Botulism — United States
Los Angeles County health officials identified 4 cases of suspected wound botulism associated with heroin injection in February 2021.
Two of the cases possibly used the same heroin batch but the other 2 cases have no known connection to other cases. The sources of the heroin remain unknown and additional cases may occur. All 4 cases required intensive care treatment and had respiratory failure requiring intubation. Symptoms of the 4 cases included diplopia, ptosis, dysphagia, slurred
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