Flesh-eating bacteria linked to black tar heroin kills 7 in San Diego County

A flesh-eating bacteria linked to the use of black tar heroin has killed at least seven San Diego County residents who injected the drug since early October, county health officials said Wednesday.

Between Oct. 2 and Nov. 24, nine people who injected black tar heroin were hospitalized with severe myonecrosis, a soft-tissue infection that destroys muscle, health officials said. The patients ranged from 19 to 57 years old; of the seven who died, five were men.

County health officials issued an advisory to the medical community to be on the lookout for additional cases of myonecrosis and wound botulism, a rare but serious illness that attacks the body’s nerves and is also linked to black tar heroin use.

“People who use black tar heroin are not only at higher risk of dying from an overdose, but also more prone to developing myonecrosis and wound botulism,” Dr. Wilma Wooten, the county’s chief public health officer, said in a statement.

There was one confirmed case in October of wound botulism linked to black tar heroin use in the county, health officials said. But there have been 13 probable or confirmed wound botulism cases in Southern California since Sept. 1. Most of those cases were among black tar heroin users.

“The sources of the black tar heroin are unknown,” county health officials said in a statement Wednesday. “Investigation is continuing and additional cases may occur.”

Symptoms of myonecrosis include severe pain in the area around a wound or injection site; swelling in the area around a wound; pale skin that quickly turns gray, dark red, purple or black; blisters with foul-smelling discharge; fever; air under the skin; excessive sweating; and increased heart rate.

Left untreated, myonecrosis can spread through the body and cause people to go into shock. It can lead to amputations or death.

Symptoms of wound botulism can sometimes be mistaken for a drug overdose and occur within days or weeks of injecting contaminated drugs. Symptoms can include weak or drooping eyelids; blurred or double vision; dry mouth; sore throat; slurred speech; trouble swallowing; difficulty breathing; and progressive symmetric paralysis that begins at the face and head and travels down the body.

Left untreated, symptoms may lead to paralysis of the respiratory muscles, arms, legs and torso, and can cause death.

County health officials said drug users experiencing symptoms of myonecrosis or wound botulism should seek immediate medical attention at the nearest emergency department.

Riggins writes for the San Diego Union-Tribune.