Flesh-Eating Bacteria Linked to Black Tar Heroin Kills 7 in San Diego

Heroin Use Is Suspected to Be Behind the Flesh-Eating Bacteria Outbreak

San Diego, California has seen seven deaths in the span of two months due to heroin-related bacterial infection. In total, 9 people were admitted to San Diego hospitals after injecting black tar heroin and suffering from the flesh-eating bacteria, but only 2 survived. Within the same time span, a case of wound botulism, another rare infection caused by black tar heroin, was reported in the San Diego area as well.

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The Risk Factor

Injection drug use is known for its high risk of infection, and black tar heroin is named for the impurities that give it the black color. Intravenous drug users (IDUs) often inject multiple times a day, sometimes with the same needle, which may have been found it or borrowed from someone else. These factors drastically escalate the risk of unintended, physical consequences. Heroin use and needles are commonly associated with intravenous use, but if the veins are too damaged to continue injection, people may inject into muscles (“muscling”) or below the skin ( “skin popping”). While none of these options return favorable results considering the tainted batch of heroin, injecting into the muscle and under the skin create a prime opportunity for this infection to damage the soft tissues.

The infections found in San Diego caused myonecrosis, or death of the soft tissue below the skin. As the bacteria live and multiply, they create toxic byproducts that harm surrounding tissues. What starts as irritation quickly escalates to a full blown infection killing the tissue near the injection site. The bacterial byproducts can often be gaseous and create pockets of gas below the skin which damage muscle and soft tissue. This condition is known as gas gangrene and, unless caught early, can result in amputation or death. These types of infections can start out red and irritated, but generally turn the skin pale and progress to black, which means there is significant cell death (necrosis).

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Preventing More Flesh-Eating Bacteria Damage

Investigations seeking the source of the heroin opened after the rash of hospitalizations, but authorities are not sure as to where or when this infection-prone batch was introduced to the city. Most of the black tar heroin comes into the US from Mexico, which may explain the outbreak considering San Diego’s proximity with the border. Governmental agencies collecting data on the origins of certain drugs coming into the US have found that Mexico has become more popular as a source for heroin since 2000. South American heroin used to be the majority, but now Mexico is the dominant source. Different kinds of heroin cross the border, but the largest proportion is black tar heroin, which is often the least pure.

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