Ricin as a weapon for bioterrorism:<br /> Clinical characteristics of ricin poisoning and management in healthcare facilities
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2006, Vol 23, Issue 3
Abstract
Ricin is a potent toxin derived from the beans of the castor plant, which can grow in essentially every part of the world. International authorities have placed ricin in category B of critical biological agents, based on its potential to cause morbidity and mortality. It can be produced easily at low cost, it can exist in a relatively stable aerosol form and there is no specific treatment or vaccine available. It has been used repeatedly in the past in terrorist attacks of small scale. The toxin is a protein synthesis inhibitor, resulting in cell death. Exposure to the toxin can involve only the skin and superficial mucosal membranes, it can involve the pulmonary and digestive tract and also there can be parenteral exposure. Aerosol exposure can lead, within a few hours, to the development of acute respiratory distress syndrome, while gastrointestinal exposure can lead to severe hemorrhagic gastroenteritis. Parenteral exposure can lead to severe systemic toxicity and subsequent multi-organ failure. Apart from isolated exposure of the skin and superficial mucosa, exposure through the other routes not infrequently leads to death, usually within 36-72 hours of exposure. Diagnosing ricin poisoning can be extremely difficult in case of an isolated attack, while in a scenario of massive exposure, usually through the pulmonary or gastrointestinal tract, the presentation of a large number of patients with a similar clinical picture within a small period of time in a particular area should raise the suspicion of deliberate release of ricin. Decontamination of the exposed person(s) is necessary using soap and water followed by sodium hypochlorite solution. The risk of secondary transmission is minimal. No specific therapy is available, while investigations are under way with candidate vaccines. Management is supportive and may include intensive care and, if needed, mechanical ventilation. The only effective prevention is avoidance of exposure to the toxin.
Authors and Affiliations
I. BARABOUTIS, A. SKOUTELIS
Keywords
Related Articles
- EP ID EP83812
- DOI -
- Views 95
- Downloads 0
The association of vitamin B12 levels with gastroscopy findings and H. pylori status in adults attending an out-patient gastroenterology clinic
OBJECTIVE To evaluate the correlation of Helicobacter pylori status with the blood levels of vitamin B12 in patients undergoing gastroendoscopic investigation. METHOD Patients who underwent gastroendoscopic investigat...
The effect of tibolone on biochemical markers of bone metabolism in late postmenopausal women
OBJECTIVE The aim of this study was to evaluate the effect of tibolone on bone metabolism in late postmenopausal women with decreased bone mineral density (BMD), as estimated by markers of bone remodelling. METHOD Si...
The incidence of electrical injuries in Messinia over the last 10 years
No abstract available
Mesenchymal tumors in the tubular gastrointestinal track
No abstract available
Complete regeneration of the pancreas including islets of Langerhans, acinar cells, centro-acinar cells, intercalated duct cells, and secretory duct cells in Lewis rats
OBJECTIVE Elucidation of in vivo systems for complete pancreatic regeneration in animal models. METHOD Using only syngeneic Lewis rats, whole liver, bone marrow (BM) with bone, BM clot, or nonparenchymal liver tissue...