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Eurosurveillance, Volume 7, Issue 2, 09 January 2003
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Citation style for this article: Editorial team. Heightened health security concern following ricin alert in the United Kingdom. Euro Surveill. 2003;7(2):pii=2143. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2143

Heightened health security concern following ricin alert in the United Kingdom

Editorial team (eurowkly@phls.org.uk), Eurosurveillance editorial office.

On 7 January the Metropolitan Police and the English Department of Health’s Deputy Chief Medical Officer (CMO) made a joint statement (1) informing the public that seven people had been arrested in London on 5 January under the Terrorism Act 2000 (http://www.hmso.gov.uk/acts/acts2000/20000011.htm). On 7 January material found in a residential premises tested positive for the presence of ricin poison after analysis at the Defence Science and Technology Laboratories at Porton Down in southwest England. The United Kingdom (UK) is believed to be a possible target for bioterrorist activities, and so because of concern for the safety of the public, the police are working closely with the English Department of Health. 

The early stages of ricin intoxication are difficult to distinguish from those of some infections, and may mimic septicaemia, and so it was particularly important that healthcare workers in the UK be alerted of the possibility of ricin poisoning. A letter was cascaded via fax and email for immediate distribution from the Deputy CMO to all members of the National Health Service on 7 January. This included the text of the joint statement, and contact details for the National Poisons Information Service and the Public Health Laboratory Service (PHLS).

The PHLS made the joint statement available on its website, with links to interim guidance for the investigation and management of outbreaks and incidents of unusual illness, ricin guidelines (2), and information on other chemicals which could be used for deliberate release. On 9 January, interim guidelines for health professionals dealing with suspect packages and materials were posted on the website (3).

A toxalbumin extracted from the beans of the castor oil plant, ricin inhibits protein synthesis, which causes cell death. Death may be due to multi-organ failure. The onset of symptoms may be delayed for several hours after exposure (which may be via ingestion, inhalation or injection), and can include irritation, gastroenteritis, conjunctivitis, respiratory symptoms, seizures and CNS depression, fluid loss leading to tachycardia, allergic reactions, abnormal liver functions, and haematuria, proteinuria and elevated creatinine.

There is no known antidote for ricin, and treatment is symptomatic and supportive only. In the event of mass exposure to ricin, careful decontamination of patients is recommended. More detailed information is available in reference 2.

Ricin is considered to be one of the chemical warfare options available to bioterrorists if used in aerosols or injected. In 1977 a Bulgarian political dissident living in London died after being fired at or injected with a ricin filled bullet (http://news.bbc.co.uk/1/hi/uk/2636459.stm).

 

References :
  1. Department of Health [England]. Joint statement from the Metropolitan Police and the Deputy Chief Medical Officer. Press release 2003/0008. 7 January 2003. (http://www.info.doh.gov.uk/doh/intpress.nsf/page/2003-0008?OpenDocument)
  2. Department of Health [England]. Ricin guidelines. Version 1.1, amended 12 December 2002. (http://www.phls.co.uk/topics_az/deliberate_release/pdf/ricin_guidelines.pdf) [accessed 9 January 2003]
  3. Responding to suspect packages and materials – actions to be taken. Interim guidelines for health professionals dealing with suspected packages and materials. Version 1: Issue date 8 January 2003. (http://www.phls.co.uk/topics_az/deliberate_release/pdf/packages_materials.pdf)

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