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Aflatoxins: essential data
Symptoms and Treatment, Toxicity, Chemistry, Site of Action, Sources, Properties, Terrorist Interest, IDC Codes
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Syndrome Name	Aflatoxicosis
Signs and Symptoms	A broad range of symptoms can be found depending upon dosage, including, vomiting, abdominal pain hemorrhage, pulmonary edema, acute liver damage including fatty change, loss of function of the digestive tract, convulsions, cerebral edema and death.
Onset of Symptoms	Relatively slow (>8 h after exposure)
Rapid diagnostic assay	None available. Rapid analytical assays are available for monitoring of the food supply.
Antidote	In cases of ingestion, feeding large quantities of an adsorbent such as activated charcoal may be used. Antioxidants such as ellagic acid and inducers of some cytochromes P450, such as indole-3-carbinol, may give a protective effect.
Supportive Care	Monitoring of liver function, dialysis or blood transfusions, treatment of symptoms.
Inactivation	Aflatoxins are inactivated by a wide range of reagents. Concentrated ammonia and sodium bisulfite have been the focus of study because they can be used on foodstuffs with affecting their organoleptic properties.

Site of Action

Aflatoxins react with nucleic acids after first being converted to an epoxide by a cytochrome P450. The epoxide reacts with guanine in DNA and RNA leading to depurination. The primary effect is to inhibit protein and DNA synthesis in the most active tissues, including the liver, the intestines, and the bone marrow.

Aflatoxins are actually rather insidious having both a rapid or acute action as described above and a longer term effect. The damage they do to DNA can be mutagenic, typically a GC to AT mutation, and also carcinogenic with liver cancer a common long-term effect of exposure. They have been listed as human carcinogens since 1988.

Source

The aflatoxins are synthesized by the filamentous fungus Aspergillus flavus and related aspergilli. These fungi affect a number of seeds and grains including peanuts, corn, cottonseed, a number of tree nuts. Aflatoxins are therefore relatively easy to manufacture, simply by practicing poor grain husbandry. Aflatoxins taken in the diet are further converted to the still dangerous aflatoxins M1 and M2 that are secreted in the milk. A great deal is now known about the enzymology and molecular biology of aflatoxin biosynthesis and it is a very complex process.

Agent Properties

Aflatoxins are known to have been weaponized by Iraq (so called "cancer bombs") and the Soviet Union has been involved in extensive research on them and other mycotoxins. They are not the most acutely toxic of weaponizable toxins and their military value is questioned by a number of authorities. They are relatively easy to manufacture and can at least be used to force enemy forces into protective gear, lowering their combat effectiveness..

Aflatoxicosis is difficult to diagnose because of the broad range of relatively unspecific symptoms without knowledge of exposure to aflatoxins. For example, an attack in a city would be difficult to diagnose but would be more likely to be observed in agricultural areas where it is a known occupational disease of grain farmers. Aflatoxins are a public health problem because they can enter the food supply by natural processes and as a result of this, sampling processes and rapid assays are available for them. Once an attack is suspected, it should be relatively easy to monitor it and to quickly detect subsequent attacks at.

Terrorist Acquisition and Attempted Use.

• None confirmed.