title: A decade of spore-forming bacterial infections among European injecting drug users: pronounced regional variation.
abstract: The recent anthrax outbreak among injecting drug users (IDUs) in Europe has highlighted an ongoing problem with severe illness resulting from spore-forming bacteria in IDUs. We collated the numbers of cases of 4 bacterial illnesses (botulism, tetanus, Clostridium novyi, and anthrax) in European IDUs for 2000 to 2009 and calculated population rates. Six countries reported 367 cases; rates varied from 0.03 to 7.54 per million people. Most cases (92%) were reported from 3 neighboring countries: Ireland, Norway, and the United Kingdom. This geographic variation needs investigation.
authors.affiliation: Health Protection Services, Health Protection Agency, London, UK. vivian.hope@hpa.org.uk
authors.forename: Vivian D
authors.initials: VD
authors.lastname: Hope
authors.forename: Norah
authors.initials: N
authors.lastname: Palmateer
authors.forename: Lucas
authors.initials: L
authors.lastname: Wiessing
authors.forename: Andrea
authors.initials: A
authors.lastname: Marongiu
authors.forename: Joanne
authors.initials: J
authors.lastname: White
authors.forename: Fortune
authors.initials: F
authors.lastname: Ncube
authors.forename: David
authors.initials: D
authors.lastname: Goldberg
mesh_terms: D000881:Anthrax / Q000453:epidemiology / Q000209:etiology; D001408:Bacillus anthracis; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology*; D001906:Botulism / Q000453:epidemiology / Q000209:etiology; D003013:Clostridium; D003015:Clostridium Infections / Q000453:epidemiology / Q000209:etiology; D003014:Clostridium botulinum; D003017:Clostridium tetani; D055030:Drug Users / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D013742:Tetanus / Q000453:epidemiology / Q000209:etiology; D006113:United Kingdom / Q000453:epidemiology
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