CASES OF WOUND BOTULISM IN INJECTION DRUG USERS
Since 1994, California has experienced an epidemic of wound botulism among injecting drug users (IDUs). Over the past 5 years, 20-24 cases of laboratory-confirmed wound botulism among IDUs have been reported on a yearly basis in California. From January 1, 2006 to date, California has already logged 22 laboratory-confirmed cases, and has released antitoxin for another 14 IDU patients whose laboratory tests are pending. We do not know the reason for this year’s increase, but the primary cause of wound botulism among IDUs has been skin-popping contaminated black tar heroin.
Description of wound botulism:
Wound botulism is caused by an infection with Clostridium botulinum, toxin-producing bacteria. Since 1988 it has been predominantly associated with subcutaneous or intramuscular black tar heroin use. Wound botulism usually begins with bilateral cranial nerve signs and symptoms including blurred vision, diplopia, ptosis, dysphagia, dysarthria, impaired gag reflex and facial weakness. It then proceeds to generalized weakness and dyspnea. On close inspection an abscess containing the bacteria may be found at a site of injection.
Click on the following links for detailed information.
Public Health Alert - Wound Botulism in Injection Drug Users 6-16-06 (
PDF 291 kb)
Public Health Alert - Wound Botulism Checklist 6-16-06 ( PDF 88 kb)
Public Health Alert - Wound Botulism Warning English 6-16-06 ( PDF 333 kb)
Public Health Alert - Wound Botulism Warning Spanish 6-16-06 ( PDF 330 kb)