CITY'S ADDICTS LIVING IN FEAR OF INJECTING ANTHRAX

By the time she died, Susan Black was injecting heroin into her
temples. Her veins were broken and useless, she had given up eating
and her legs were covered in abscesses. But it was the egg-sized sore
on her stomach that killed her.

Susan - not her real name - is one of 11 Glaswegian drug addicts whose
deaths in the past 10 days have baffled scientists and led to the
theory that anthrax may have found its way into the drug supply.

At least 24 people have been treated and 10 remain in hospital with
abscesses like the one on Susan's stomach, lesions more painful and
much more deadly than those commonplace among heroin addicts. These
sores are killing people in days, causing massive organ failure and
leaving the skin around infected areas black, like anthrax or the
flesh-eating disease necrotising fasciitis.

Microbiologists and public health officers were so concerned that they
sent tissue samples from seven victims to the biological defence
laboratory at Porton Down, Wiltshire, where scientists specialising in
germ warfare research tested for anthrax. Two of the samples came up
weakly positive.

Samples from those two victims have now been retested and found to be
negative, but all new cases are still being tested for the disease and
public health officials have not formally ruled it out as a cause.

Susan, an addict in her late twenties, became ill after buying
one-sixteenth of an ounce of Indian brown heroin with her friend,
Tracey (also a false name) from a female dealer in Govanhill on the
south side of the city. Tracey asked The Independent to withhold
Susan's real name because some of her family had not been informed of
her death.

"We paid Pounds 70 for it and went to a friend's flat in Saltmarket [near
the centre of Glasgow] and had a hit," said Tracey. "Susan's veins
were gone and sometimes she would inject into the side of her head,
her temples. She had abscesses everywhere because she used to
muscle-pop, whereas I did it into a vein. That's why I'm alive and
she's dead."

"Muscle-popping" is the practice of injecting into tissue either by
accident or because no veins can take a needle. Doctors have
established that all those who died had injected into muscle, which
takes longer to break down the drug than injecting into a vein. And it
was during this absorption that whatever was in the heroin infected
its victims.

"Susan must have injected the bad heroin into her stomach at some
point because she got this abscess that was worse than the others,"
said Tracey. "We begged her to go to hospital but she wouldn't. After
a few days, she became delirious but would still not go to hospital.
Eventually, some of my friends took her anyway, but she was dead on
arrival."

Sources say Susan was, in fact, still alive, but so ill she died
within minutes. Tracey could not say why none of her friends called an
ambulance sooner, but it is common for heroin addicts to avoid all
contact with the emergency services if they can.

"I keep asking why it was her and not me," said Tracey. "She was a
good person and it always seems to be the good ones who die. So many
of my friends have died in front of me. I have a history of trying to
kill myself and of mental illness. I wouldn't have minded. I'd have
swapped places."

Despite the spate of deaths, users have not been put off the drug.
Andrew Horne, manager of the Glasgow drug crisis centre, said: "The
other day, I sat down with four female addicts and I asked them what
they would do if I put a bag of heroin in front of them and told them
that there was a 90 per cent chance they'd get anthrax from it. They
all said they'd take it anyway."

Mr Horne refuses to support or reject the anthrax theory."We've sent
four people to hospital so far and we expect to see some more cases,
even though they appear to be tailing off," he said. "But why should
we be surprised if it was anthrax? This is a product from places like
Afghanistan and Iran where anthrax is endemic and public health is not
very well developed."

Among heroin addicts, rumour over the cause of the deaths is rife. One
theory has it that a former pharmacist in Govanhill is contaminating
the drug because of hatred for users; others are convinced the
infection derives from a bad batch of citric acid, with which heroin
is diluted.

Initially, there was concern that eight of the 11 dead were women,
when only 30 per cent of users are female. However, a number of
addicts say that was because a batch of the contaminated heroin found
its way to a women's hostel in Inglefield Street. The authorities
refuse to name the victims or divulge where they lived.

Despite the symptoms in affected addicts, no samples of blood or
tissue from dead and living victims has shown up anthrax. However,
Streptococcus A, an organism carried harmlessly by some people in
their nose and throat, has been found in blood cultures from three
patients.

Dr Syed Ahmed, consultant in public health medicine for the Greater
Glasgow Health Board, said: "That is normally harmless, but if there
was some irritant in the heroin that caused an infection, that could
act as a focus for the Streptococcus and various other organisms that
would normally not cause a problem.

"We are testing for everything and, at this stage, it would be
negligent if we ruled out anything, including anthrax. We were alerted
to the fact that an addict in Norway had died in similar circumstances
and they grew anthrax organisms from his brain.

"The thing that is puzzling is that, the way drugs are manufactured in
bulk and then distributed, you might expect to see cases around the
world, not just this cluster in Glasgow and one in Norway."

Another name might join that list in the next few days; the death of
an addict in Aberdeen was being investigated yesterday. Whether that
user becomes the 12th victim - and whether other cities are affected -
remains to be seen.