A drug user’s death in Germany is being linked by the Health Protection Agency and German scientists to the anthrax outbreak that killed nine heroin users in Scotland, as tests show the infection to be indistinguishable from the Scottish cases.

These results indicate that anthrax contamination in both Scotland and Germany comes from a common source.

There have been 19 confirmed anthrax infection cases in Scotland, so far, with the outbreak beginning when cases were identified in NHS Greater Glasgow and Clyde in December.

While, the same strain of anthrax has been found in fourteen of the confirmed cases in Scotland, the others are under investigation.

Health Protection Scotland said the German patient who died mid-December has the same strain, with the agency confirming another case of anthrax in London, with the patient having a history of heroin use, though he developed symptoms end-January 2010. While, investigations continue, no connection to Scotland has been identified, yet.

Drug users across Scotland have been warned to be vigilant, and advised to cease taking heroin by any route, if possible, as evidence suggests contaminated heroin to be in circulation, still.

Last month, the French health ministry also issued a warning about contaminated heroin, saying the drug could also be in circulation in other European countries.

Dr Colin Ramsay, heading the national outbreak control team advises all users to seek urgent medical attention, if they experience symptoms like redness or swelling at or near an injection site, including high temperature, chills or a severe headache. Early antibiotic treatment can save lives.

A potentially lethal bacterial infection, Anthrax exists naturally in the soil and mostly occurs in animals in Asia and Africa, with humans seldom infected, as it is extremely rare that it spreads from person to person.