It was after a container of ricin poison was found in a South Carolina postal facility in 2003 that Jennifer Audi, M.D., became intrigued with the toxin.
How toxic is it?
What is the medical protocol for treating a patient with ricin poisoning?
And how do you know if someone has been poisoned by ricin?
Dr. Audi, who was working at the Center for Disease Control and Prevention (CDC) in Atlanta, Ga., as a fellow in medical toxicology, and several of her colleagues, including John Osterloh, M.D., Joshua Schier, M.D., Manish Patel, M.D., and Martin Belson, M.D., were asked to write a review of ricin.
Their article, “Ricin Poisoning, A Comprehensive Review,” appeared in the Journal of the American Medical Association on Nov. 9.
After an extensive review of current literature on the toxin, Dr. Audi said they found no concise papers on its toxicity. “Since many of the toxicologists in my branch at the CDC were also practicing emergency medicine physicians we decided to focus on the clinical presentation and management of ricin toxicity, based on route of exposure,” she said.
“In an age where people are very concerned about terrorism and the ease with which this biologic toxin can be obtained by terrorists, we felt it was important to educate health care professionals and the public about ricin,” Dr. Audi said.
The article explores the signs and symptoms of ricin poisoning, the routes of exposure and potential treatments.
“Ricin is a toxin derived from the castor bean plant,” she said. “Poisoning can occur through ingestion, inhalation or dermal exposure.”
Mild poisoning from ingesting ricin can result in nausea, vomiting and diarrhea, said Dr. Audi, but if it is inhaled the onset of illness will occur in eight hours and can progress to respiratory distress and death.
“Biological and chemical terrorism is at the forefront of everyone’s minds and there are people in the world who mean us harm so we need to be prepared,” Dr. Audi said. “Being prepared means being educated about all the potential things that are out there so that we can protect ourselves against them and recognize them when they occur.”
Dr. Audi works as the assistant medical director of the Nebraska Regional Poison Center and is an assistant professor of emergency medicine in the department of surgery at UNMC.