Recent Wound Botulism Death Confirmed
The incidence and severity of wound botulism cases among patients in California as a result of opioid drug injection continues to make national headlines. Following up on a January report by Today’s Wound Clinic (TWC),1 the Centers for Disease Control and Prevention has confirmed at least one death among the nine patients (eight confirmed, one suspected) in San Diego County who have been diagnosed with the condition, a rare illness that is caused by skin popping, a method of injecting a drug under the skin instead of into a vein or a muscle (muscling). As of TWC’s press time, all patients involved in the reported outbreak had been hospitalized in the intensive care unit and treated with heptavalent botulism antitoxin (BAT),2 according to a report by Contagion, a print and online news resource that covers all areas of infectious disease. The lone death reportedly occurred in a long-term care facility one week after receiving BAT. All nine patients may have injected black tar heroin, a cruder form of the drug that is most dangerous when injected under the skin, with toxicology results confirming drug use in at least six patients, according to the Contagion report. At least seven patients reportedly claimed using the black tar heroin specifically, while six reported to have used the drug through the skin popping method. At least two patients were said to have received naloxone, a medication designed to rapidly reverse opioid overdose, without experiencing relief symptoms, including the patient who later died. Additionally, the California Department of Public Health reportedly released BAT for 45 patients with suspected wound botulism in various counties from Jan. 1 through Nov. 5, 2018, according to the Contagion report, which also cited the opioid epidemic as “one of the top five infectious disease concerns to monitor in 2019.”3
1. Wound botulism tied to opoioid epidemic. TWC. 2018;13(1):5.
2. Lorenz J. Wound botulism outbreak linked to heroin raises concern of opioid epidemic effects. Contagion. 2019. Accessed online: www.contagionlive.com/news/wound-botulism-outbreak-linked-to-heroin-raises-concern-of-opioid-epidemic-effects
3. Top 5 infectious disease concerns to watch in 2019. Contagion. Accessed online: www.contagionlive.com/news/top-5-infectious-disease-concerns-to-watch-in-2019/?rel=0