Lessons for Control of Heroin-Associated Anthrax in Europe from 2009–2010 Outbreak Case Studies, London, UK (http://wwwnc.cdc.gov/eid/article/20/7/13-1764)

摘要

Heroin-associated anthrax resulting from direct injection or injection under the skin, or “skin popping,” among persons who inject drugs (PWIDs) is a distinct form of anthrax seen during a 2009–2010 outbreak in Scotland and England and again during 2012–2013 in northern Europe and Germany. There are an estimated 281,000 heroin users in England and >50,000 in Scotland (1), suggesting that the cases recognized and diagnosed during the outbreaks are the tip of the iceberg. The first 2 cases of heroin-associated anthrax occurred in the Greater Glasgow and Clyde area of Scotland and were reported on December 10, 2009. By July 2010, there were 47 confirmed case-patients in Scotland, of whom 13 (28%) died (2). In January 2010, the first cases outside Scotland were described in England and Germany (3); the final outbreak total in England was 6, with 4 deaths (4). The last case from this outbreak occurred in October 2010, and Health Protection Scotland declared the UK outbreak over on December 23, 2010; no active surveillance was established afterward (4,5).