Cluster of wound botulism cases in injecting drug users in England - update

Six suspected cases of wound botulism have been reported in England, following the public health alert issued on 30 October 2002 (1,2). All six cases are known to be in injecting drug users. To date, the number of suspected cases of wound botulism reported in 2002 in the United Kingdom is now known to be sixteen. Nine of these cases have been laboratory confirmed. Clostridium botulinum toxin type A was detected in seven cases, and toxin type B in two cases. Tests are continuing on two patients; two cases previously reported as suspected cases of wound botulism are now thought to be more compatible with other clinical diagnoses.