Public Health investigating possible wound botulism from injected Black Tar Heroin

Butte County Public Health (BCPH) announced Tuesday it is investigating a case of wound botulism in a Butte County resident who inject drugs, including black tar heroin and meth.

Posted: Nov 17, 2020 11:23 AM

BUTTE COUNTY, Calif. – Butte County Public Health (BCPH) announced Tuesday it is investigating a case of wound botulism in a Butte County resident who inject drugs, including black tar heroin and meth.

Public Health said laboratory testing to confirm the diagnosis is pending. The source of the heroin is unknown currently. Black tar heroin has been linked to other wound botulism outbreaks in injection drug users, so there is concern that locally available black tar heroin may be contaminated, according to BCPH.

An increase in wound botulism, likely associated with black tar heroin use, is occurring in multiple areas of California, said BCPH. However, this is the first case in Butte County since 2018.

“Wound botulism occurs when a wound becomes infected with Clostridium botulinum (the cause of foodborne botulism) or a closely related Clostridium bacterium,” explained BCPH in a news release. “The bacteria multiply in the wound and create a toxin that acts on the nerves. Most, but not all, people with wound botulism will have a visibly infected wound. Persons injecting black tar heroin into their muscles (“muscling”) or under their skin (“skin popping”) are at the highest risk of wound botulism. Persons with wound botulism cannot transmit the illness to others.”

Health officials said symptoms of wound botulism occur within days or weeks of injecting contaminated drugs and may be mistaken for a drug overdose.

Symptoms can include weak or drooping eyelids, blurred or double vision, dry mouth, sore throat, slurred speech, trouble swallowing, difficulty breathing, and a progressive symmetric paralysis that begins at the face and head and travels down the body. If left untreated, symptoms may progress to paralysis of the respiratory muscles, arms, legs, and trunk with subsequent death. Prompt diagnosis and treatment is critical to decreasing the severity and duration of illness.

BCPH is asking healthcare providers to immediately report any suspected cases of botulism to them. BCPH will then facilitate testing and the acquisition of antitoxin treatment.

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