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Isolation and Quantification of Botulinum Neurotoxin From Complex Matrices Using the BoTest Matrix Assays

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Botulism in injecting drug users, Dublin, Ireland, November-December 2008.

J Barry¹, M Ward, S Cotter

¹Department of Public Health, Health Services Executive, Dublin, Ireland.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin

|January 24, 2009

Summary

Six cases of wound botulism in heroin users were reported in Dublin in late 2008. This marks the first outbreak in Ireland since 2002, with one fatality.

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Area of Science:

Public Health
Infectious Diseases
Toxicology

Background:

Wound botulism is a rare but serious condition caused by toxins produced by Clostridium botulinum bacteria.
Injecting drug use is a known risk factor for wound botulism due to non-sterile injection practices.
An outbreak of wound botulism in heroin users was last documented in Ireland in 2002.

Purpose of the Study:

To report on a cluster of suspected wound botulism cases among heroin injecting drug users in Dublin.
To highlight the resurgence of wound botulism in this vulnerable population.
To inform public health surveillance and prevention strategies.

Main Methods:

Retrospective case series analysis.
Review of clinical data from six suspected cases.
Epidemiological investigation of reported cases in Dublin.

Main Results:

Six cases of suspected wound botulism were identified between November and December 2008.
All cases involved heroin injecting drug users residing in Dublin.
Patient ages ranged from 23-42 years, with four males affected.
One patient died following hospital admission.
Cases presented across four different Dublin hospitals.

Conclusions:

The findings indicate a significant increase in wound botulism cases among injecting drug users in Dublin.
This outbreak underscores the ongoing risk of botulism associated with injecting drug use in Ireland.
Enhanced surveillance and targeted harm reduction interventions are crucial for this population.