Suspicious Letters Sent to Obama and a Senator

Government authorities have confirmed that two suspicious letters, one sent to President Obama and another to Senator Roger Wicker (R-Miss.) have tested positive for the toxic substance ricin.

Yesterday, an off-site facility which handles Senate mail notified the U.S. Capitol Police that it had received an envelope containing “a white granular substance.” The FBI reported this morning that a similar substance was intercepted at a screen facility for White House mail and was addressed to President Obama. Both envelopes were similar in appearance and had similar markings. The substance in both cases tested positive for ricin in the field and are being sent to the laboratory for further testing.

At the present time, there are no known injuries or exposures from these letters.

This news couldn’t come at a worse time. Tensions in Washington and across the country are already running high due to the deadly bombings on Monday at the Boston Marathon. Three people were killed and more than 170 were injured in two bomb blasts.

What is ricin?

Source: Centers for Disease Control

Ricin is a poison found naturally in castor beans. Castor beans are processed throughout the world to make castor oil. Ricin is part of the waste “mash” produced when castor oil is made.

Ricin can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid. If made into a partially purified material or refined into a terrorist or warfare agent, ricin could be used to expose people through the air, food, or water.

Ricin works by getting inside the cells of a person’s body and preventing the cells from making the proteins they need. Without the proteins, cells die. Eventually this is harmful to the whole body, and death may occur.

What are the signs of ricin poisoning?

The effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected.

Signs and symptoms of ricin exposure

The major symptoms of ricin poisoning depend on the route of exposure and the dose received, though many organs may be affected in severe cases.

Initial symptoms of ricin poisoning by inhalation may occur as early as 4- 8 hours and as late as 24 hours after exposure. Following ingestion of ricin, initial symptoms typically occur in less than 10 hours.

Inhalation: Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be:

  • respiratory distress (difficulty breathing)
  • fever
  • cough
  • nausea
  • tightness in the chest

Heavy sweating may follow as well as fluid building up in the lungs (pulmonary edema). This would make breathing even more difficult, and the skin might turn blue. Excess fluid in the lungs would be diagnosed by x-ray or by listening to the chest with a stethoscope. Finally, low blood pressure and respiratory failure may occur, leading to death.

Ingestion: If someone swallows a significant amount of ricin, he or she would likely develop:

  • vomiting and diarrhea that may become bloody.
  • severe dehydration may be the result, followed by low blood pressure.

Other signs or symptoms may include seizures, and blood in the urine. Within several days, the person’s liver, spleen, and kidneys might stop working, and the person could die.

Skin and eye exposure: Ricin is unlikely to be absorbed through normal skin. Contact with ricin powders or products may cause redness and pain of the skin and the eyes. However, if you touch ricin that is on your skin and then eat food with your hands or put your hands in your mouth, you may ingest some.

Death from ricin poisoning could take place within 36 to 72 hours of exposure, depending on the route of exposure (inhalation, ingestion, or injection) and the dose received.

How is ricin poisoning treated?

At the present time, no antidote exists for ricin.

Symptomatic ricin poisoning is treated by giving victims supportive medical care to minimize the effects of the poisoning. The types of supportive medical care would depend on several factors, such as the route by which victims were poisoned (that is, whether poisoning was by inhalation, ingestion, or skin or eye exposure).

Care could include such measures as helping victims breathe, giving them intravenous fluids (fluids given through a needle inserted into a vein), giving them medications to treat conditions such as seizure and low blood pressure, flushing their stomachs with activated charcoal (if the ricin has been very recently ingested), or washing out their eyes with water if their eyes are irritated.

 

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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