroin-users in Scotland.
Dr Laurence Gruer, a consultant in public health medicine with the Greater Glasgow Health Board, said specialists in Glasgow and Atlanta were focusing on a bacterium which grows in the absence of oxygen. When drug-users inject heroin into dead tissue or muscle, instead of veins, they are susceptible to the bacterium.
"Some people are working through the weekend to push things on as fast as they can," Dr Gruer said.
Dr Joe Barry, a public health specialist with the Eastern Regional Health Authority, said they were not as definite about the cause of the illness, which has led to eight deaths in Dublin.
"We are not certain. There are a few theories, and we are not in any definite position," he said. But it would be unlikely that the cause in Glasgow would differ from Dublin.
Dr Gruer said heroin could have been contaminated with soil or dust. "It may have happened accidentally at a point where they were cutting heroin and filling it out with some other product to get more out of it."
The number of confirmed deaths among heroin addicts from the illness has risen to 29 this week, following the death of a woman user in Glasgow on Thursday. There have been 58 cases of the illness in Britain and the Republic.
Since the beginning of May 16 people have died in Scotland, eight in Dublin and five in the north-west of England.
A spokesman for the NHS Executive North West in England said it had linked the nine cases in its area to the Dublin and Scotland cases due to the presence of abscesses and the progression of the illness. He said the Public Health Laboratory Service in London was involved in the investigation.
Of the five deaths in northwest England, one was in Liverpool and four in Manchester.
Dr Barry said he would have expected more cases in Liverpool and Manchester if the illness was similar to the Dublin and Glasgow cases, because of the size of the cities.
Dr Gruer said sufferers are often admitted with low blood pressure, as the bacteria release toxins which affect the heart. He said once the illness was at an advanced stage it was difficult to prevent death. "Over 90 per cent of people who were severely ill before being treated have died," he added.
The symptoms of the illness include inflammation at an injection area and severe infection of the system. The patient then usually suffers toxic shock and is taken into intensive care.
Dr Barry said 200 people had sought heroin withdrawal treatment in Dublin since the warnings about injecting were issued.