The EMCDDA and the European Centre for Disease Prevention and Control (ECDC) released a joint rapid risk assessment report on 22 June following a recent anthrax outbreak among drug users in Germany (1). Anthrax is an acute infectious disease caused by the bacterium Bacillus anthracis. It most commonly occurs in wild and domestic animals and is endemic in a number of mainly agricultural countries. It remains rare in Europe.
The agencies conclude in the report that it is likely that the two cases identified were linked via the drug users’ exposure to heroin contaminated with Bacillus anthracis. While the geographical distribution of the contaminated heroin is unknown at this time, the report states that it is possible that the batch is from the same source as the contaminated heroin incriminated in the 2009–10 outbreak in Scotland. It concludes that the risk of exposure to the bacterium for heroin users in Germany, and in other countries, is ‘presumably still present’ and that it is therefore ‘likely that additional cases among IDUs will be identified in the near future’.
The early-warning networks of both agencies, as well as the EMCDDA expert networks on drug-related infectious diseases and deaths, have been alerted to these new cases and surveillance has been strengthened to report any additional cases in Europe. ECDC and the EMCDDA will continue to monitor the evolution of the situation according to the epidemiological data available.
(1) Joint rapid risk assessment: Anthrax cases among injecting drug users, Germany (22 June) – two cases reported. A third confirmed case was reported on 4 July from a different region in Germany (Berlin) than the first two cases (Regensburg, Bavaria), suggesting that the contaminated heroin may be circulating more widely in Germany than previously thought. See updated report (6 July).
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