An injecting drug user in Oxford has been diagnosed with an anthrax infection, according to the Health Protection Agency (HPA). The patient is said to be recovering. The case brings the total number of UK infections to five in the ongoing 2012 outbreak. There have been three confirmed cases in England, two of which – in Blackpool – were fatal (DDN, October, page 5) and one each in Scotland and Wales. Twelve cases in all have been identified across Europe since June, with the others in Germany, Denmark and France. HPA says it remains unclear whether the UK cases are linked to those in mainland Europe, but it is ‘continuing to monitor the situation’. The source of the infection in all cases is presumed to be contaminated heroin. The HPA has advised local DAATs to talk to their service users about the risks of infection, said director of its Thames Valley Health Protection Unit, Dr Éamonn O’Moore. ‘Injecting drug users often experience skin infection but we strongly advise them not to ignore signs such as redness or excessive swelling around injection sites, or other symptoms of general illness such a high temperature, chills, severe headaches or breathing difficulties,’ he said. ‘They should seek medical advice quickly in such circumstances generally, but particularly now because we have concerns that some batches of heroin in circulation in Oxfordshire and the wider Thames Valley may be contaminated with anthrax. Early treatment with antibiotics is essential for a successful recovery.’ Meanwhile, the government has announced that the ‘legal high’ methoxetamine, known as ‘mexxy’, and its related compounds are to become illegal class B drugs, along with synthetic cannabinoids such as those sold as ‘black mamba’. The decision follows a recommendation by the Advisory Council on the Misuse of Drugs (ACMD). Methoxetamine – which was being sold as a ‘safe’ alternative to ketamine – has been subject to a temporary class drug order (TCDO) since March (DDN, April, page 4).