This document provides guidance on the public health management of illnesses caused by spore-forming bacteria (SFB) among people who inject drugs (PWID).

The guidance focuses on the three infections that are considered to be a continuin​g, significant risk to public health and that are commonly encountered in an outbreak context:

  • tetanus
  • botulism
  • anthrax

General enquiries

If you have an enquiry relating to this publication, please email

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email

To report any issues with a publication, please email

Last updated: 21 March 2024
Was this page helpful?