The mystery illness that has led to the deaths of 15 drug addicts in Scotland has now killed five people in North-west England.

The mystery illness that has led to the deaths of 15 drug addicts in Scotland has now killed five people in North-west England.

Two heroin users from Liverpool and three from Manchester have died over the past month from the still unidentified illness, bringing the number of deaths in Britain and Ireland up to 35.

A spokesman for the NHS Executive North West said yesterday that it had identified nine cases in the two cities during the past month, and five of them had now died. The cases are being linked to the deaths in Scotland as well as eight in Dublin and seven in other parts of England.

Health officials believe that the illness has been caused by anaerobic bacteria, which survive without oxygen and can cause tetanus, botulism and gas gangrene.

The speed of the infection initially led to theories that the outbreaks of the disease had been caused by anthrax, but tests have now confirmed the emergence of an unknown bug.

Specimens from the most recent Glasgow deaths are being tested at specialist laboratories in Britain and at the Center for Disease Control and Prevention in Atlanta, Georgia.

It is thought that the illness sets in when heroin is injected into muscle or other tissue, rather than into a vein. The early symptoms include swelling or inflammation around the site of the injection, followed by abscesses that become worse over several days. The patient usually suffers toxic shock and has to be taken into intensive care.

The spread of effects is rapid, and culminates in an attack on the heart, kidneys and liver. Once these vital organs have been reached, treatment is useless.

Professor John Ashton, the regional director of public health, said: "We are very concerned that the infection has appeared in the North-west. As yet we have found no pattern, either in where the patients come from or in their supply of heroin.

"We are working closely with the Communicable Disease Surveillance Centre and our colleagues in Scotland and Ireland to identify the cause of the illness."

Professor Ashton added that local monitoring arrangements had been set up in all hospitals in the region, and GPs and health workers had been informed of the position.

The Scottish National Party yesterday called for an urgent inquiry into the deaths. Rose-anna Cunningham, MSP, the shadow Minister of Justice, and her deputy, Michael Matheson, want the Scottish Executive to investigate the deaths.

"It is difficult to escape the conclusion that if 15 people had died with unexplained non-drug-related symptoms in such a short space of time, an inquiry would already have been set up," Ms Cunningham said.

"At present, health officials remain unclear as to the exact nature of the toxin responsible for these fatalities. This situation cannot be allowed to drift any further," she said.

Health officials in continental European countries have been alerted about the outbreaks, and Customs and Excise is co-operating in making checks on consignments of drugs it has intercepted on their way from the Indian sub-continent, which may have been tainted.