Butte County may have third wound botulism case

California leads nation in illness that can be caused by black tar heroin injection

The Butte County Public Health Department announced on Friday that it is investigating a case of wound botulism suffered by a Butte County resident who injected drugs, including black tar heroin.

The department says a lab test to confirm the diagnosis is pending and the source of the heroin is unknown.

However, the department said in a press release that black tar heroin has been linked to other wound botulism cases and outbreaks connected to injection drug users so there is concern that the black tar heroin available in Butte County may be contaminated.

The department has also issued a health advisory to area providers to promote rapid diagnosis and reporting and it has conducted outreach and provided information to homeless shelters, drug treatment facilities and other locations that serve persons who may be at risk of wound botulism.

According to the department, this would be the third case of wound botulism in the

county this year. California has the highest rate of wound botulism in the country.

Wound botulism occurs when a wound becomes infected with Clostridium botulinum (the cause of foodborne botulism) or a closely related Clostridium bacterium, BCPH said.

The department said that the bacteria multiply in the wound and creates a toxin that acts on the nerves and added most, but not all, people with wound botulism will have a visibly infected wound. Persons injecting black tar heroin into their muscles (“muscling”) or under their skin (“skin popping”) are at the highest risk of wound botulism.

The department added those infected cannot transmit the illness to others.

The department said that symptoms occur within days or weeks of injecting contaminated drugs and may be mistaken for a drug overdose. Symptoms can include weak or drooping eyelids, blurred or double vision, dry mouth, sore throat, slurred speech, trouble swallowing, difficulty breathing and a progressive symmetric paralysis that begins at the face and head and travels down the body.

If left untreated, symptoms may progress to paralysis of the respiratory muscles, arms, legs and trunk followed by death. Prompt diagnosis and treatment is critical to decreasing the severity and duration of illness. Any injection drug users with symptoms of wound botulism should seek medical attention immediately at the nearest emergency room.