ANTHRAX has been found in a drug addict who died earlier this week and another who was being treated in hospital last night.
Medical authorities have issued a warning to thousands of heroin users over fears of a contaminated batch of the drug in Glasgow.
A man, who has not been named, died at the Victoria Infirmary on Wednesday, and a woman being treated at the same hospital has also tested positive for the acute bacterial infection.
Another suspected case elsewhere in the city is being tested.
Health officials confirmed yesterday evening that blood tests on the dead man, an injecting heroin user, showed the presence of the deadly bacterium.
Investigators last night said it was possible that an agent used to cut the heroin was to blame.
NHS Greater Glasgow and Clyde said it is "entirely conceivable" that a batch of heroin could have been contaminated, possibly with ground bonemeal from an animal in a country where anthrax is common.
With no indication as to how widely any contaminated batch of heroin has been circulated, authorities are bracing themselves for a potential deluge of users with infections.
NHS Greater Glasgow and Clyde, which is working with Strathclyde Police and the procurator-fiscal's office to identify a source, has issued warnings to health boards across the country and is following up potential incidents nationwide.
However, with nearly 5,000 intravenous drug users in Glasgow alone, the focus for the moment is on ensuring the city's addicts are not at risk.
Any heroin users admitted to hospital with serious soft-tissue infections now or during the past four weeks will be investigated for anthrax. The health board stressed that, given there was no significant risk of airborne transmission, the wider public was not at risk.
The man who died was first admitted to hospital on 9 December, reporting serious infections in the area where he had injected the opiate. It is understood he died from the anthrax infection.
The tests confirming his infection were carried out at the Ministry of Defence's Porton Down laboratory in Wiltshire.
No further details were available last night on the woman who has been confirmed as having anthrax at Victoria Infirmary.
The third case involves a man also with serious soft tissue infections. He is being treated at the Royal Infirmary, and test results showing whether he is infected are expected early next week.
The health board said the first two cases did not appear to be related, and there was no indication that any of the cases were directly linked. Dr Colin Ramsay, a consultant epidemiologist with Health Protection Scotland, said investigations were ongoing into the source of the contamination.
He said: "The evidence is that heroin is prepared in non-sterile circumstances, and it is conceivable it could be contaminated by a variety of organisms, which could happen naturally if they occur in the environment in which the heroin is prepared.
"We are not suggesting that there is any evidence that someone deliberately added it."
Anthrax is most commonly found in hoofed animals, including cattle and goats, and is found in countries where Scotland's heroin comes from, such as Afghanistan. Dr Ramsay said this theory was "highly conceivable".
He explained: "Heroin comes from countries where anthrax is more likely in the animal population, so the chances of it being in the environment in these countries is higher."
Professor Neil McKeganey, director of the Centre for Drug Misuse Research at the University of Glasgow, called the confirmation of anthrax "extraordinary shocking and alarming".