Botulism cases blamed on black tar heroin

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Two people have been hospitalized in the Seattle area with suspected cases of botulism probably contracted by injecting black tar heroin.

Four additional cases have been reported in Texas over the last few weeks, said health officials, who warned that serious, untreated cases could result in paralysis of breathing muscles and death.

‘There is no way for a person on the street to tell if black tar heroin is contaminated, nor any way to clean it to make it safe,’ Jeff Duchin, chief of communicable disease epidemiology for the Seattle and King County Public Health Department, said in a statement.

Black tar heroin, produced in Latin America and sold mainly in Western U.S. states, is a cruder, less-refined form of heroin that contains more morphine derivatives than pure heroin. When injected under the skin or into the muscles, the botulinum neurotoxin can fester and grow in the wound, producing potentially deadly infection, health officials say.

California has had 17 injection-drug-related cases since 1997, about three-fourths of all cases in the U.S., state officials reported this year in the online journal Clinical Infectious Diseases. All the California cases involved heroin users.

Early hospital treatment with antitoxin is usually successful, though King County officials, who have an information page about how to avoid infection, said it may take several days to two weeks for symptoms to develop -- blurred vision, difficulty speaking or swallowing, fatigue and dizziness.

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--Kim Murphy in Seattle