MYSTERY ILLNESS KILLS 30 DRUG USERS IN GREAT BRITAIN

WASHINGTON -- In a scenario eerily reminiscent of the beginnings of the
AIDS epidemic, nearly 60 intravenous drug users in Scotland, Ireland and
England have become ill and half of them have died since April of a
mysterious illness whose origins health officials have not yet identified.

The baffling ailment is characterized by excessive swelling and redness at
the injection site, low blood pressure and a high white blood cell count,
often followed by heart failure.

Those who have died - most of them about two days after being admitted to a
hospital - did so despite treatment with broad spectrum antibiotics and
other measures.

And while blood and tissue cultures have shown multiple organisms, none has
yet been identified as a likely culprit.

The U.S. Centres for Disease Control and Prevention, called two weeks ago
by authorities in the United Kingdom to help in the investigation, said in
its first public report on the mystery illness Thursday that "the emergence
of a new illness is possible," but stressed that it appears to be confined
to intravenous drug users.

"This is a serious illness among members of this particular community,"
said Dr. Marc Fischer, co-ordinator of CDC's surveillance project for
unexplained deaths and critical illnesses.

"Something is going on - but we're not sure at this point what it is.
"Right now, though, the greatest likelihood is that it is an organism
previously known and described and showing itself in a new way," he said.

But he emphasized that, because the early part of the illness involves the
injection site, "this suggests it is somehow related to that practice."

No cases have shown up as yet in the U.S., but the experience of AIDS -
believed to have begun in Africa - has taught the public health community a
sobering lesson that it has not forgotten: that deadly infectious agents
are but an airplane ride away.

Surveillance has been heightened in the United Kingdom and Ireland, as well
as in the U.S. CDC sent letters last week to state health authorities
alerting them to the cases and asking them to be on the lookout for them in
their jurisdictions.

Health officials in the U.S. and abroad are disseminating information about
the illness to health-care practitioners and trying to identify possible
risk factors so prevention strategies can be developed.

They are questioning patients to see what they might have in common -
specifically sources of their drugs and the timing of injections.

Thus far,there have been 59 cases - 30 in Glasgow, Scotland; 15 in Dublin,
Ireland; and 14 around England, with 30 deaths among them, CDC said. Five
who died in Manchester and Liverpool were among nine suspected cases in
those areas.

Health officials at first feared the cause might be anthrax, because the
bacterium had been isolated from the spinal fluid of an intravenous drug
user in Olso, Norway, who became ill and died. But health investigators
have found no evidence of anthrax among any of the U.K. cases.

Cultures have found several bacteria among some of the patients, including
group A streptococcus, Staphylococcus aureus, and bacteria from the
families of clostridium and bacillus, which cause several potentially
serious diseases.

Because antibiotics have failed to help any of these patients, health
authorities speculated that the agent could be a toxin-producing one. Also,
these patients typically have a high white blood cell count, which is often
the body's response to an infection or to a toxin-producing agent, Fischer
said.

Once a toxin is produced, the illness is difficult to treat unless specific
anti-toxins are available for the disease.

A few toxin-related illnesses - such as botulism and tetanus - can be
treated with anti-toxins, Fischer said.

"But we can't treat a toxin when we don't know what it is."