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Ricin - 7 Things to know

7 Things to Know
May 30, 2013 7:27:37 AM PDT
What is ricin? That's a question many are asking after letters addressed to Mayor Michael Bloomberg have come back positive for the substance. Below are 7 things to know about ricin:

1) What is it?

  • Potent biological protein toxin
  • It inhibits the body from making protein resulting in cell death
  • Category B bioterrorism agent and Schedule I chemical warfare agent
  • Ricin is derived from the waste made during the processing of castor oil from beans from the castor plant
  • Can be found powder, aerosolized, pellets, liquid

    2) How it is transmitted

  • Can be ingested, injected, inhaled, swallowed, skin contact
  • Inhalation (esp. aerosolized): Very potent and most lethal form of Ricin; leads to more rapid onset of symptoms; it can remained in undisturbed air for several hours

    3) How is Ricin detected?

  • Ricin in a letter is usually the powder form, which can be inhaled (powder becomes aerosolized if letter is open) or the ricin can come in direct contact with the skin
  • AVOID opening, moving, or touching the letter or package to prevent aerozolization
  • If a letter is laced with Ricin (as in this current situation)
  • If a postal worker notices a "white powder" or if a sensor picks up a signal, they will isolate the package
  • Certain locations in US, such as post offices and government buildings, use sensors to test for traces of agents such as Ricin in letters and packages
  • The postal office will first requests a HAZMAT to the site
  • The site is surveyed and screened (with a sensor if not already performed)
  • If a signal is positive ? a sample of the suspicious agent is sent to the Laboratory Response Network (LRN) for testing
  • The FBI, local law enforcement, and local emergency management officials are notified
  • Is samples test positive for Ricin at LRN, then it may be sent to the CDC for further testing and public health officials are notified

    4) What happens when exposed to Ricin?

  • Rapid, progressive symptoms within 1 to 36 hours from time of exposure, though there can be an incubation period (time between exposure and development of symptoms) of 4 to 12 hours
  • Death can occur within 36 hours of exposure, sooner if it is inhaled
  • If death does not occur by 5 days, then victim likely to recover

    5) Symptoms after exposure?

  • Death can occur effects can occur within 36 to 72 hours of exposure
  • The onset of symptoms and severity usually depends on route (inhalation vs injection vs ingestion), earlier onset when inhaled
  • Inhalation, ingestion, and injection cause similar symptoms
  • Mild symptoms - nausea, vomiting, can be seen within 1-6 hours of exposure
  • Flu-like symptoms
  • Respiratory distress, may start with cough
  • Sweating
  • Cyanosis (turning blue due to lack of oxygen)
  • Blood in urine
  • Seizures
  • Hallucinations (ingestion)
  • Multi-organ failure
  • Death
  • If a patient hasn't died in 3 to 5 days, then they will likely survive

    6) How do you diagnosis patients with Ricin exposure?

  • History of potential exposure
  • Symptoms
  • Basic labs: complete blood count, chemistries, liver test
  • Specific testing for Ricin is perform using antibodies and DNA matching; not always immediately available and may take long

    7) How do you treat patients with Ricin exposure?

  • No antidote
  • Remove Ricin from skin (flush eyes and skin) and air (open windows, move to another location) as soon as possible
  • If inhaled, sit patient upright, provide oxygen; may need to place patient on ventilator
  • If ingested, give activated charcoal as soon as possible. Also remove stomach contents and give fluids.
  • Protect head in case of seizures

    Source: ABC News Medical Unit

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