Inquiry into botulism outbreak after death in Dublin


An investigation is underway into a possible outbreak of the disease botulism in Dublin, and into whether it has originated in a contaminated batch of heroin. One person with a suspected case of botulism died today.

The Health Service Executive has been investigating an outbreak of botulism among heroin users in the past two weeks.

Four possible cases of the disease were notified in the week of November 24th, the HSE said.

Two further suspected cases were notified in the past two days and one of the patients died today.

“The incident is being managed by an outbreak control team from the Department of Public Health (east) and alerts have been issued to drug services and relevant clinical staff in emergency departments and other locations,” a statement said.

Prof Joe Barry of the HSE said: “Botulism caused by infection with a toxin clostridium botulinum, is a rare occurrence in drug users, occurring when contaminated heroin is injected into soft tissue as opposed into veins.”

“Botulism last occurred in drug users in Ireland in 2002 and in 2000 eight drug users died when heroin contaminated with clostridium novyi was in circulation in Dublin.

““We are investigating whether the source of heroin in the present outbreak is contaminated,” he said.

Drug users are being advised to seek medical help if they experience neurological difficulties, particularly as a result of injecting heroin into muscle or under the skin and if they develop abscesses.

Botulism, which must be notified to health authorities, is caused by a botulinum toxin, which is a poison produced by the bacterium clostridium botulinum.

The bacterium is common in the soil in the form of spores, according to the Health Protection Surveillance Centre (HPSC).

Symptoms often begin with blurred vision and difficulty in swallowing and speaking, but sometimes diarrhoea and vomiting can occur.

The symptoms are caused not by the organism itself, but by eating or breathing in the toxin released by the organism.

The disease can lead to problems with vision, and paralysis.

Most cases make a recovery, but the recovery period can be many months. The disease can be fatal in 5-10 per cent of cases.

Fine Gael's health spokesman, Dr James Reilly, said the news was shocking, and that it was "somewhat worrying" that little has been heard about the cases since they were first identified 16 days ago.

He said the statement left a number of questions unanswered, including if the death could have been prevented if there was general notification of the threat to the drug addict and wider community at an earlier stage.

“I have long been advocating for the publication by the gardaí of a weekly bulletin listing contaminants found in drugs seized on the streets. I believe this would raise awareness amongst all drug users, including those
who feel they have but a social habit, that drug abuse is a deadly game of roulette,” he said.

Sinn Fein TD Aengus Ó Snodaigh called on the Minister for health to open an investigation.