Drug users who ingested cocaine cut with a substance called levamisole have contracted a blood disease known as agranulocytosis in Massachusetts and other states, the Boston Globe reported Sept. 1.

Massachusetts doctors recently treated their first patient known to have contracted the disease from cocaine cut with levamisole, a drug that has been used as an antibiotic and to treat roundworm in livestock and fish. Cocaine cut with levamisole also has been blamed for illnesses and deaths in Washington and other states.

Health officials in Massachusetts and Washington have sent out warnings about levamisole and the risk of agranulocytosis, a disease that causes a drop in white blood-cell count and carries symptoms including high fever, chills, weakness, swollen glands, and painful sores. “This can be very serious,” said Al DeMaria, the chief epidemiologist in Massachusetts. “Why someone would be using this in cocaine, no one really knows.”