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San Francisco Marin Medical Society Blog

SFDPH Health Alert: Wound Botulism in Injection Drug User

Wound botulism has been confirmed in one injection drug user in San Francisco. Symptoms began 11/30/2013.

Additional cases may occur. Because this condition is quickly progressive and life threatening, SFDPH is alerting clinicians and requesting they follow these recommendations.

Actions requested of all clinicians:

  1. Be alert for cases of wound botulism especially in injection drug users.
  2. Report suspect cases to Communicable Disease Control Unit (CDCU) at 415-554-2830. CDCU staff can facilitate release of antitoxin.
  3. Consider Neurology and Infectious Disease consultation.
  4. Conduct a thorough search for a wound, and consider surgical consultation.
  5. Obtain serum for toxin assays (in serum separator tubes). Instructions for specimen collection may be found at
  6. Warn patients who inject drugs about wound botulism and inform them of symptoms, the need to seek medical care promptly, and prevention methods.
  7. Because of a higher risk of tetanus in injection drug users, provide tetanus vaccine every 5 years.

Click here to view the SFDPH clinician notification as well as flyers that can be posted.

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