Smoking heroin carries less risk, drug users told

US team of specialists is asked to work round the clock to try to trace cause of fatal disease that has now killed 20 addicts

The Drugs Tsar urged heroin addicts yesterday to smoke rather than inject the drug as a precaution against a mystery infection that has contaminated batches of the drug and killed 20 users in Scotland and Ireland.

The Drugs Tsar urged heroin addicts yesterday to smoke rather than inject the drug as a precaution against a mystery infection that has contaminated batches of the drug and killed 20 users in Scotland and Ireland.

The Government's anti-drugs co-ordinator, Keith Hellawell, said the illness was restricted to drug users who inject. "At the moment, when you are in a crisis ... receive medical advice. Smoke it rather than inject it," he said.

Doctors attempting to trace the source of the illness admitted they faced a race against time to prevent the outbreak spreading to users in other parts of the country.

A specialist team, including a senior American epidemiologist, has been told to work around the clock to track down the mystery bug as the death toll mounted in the worstaffected areas, Glasgow and Dublin. Last night health authorities confirmed they were linking two deaths in Aberdeen and a number of cases of severe illness among addicts in Wicklow and Kildare in the Irish Republic to the outbreak.

Medical experts are concerned at the ability of the bacterium to spread rapidly through the body via large abscesses before attacking the vital organs, in particular the heart, causing death.

Dr Laurence Gruer, public health consultant for the Greater Glasgow Health Board, said: "The infection is resistant to antibiotics and produces a toxin which quickly leaches into the blood and attacks the heart, liver and kidneys. Once that happens, it's curtains.

"There is a good chance of the bacteria spreading to addicts anywhere on the routes where this batch originated, from Glasgow and Dublin to elsewhere in Scotland and Ireland. The risk of further cases cannot be ruled out."

Health officials in Britain have warned other European countries to look out for further tainted consignments of brown heroin originating from the Indian sub-continent.

The death toll from the infected drugs continued to rise as the authorities in Dublin confirmed they were investigating 16 deaths linked to the bug. Eight fatalities from the illness have been confirmed in the Irish Republic.

In Glasgow, 12 addicts, most from the Govan Hill area, have been killed by the disease, which causes large abscesses that spread from injection areas and results in multiple organ failure. Fourteen heroin users in the city have also been infected. Glasgow has one of the worst heroin problems in the British Isles.

The death in Aberdeen on Sunday of Rachael Wilson, 25, who had one child, is one of two fatalities being investigated in the Grampian region. There are several seriously ill addicts in Wicklow and Kildare.

Adding to fears that the outbreak may claim more lives, drug workers in Glasgow said addicts were preferring to risk infection rather than seek alternative supplies of heroin.

George Hunter, manager of the Turning Point drug crisis centre, said: "There is a fatalistic attitude. Users inject three or four times a day and most would rather not know what the drug has been cut with - even if that includes the risk of a horrible death."

In recent days officials in Scotland and the Irish Republic have increased their efforts to pinpoint the bacterium and contain the outbreak.

Tissue samples have been sent to the Centre for Disease Control and Prevention in Atlanta, Georgia, while one of its leading infection experts, Dr Jai Lingappa, is in Glasgow to help with laboratory tests.

Health experts in Dublin are assisting the international effort, which is focusing on the possibility that a hitherto untraceable bacterium may be to blame for the illness.

A close link between the outbreaks in Dublin and Glasgow has been established by the teams - but the fact that most common bacteria have been eliminated as the cause has left scientists puzzled.

Dr Gruer said: "We are now concentrating on testing for rare or difficult to trace organisms that may be present in dust or other matter when the heroin was cut or diluted.

"Given the localised nature of the outbreaks, the contamination probably happened at a stage close to distribution in Britain and Ireland. It is unlikely the bacteria comes from the country of origin."

Earlier suggestions, caused by an addict's death in Norway, that anthrax may have been to blame have been ruled out, and biologists are now investigating the possibility of whether a botulism-type bug may have been mixed with the heroin in the form of spores.

One theory is that citric acid may be providing the oxygen-free conditions necessary for a bacterium similar to clostridium to multiply and attack the weakened muscle-tissue of addicts once injected.

A clostridium bug was blamed for an outbreak of illness in San Francisco last year that killed five heroin addicts in three weeks.