Skip to main content Accessibility help
×
Home

Epidemiological findings and medical, legal, and public health challenges of an investigation of severe soft tissue infections and deaths among injecting drug users – Ireland, 2000

Published online by Cambridge University Press:  29 November 2005


K. MURRAY-LILLIBRIDGE
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
J. BARRY
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
S. REAGAN
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA
D. O'FLANAGAN
Affiliation:
National Disease Surveillance Centre, Dublin, Ireland
G. SAYERS
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
C. BERGIN
Affiliation:
St. James's Hospital, Dublin, Ireland
E. KEENAN
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
S. O'BRIAIN
Affiliation:
St. James's Hospital, Dublin, Ireland
P. PLUNKETT
Affiliation:
St. James's Hospital, Dublin, Ireland
G. McMAHON
Affiliation:
St. James's Hospital, Dublin, Ireland
C. KEANE
Affiliation:
St. James's Hospital, Dublin, Ireland
P. O'SULLIVAN
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
D. IGOE
Affiliation:
National Disease Surveillance Centre, Dublin, Ireland
L. MULLEN
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
M. WARD
Affiliation:
Eastern Regional Health Authority, Dublin, Ireland
A. SMITH
Affiliation:
National Disease Surveillance Centre, Dublin, Ireland
M. FISCHER
Affiliation:
Centers for Disease Control and Prevention, Atlanta, GA, USA

Abstract

In May 2000, public health authorities in Dublin, Ireland, identified a cluster of unexplained severe illness among injecting drug users (IDUs). Similar clusters were also reported in Scotland and England. Concurrent investigations were undertaken to identify the aetiology and source of the illnesses. In Dublin, 22 IDUs were identified with injection-site inflammation resulting in hospitalization or death; eight (36%) died. Common clinical findings among patients with severe systemic symptoms included leukaemoid reaction and cardiogenic shock. Seventeen (77%) patients reported injecting heroin intramuscularly in the 2 weeks before illness. Of 11 patients with adequate specimens available for testing, two (18%) were positive by 16S rDNA PCR for Clostridium novyi. Clinical and laboratory findings suggested that histotoxic Clostridia caused a subset of infections in these related clusters. Empiric treatment for infections among IDUs was optimized for anaerobic organisms, and outreach led to increased enrolment in methadone treatment in Dublin. Many unique legal, medical, and public health challenges were encountered during the investigation of this outbreak.


Type
Research Article
Copyright
2005 Cambridge University Press

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 0
Total number of PDF views: 42 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 29th November 2020. This data will be updated every 24 hours.

Access
Hostname: page-component-8465588854-lkhsq Total loading time: 0.474 Render date: 2020-11-29T04:12:06.493Z Query parameters: { "hasAccess": "1", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags last update: Sun Nov 29 2020 03:24:28 GMT+0000 (Coordinated Universal Time) Feature Flags: { "metrics": true, "metricsAbstractViews": false, "peerReview": true, "crossMark": true, "comments": true, "relatedCommentaries": true, "subject": true, "clr": false, "languageSwitch": true }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Epidemiological findings and medical, legal, and public health challenges of an investigation of severe soft tissue infections and deaths among injecting drug users – Ireland, 2000
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Epidemiological findings and medical, legal, and public health challenges of an investigation of severe soft tissue infections and deaths among injecting drug users – Ireland, 2000
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Epidemiological findings and medical, legal, and public health challenges of an investigation of severe soft tissue infections and deaths among injecting drug users – Ireland, 2000
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *