Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013

E MacDonald; T M Arnesen; A B Brantsaeter; P Gerlyng; M Grepp; B Å Hansen; K Jønsrud; B Lundgren; H Mellegård; J Møller-Stray; K Rønning; D F Vestrheim; L Vold

doi:10.2807/1560-7917.ES2013.18.45.20630

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Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013
E MacDonald^1,2 , T M Arnesen¹ , A B Brantsaeter³ , P Gerlyng⁴ , M Grepp⁵ , B Å Hansen⁶ , K Jønsrud⁷ , B Lundgren⁸ , H Mellegård⁹ , J Møller-Stray^1,5 , K Rønning¹ , D F Vestrheim^10,11 , L Vold¹
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Affiliations: ¹ Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway ² European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden ³ Department of Acute Medicine and Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway ⁴ Medical Clinic, Lovisenberg Diakonale Hospital, Oslo, Norway ⁵ Department of Public Health, Health Agency, Municipality of Oslo, Oslo, Norway ⁶ Vestfold Hospital Trust, Tønsberg, Norway ⁷ Vaccine Supply Unit, Norwegian Institute of Public Health, Oslo, Norway ⁸ Akershus University Hospital, Lørenskog, Norway ⁹ Center for Food Safety, Norwegian School of Veterinary Science, Oslo, Norway ¹⁰ Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway ¹¹ European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

Correspondence:
E MacDonald
Emily.MacDonald fhi.no
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Citation style for this article: MacDonald E, Arnesen T M, Brantsaeter A B, Gerlyng P, Grepp M, Hansen B Å, Jønsrud K, Lundgren B, Mellegård H, Møller-Stray J, Rønning K, Vestrheim D F, Vold L. Outbreak of wound botulism in people who inject drugs, Norway, October to November 2013. Euro Surveill. 2013;18(45):pii=20630. https://doi.org/10.2807/1560-7917.ES2013.18.45.20630 Received: 28 Oct 2013

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Abstract

In October and November 2013, four cases of wound botulism were confirmed in people who inject drugs (PWID) in Norway. Two additional cases are suspected. Because of the international distribution pathways for heroin - the likely source of the outbreak - healthcare workers and public health authorities in other countries should remain vigilant for wound botulism in PWID. This outbreak serves as a reminder that countries should ensure access to botulinum antitoxin in case of outbreak situations. .