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Wound Botulism Among Persons Who Inject Black Tar Heroin in New Mexico, 2016

Nicole Middaugh1,2, Leslie Edwards1, Kevin Chatham-Stephens1

  • 1Centers for Disease Control and Prevention, Atlanta, GA, United States.

Frontiers in Public Health
|January 3, 2022
PubMed

Insights

Outbreaks of wound botulism are rare but can occur in people who inject drugs. Early suspicion and diagnosis are crucial for prompt treatment and preventing prolonged illness.

Area of Science:

  • Infectious Diseases
  • Toxicology
  • Public Health

Background:

  • Wound botulism is a rare but serious condition.
  • It is associated with injecting drug use.
  • Early recognition is key for effective treatment.

Purpose of the Study:

  • To describe an outbreak of wound botulism.
  • To highlight diagnostic challenges and treatment delays.
  • To emphasize the importance of clinical suspicion in at-risk populations.

Main Methods:

  • Case series reporting on three individuals.
  • Laboratory confirmation of botulism.
  • Analysis of clinical presentation and exposure history.

Main Results:

  • Three laboratory-confirmed cases of wound botulism were identified in a single outbreak.
  • One case showed persistent botulinum toxin type A in wound cultures 43 days post-exposure.
  • Diagnostic delays led to prolonged hospitalizations.

Conclusions:

  • Clinicians must maintain high suspicion for wound botulism in persons who inject drugs.
  • Prompt diagnosis and treatment are essential to improve outcomes.
  • The persistence of botulinum toxin underscores the severity and potential for delayed recovery.
Keywords:
black tar heroinbotulismheroinintubationoutbreakwound

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