heroin and Tetanus

Topics: Abscess; Adult; Animals; Autopsy; Blindness; Brain Diseases; Cerebrovascular Disorders; Endocarditis; Haplorhini; Hepatitis A; Heroin; Heroin Dependence; Humans; Male; Muscular Diseases; Myelitis, Transverse; Nervous System Diseases; New York City; Peripheral Nervous System Diseases; Quinine; Substance-Related Disorders; Tetanus

Topics: Adolescent; Adult; Endocarditis; Female; Hepatitis; Heroin; Humans; Lung Diseases; Male; Middle Aged; Substance-Related Disorders; Tetanus

Since 2000 in the United Kingdom, infections caused by spore-forming bacteria have been associated with increasing illness and death among persons who inject drugs (PWID). To assess temporal and geographic trends in these illnesses (botulism, tetanus, Clostridium novyi infection, and anthrax), we compared rates across England and Scotland for 2000-2009. Overall, 295 infections were reported: 1.45 per 1,000 PWID in England and 4.01 per 1,000 PWID in Scotland. The higher rate in Scotland was mainly attributable to C. novyi infection and anthrax; rates of botulism and tetanus were comparable in both countries. The temporal and geographic clustering of cases of C. novyi and anthrax into outbreaks suggests possible contamination of specific heroin batches; in contrast, the more sporadic nature of tetanus and botulism cases suggests that these spores might more commonly exist in the drug supply or local environment although at varying levels. PWID should be advised about treatment programs, injecting hygiene, risks, and vaccinations.

Topics: Adult; Anthrax; Bacillus anthracis; Botulism; Clostridium; Clostridium botulinum; Clostridium Infections; Clostridium tetani; Disease Outbreaks; Drug Contamination; England; Female; Heroin; Humans; Incidence; Male; Scotland; Spores, Bacterial; Substance Abuse, Intravenous; Tetanus

Topics: Adult; Drug Eruptions; Heroin; Humans; Injections, Intravenous; Injections, Subcutaneous; Male; Quinine; Substance Abuse, Intravenous; Tetanus

Topics: Endocarditis, Bacterial; Heroin; Heroin Dependence; Humans; Naloxone; Substance Withdrawal Syndrome; Substance-Related Disorders; Tetanus

Topics: Adult; Amino Acids; Body Weight; Catheterization; Diet Therapy; Female; Heroin; Humans; Hypertonic Solutions; Male; Methods; Morphine Dependence; Nitrogen; Parenteral Nutrition; Subclavian Vein; Tetanus

Topics: Adult; Anesthesia; Cellulitis; Female; Hepatitis A; Heroin; Humans; Male; Maternal-Fetal Exchange; Menstruation Disturbances; Physician-Patient Relations; Pregnancy; Pulmonary Edema; Substance-Related Disorders; Surgical Procedures, Operative; Tetanus

Topics: Adolescent; Adult; Brain Abscess; Brain Edema; Cerebral Hemorrhage; Deafness; Heroin; Humans; Male; Meningitis; Myelitis, Transverse; Myoglobinuria; Myositis; Neuritis; Neurocognitive Disorders; Polyradiculopathy; Substance-Related Disorders; Tetanus

Topics: Abdomen, Acute; Aneurysm, Infected; Contracture; Diagnosis, Differential; Femoral Artery; Gastrointestinal Diseases; Hand; Heart Valve Prosthesis; Heroin; Humans; Inflammation; Injections, Intravenous; Skin Diseases, Infectious; Substance-Related Disorders; Surgical Procedures, Operative; Tetanus; Thrombophlebitis

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs. Sydney E. Salmon and Robert W. Schrier, Assistant Professors of Medicine, under the direction of Dr. Lloyd H. Smith, Jr., Professor of Medicine and Chairman of the Department of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, San Francisco, Ca. 94122.

Topics: Bacterial Infections; Chemical and Drug Induced Liver Injury; Endocarditis, Bacterial; Heroin; Humans; Lung Diseases; Malaria; Substance Withdrawal Syndrome; Substance-Related Disorders; Tetanus

Topics: Acute Disease; Adolescent; Adult; Chemical and Drug Induced Liver Injury; Duodenal Ulcer; Female; Heart Failure; Heroin; Humans; Jaundice; Male; Maryland; Middle Aged; Neurotic Disorders; Pneumonia; Pulmonary Edema; Pulmonary Fibrosis; Radiography; Sarcoidosis; Substance-Related Disorders; Tetanus

Topics: Adolescent; Adult; Brain; Brain Damage, Chronic; Endocarditis, Bacterial; Female; Heroin; Humans; Male; Myelitis; New York City; Polyneuropathies; Substance-Related Disorders; Tetanus

Topics: Adolescent; Adult; Female; Heroin; Humans; Injections; Lung; Lung Abscess; Male; Morphine Dependence; New York City; Pleural Effusion; Pneumonia; Pseudomonas Infections; Pulmonary Edema; Radiography; Spondylitis; Substance-Related Disorders; Tetanus; United States

Topics: Heroin; Heroin Dependence; Humans; Substance-Related Disorders; Tetanus; Tetanus Toxoid