WENATCHEE — A patient was diagnosed in a Chelan County hospital with wound botulism, a paralyzing toxic reaction believed to derive from injecting tainted heroin.
Chelan-Douglas Health District spokeswoman Mary Small said her agency was alerted Wednesday to the botulin poisoning, which poses no wider risk to the general public. The health district gave notice of the health case Thursday to local health providers and police, in case more such poisonings emerge, Small said.
“We just wanted to put out an awareness to people who provide service and work with people who are using drugs,” she said.
Botulism is a potentially fatal bacteria-related poisoning that can occur from eating tainted food or, in the case of wound botulism, introducing botulin-producing bacteria through the skin. It is not communicable from person to person.
Small could not give the name of the patient due to federal privacy laws, and did not know the patient’s condition. She said a photograph distributed with her alert, which shows a patient’s bare legs with several open sores, was meant as illustration and was not a photo of the Chelan County victim. Open sores are associated with IV drug injection but are not necessarily a symptom of botulin poisoning.
Early symptoms of botulism — presenting anywhere from one day to two weeks after exposure — include weakness and drooping eyelids, blurred or double vision, extreme dry mouth and sore throat, trouble swallowing or speaking, and shortness of breath or other breathing trouble. Left untreated, it can paralyze the muscles involved in breathing, leading to death.
There are about 145 cases of botulism reported each year according to the Centers for Disease Control and Prevention. About 20 percent of all cases stem from wound infections, and most wound botulism cases are associated with the injection of black tar heroin.
The toxic bacterium is believed to live within diluting agents — “dextrose, burned cornstarch, instant coffee, and sometimes even dirt,” according to a 2004 medical study— introduced while processing the heroin. This means disinfected needles and clean injection points can’t prevent infection.
Ten Americans have died of wound botulism since 2001. Cases have been reported over the last decade among IV drug users in the Yakima area, including two in 2010, one in 2007 and four others in 2003, but Small said this appears to be the first such instance in the Wenatchee Valley.
“We’re hoping not to see any more cases in our area,” Small said.