Public Health responding to infectious disease outbreak amongst people who inject drugs

HAMILTON, ON - Public Health is investigating an increasing trend in the number of newly diagnosed HIV cases, and invasive Group A strep (iGAS) cases among people who inject drugs in Hamilton. In response to this concerning trend, public health staff and partner agencies are working to connect directly with individuals at highest risk of suffering harm in an effort to prevent the spread of illness and build pathways to treatment. Staff and partners are undertaking activities to build awareness amongst those at risk, recommending and connecting individuals with HIV testing, and promoting safer practices that can reduce risk of transmitting the HIV virus.

Public Health Services offers rapid point of care and anonymous HIV testing. As a response to this outbreak, staff and partner agencies are working to expand access to rapid HIV testing outreach services with strong linkages to HIV treatment.

These infections can be linked more broadly to issues of health equity including housing instability, mental health, and addictions.

To reduce the risk of HIV and iGAS, Public Health recommends:

• Using all new/sterile injection equipment every time.
• Washing hands or use an alcohol-based hand rub prior to preparing drugs
• Cleaning the injection site skin with an alcohol swab before you inject.
• Cooking your drugs (including a wash) every time: heat the solution until it bubbles, then cool before injecting.
• Preparing and use drugs in more hygienic environments; use Hamilton’s Consumption & Treatment Services site at 71 Rebecca St.
• Keeping all wounds (breaks in skin such as a cut or scratch) clean and covered. Watching for signs of infection such as warm skin, sudden or worsening redness, red streaking, swelling, pus, drainage, pain and fever. 
• People who inject drugs that have signs of an infected wound should see a health care provider right away.

Quick Facts

• Between September 1, 2018 to May 17, 2019 there were 16 new HIV diagnoses of which 7 persons reported injection drug use and/or shared drug equipment history (44 per cent), and 40 cases of iGAS of which 12 were amongst people who inject drugs (30 per cent). The increase in incidences within the population is higher than it has been historically.
• HIV is a virus that attacks a person’s immune system by destroying white blood cells leaving a person unable to fight other infections and illness. HIV is primarily spread through unprotected vaginal or anal sex with a person who has untreated HIV, and/or sharing needles or equipment for drugs.
• Safer drug use practices, including using clean injection supplies, and heating the drugs to be used with a lighter for 10 seconds, can destroy the HIV virus preventing transmission.
• iGAS is a severe and sometimes life-threatening infection in which the bacteria have invaded parts of the body, such as the blood, deep muscle and fat tissue or the lungs. iGAS is spread by contact with fluids from the nose, throat and sores of infected persons. People with skin cuts or sores, inject drugs or use alcohol, have weak immune systems (HIV, diabetes or cancer), have a higher chance of severe iGAS.

Additional Resources

• For information about HIV and anonymous and rapid HIV testing visit www.hamilton.ca/HIV or call the Sexual Health Information Line: 905-528-5894
• City of Hamilton needle syringe, harm reduction supplies, and safe disposal information
• City of Hamilton information about invasive Group A Strep