CAUSE OF ADDICT'S DEATHS IDENTIFIED

The answer to the medical mystery behind the rash of deaths among heroin
users here and in Britain would appear to have come in Cardiff yesterday. A
team lead by Prof Brian Duerden at the Public Health Laboratory Service
unit (PHLS) in the Welsh capital identified the bug that has killed heroin
users in Britain as clostridium novaea, a member of the clostridium family.
Clostridium is an anaerobic bacterium, meaning it flourishes in the absence
of oxygen.

It can exist, however, in a kind of "suspended animation" as spores in dust
or soil. If heroin is cut with soil or dust containing the bacterium, once
injected into the oxygen-free environment of body muscle, it can multiply
and produce potentially fatal toxins which attack the body. However, a
spokeswoman for the Eastern Regional Health Authority here said its
department of public health was still trying to establish the cause of the
illness here.

"The particular type of clostridium confirmed in the three cases in Glasgow
has not been isolated in any case in Dublin," she said.

But Dr Laurence Gruer, of the Greater Glasgow Health Board (GGHB), said the
illnesses here and in Scotland were "almost certainly linked". He said
there was still some way to go in isolating the bacterium from heroin
samples. "So far, the tests have been negative. We are at a serious
disadvantage because we cannot be sure that the heroin we are testing is
the same heroin that the patients had been injecting." The identification
of clostridium novaea (type A) is not therefore a definitive answer to the
mystery behind the heroin deaths. Another case of the illness among heroin
users was confirmed in Dublin yesterday, bringing the total here to 16.
Anti-drugs workers welcomed the probable identification of the bacterium
behind the illness, which has killed 26 IV drug users in this State and
Britain since April 26th.

The Cardiff announcement would appear to confirm a report in Wednesday's
Irish Times, which identified the clostridium strain. The PHLS has been
working with the Centre for Disease Control in the United States. Doctors
there are urging anyone with symptoms to get to hospital quickly - but warn
that the infection is hard to treat, even with modern antibiotics. The
novaea (type A) strain has been known to cause severe infection in domestic
animals but was rarely seen in humans, said Prof Duerden at a press
conference convened by the GGHB yesterday.

"It is commonly found in soil and may be present in animal faeces," he
said. "As far as we know, this is the first time this bacterium has ever
caused an infection in drug injectors."

Mr Tony Geoghan, director of the Merchant's Quay Centre in Dublin, said he
was glad the probable cause had been identified but said "it doesn't hold
out much hope" for the majority of users.

"What they need desperately is a better network of services and a better
range of services," he said.