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Trichothecene mycotoxins:
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Symptoms and Treatment, Toxicity,
Chemistry, Site of Action,
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| T2 toxin in detail | Satratoxin H in detail. | ||||||||||||||
| Symptoms, Treatment, Decontamination | |||||||||||||||
| Syndrome Name | Trichothecene mycotoxicosis, Alimentary Toxic Aleukia was used for the symptoms arising from eating contaminated grains in the Soviet Union. | ||||||||||||||
| Symptoms | |||||||||||||||
| The effects of trichothecenes at high doses are in part derived
from information on yellow rain attacks and animal experiments. These
symptoms and effects are distinct from those found in
alimentary toxic aleukia that is a result of chronic exposure.
These acute symptoms show variability in the speed and scale of onset that are probably dose-dependent. The earliest symptoms are seen within half an hour on the skin, in the eyes, and the upper respiratory and upper digestive tracts. Trichothecenes are blistering agents that seem to be about as effective as mustards and Lewisite and the first symptom of an aerosol or spray attack is blistering of the skin, pain in the eyes, blurred vision that can last about a week and pain in the mouth and throat. Other short term symptoms reported include weakness, dizziness, and loss of coordination. Systemic effects begin within a few hours. The first sign is diarrhea that is often bloody. The victim may have difficulty breathing and will also cough and may cough up blood (hematoptysis). The gums and nose may begin to bleed and there may be vomiting of blood accompanied by abdominal pain. The damage to the digestive tract means that patient loses appetite and becomes dehydrated. As the poisoning takes its toll, the primary skin effects may worsen and blisters may spread and turn into pathological lesions of the skin, including bullae, pettechiae, and ecchymoses with some areas becoming necrotic (dying) and turning black. In the terminal stages of the poisoning, the victims blood pressure and body temperature drop and the heart races (tachycardia). Blood may ooze from the mouth and nostrils. Tremors, seizures, and coma also occur during the final decline. The frequency of reported symptoms from victims in Southeast Asia and Afghanistan are:
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| Onset of Symptoms | From minutes to days, depending upon the dose and the toxin. | ||||||||||||||
| Rapid diagnostic assay | None available | ||||||||||||||
| Antidote and Specific Treatments | |||||||||||||||
| There is no specific therapy for trichothecene exposure and
symptoms are treated. Current US practice models treatment for trichothecene
poisoning after treatments for mustards. The first concern is to remove
as much as possible from those exposed. Vigorous washing with soap and
water will clear residues on the skin and contaminated clothing must be
removed and disposed of. Delayed mild effects on the skin can be treated
with calamine lotion, camphor, or other skin lotions.
Secondary exposure from inhaled toxins comes as they cleared out of the lungs and swallowed. Ingested (swallowed) toxins are absorbed with a powerful sorbent such as superactivated charcoal. Civilians who do not have access to chemical and biological warfare kits containing charcoal can eat several slices of burnt toast as an emergency measure. Mild respiratory symptoms can be treated with codeine, cough suppressants, or steam inhalation. More severe symptoms will require specialized respiratory care.
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| Inactivation | Contaminated individuals can be decontaminated with soap and water. | ||||||||||||||
Follow this link for information on the toxicity of trichothecenes.
Follow this link for structural information on a range of trichothecenes.
Trichothecenes are known to inhibit protein synthesis by chemical inactivation of ribosomes and this accounts for the medium- and long-term cytotoxicity. Some of the immediate effects may be due to effects on the blood clotting system as some inhibitors of blood clotting weaken the effects of trichothecenes in animals.
A number of species of fungi of the genus Fusarium and its relatives. It is difficult to give a definitive list of producer organisms because of the difficulty in identifying them, and their names and taxonomic positions change surprisingly frequently. Extensive work by Soviet scientists investigating Alimentary Toxic Aleukia after World War II defined conditions for the synthesis of these compounds by the Fusarium species they identified.
Trichothecenes can be easily manufactured by neglect: by failing to maintain stored grains properly in dry, warm conditions. They are poorly soluble in water but can be easily extracted from contaminated grains with organic solvents. Many of the producer organisms are well characterized as crop pests and their culture properties are well known. Cereal grains are monitored for trichothecene mycotoxin contamination in the US and Europe and standard analytical practices and reagents are available that could be used to monitor possible attacks.
Unlike most other toxins with weapons potential, they act on the skin and exposed mucous surfaces, such as the mouth, eyes and throat and so can be used as a threat to force an enemy into protective clothing and shelters with a loss of operational efficiency without ever being used.
| Disease | ICD-9-CM | ICD-10 |
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