DIRTY TRICKS

Are soil bacteria behind a recent spate of heroin deaths?

DRUG dealers who have deliberately cut heroin with a soil normally used in
industry may be to blame for the wave of mystery deaths among British and
Irish addicts, say infectious disease experts.

Last week government scientists identified Clostridium novyi, a common soil
bacterium, as a likely suspect in the hunt for the mystery killer of 30
heroin addicts in Britain. But it may not be the only culprit. A lethal
cocktail of soil bacteria, including anthrax in one case, seems to have
contaminated Europe's heroin, possibly because someone doctored the drug
with earth.

Scientists including Les King of Britain's Forensic Science Service and
epidemiologist Martin Hugh-Jones of Louisiana State University at Baton
Rouge, suspect earth that is rich in oxygen-hating bacteria such as C. novyi
and Bacillus may be to blame. These bacteria have been found in either
victims or suspect heroin.

King says looking at a heroin sample under a microscope could help settle
the question. But, he says, no one routinely analyses heroin. For the sake
of public health, "someone should survey the microorganisms and inorganic
components in it".

Cases of the mystery illness are still emerging. Last week there were five
new victims in Scotland, six in England, and one in Dublin (see Graphic).
All the heroin users injected into muscle and developed an abscess, then
symptoms of toxic shock. Because the symptoms are so similar to anthrax, and
a Norwegian addict died of the disease in April, scientists suspected that
this infamous bacterium might be to blame for the Scottish cases as well
(New Scientist, 20 May, p 4).

However, tissue samples from the victims never revealed the large numbers of
bacteria typical of anthrax infection. At a meeting in Glasgow last week,
investigators said that the most probable culprit was C. novyi, which stays
near the site of initial infection and whose toxins produce similar
symptoms. Clostridium has been found in only nine victims in Glasgow, and
three are confirmed as the species C. novyi. No Clostridium has been found
in Irish victims, and the Eastern Regional Health Authority in Dublin says
it is "keeping an open mind on the cause".

The bacteria might have been missed in some cases because they are
notoriously difficult to culture. But the important public health question,
says King, might not be which bacteria killed addicts, but where they came
from. C. novyi, the anthrax in Norway, and three additional species of
Bacillus found in heroin samples linked to deaths in Glasgow are all
anaerobic soil bacteria which lie dormant in earth in tough resistant
spores.

This suggests the heroin was contaminated with earth, says Hugh-Jones. He
believes that "diatomaceous earth", a natural silica widely used in
industry, could be to blame. The fact that this beige powder closely
resembles heroin would possibly make it attractive to heroin dealers seeking
to adulterate the drug. The earth is frequently dug from wet,
oxygen-deprived environments where anaerobic bacteria like to live.

There is often insoluble material in heroin, says King. The heroin behind
the current outbreak was reported to be hard to dissolve. But no heroin
analyses have yet been published by Norway, Britain or Ireland. Until a
government agency takes responsibility for carrying out this kind of
analysis, King fears, outbreaks like this will continue. Andria
Efthimiou-Mordaunt, editor of The User's Voice, a Londonbased drug policy
magazine, says: "Someone must take the initiative to start testing heroin."