| Titre : | Wound botulism associated with black tar heroin among injecting drug users. (1998) |
| Auteurs : | D.J. PASSARO ; W.R. MACKENZIE ; J. MCGEE ; D.J. VUGIA ; S.B. WERNER ; Division of Communicable Disease Control. California Department of Health Services. Berkeley. USA ; Division of Field Epidemiology. Epidemiology Program Office. Centers for Disease Control and Prevention. Atlanta Ga. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 279, n° 11, 1998) |
| Pagination : | 859-863 |
| Langues: | Anglais |
| Mots-clés : | Botulisme ; Bactériose ; Infection ; Toxicomanie ; Héroïne ; Complication ; Epidémiologie ; Facteur risque ; Toxicomane ; Homme ; Etats Unis ; Amérique du Nord ; Amérique |
| Résumé : | [BDSP. Notice produite par INIST dR0xn0E0. Diffusion soumise à autorisation]. Context. - Wound botulism (WB) is a potentially lethal, descending, flaccid, paralysis that results when spores of Clostridium botulinum germinate in a wound and elaborate neurotoxin. Since 1988, California has experienced a dramatic increase in WB associated with injecting "black tar" heroin (BTH), a dark, tarry form of the drug. Objective. - To identify risk factors for WB among injecting drug users (IDUs). Design. - Case-control study based on data from in-person and telephone interviews. Participants. - Case patients (n=26) were IDUs who developed WB from January 1994 through February 1996. Controls (n=110) were IDUs newly enrolled in methadone detoxification programs in 4 counties. Main Outcome Measures. - Factors associated with the development of WB. Results. - Among the 26 patients, the median age was 41.5 years, 15 (58%) were women, 14 (54%) were non-Hispanic white, 11 (42%) were Hispanic, and none were positive for the human immunodeficiency virus. Nearly all participants (96% of patients and 97% of controls) injected BTH, and the mean cumulative dose of BTH used per month was similar for patients and controls (27 g and 31 g, respectively ; P=6). Patients were more likely than controls to inject drugs subcutaneously or intramuscularly (92% vs 44%, P<. 001) and used this route of drug administration more times per month (mean, 67 vs 24, P<. 001), with a greater cumulative monthly dose of BTH (22.3 g vs 6.3 g, P<. 001). (...) |
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