Vidyya Medical News Service
Volume 6 Issue 43 Published - 14:00 UTC 08:00 EST 12-Feb-2004 Next Update - 14:00 UTC 08:00 EST 13-Feb-2004
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Information for patients: Question and answers about ricin

What ill health effects/symptoms does ricin cause?
Initial symptoms of ricin poisoning by inhalation (breathing in the ricin) may occur within 8 hours of exposure. Following ingestion (swallowing) of ricin, initial symptoms typically occur in less than 6 hours. Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be respiratory distress (difficulty breathing), fever, cough, nausea, and 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. People who know they have been exposed to ricin should seek medical care if they have respiratory symptoms that started within 12 hours of inhaling ricin.

If someone swallows a significant amount of ricin, he or she would 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 hallucinations, seizures, and blood in the urine. Within several days, the person's liver, spleen, and kidneys might stop working, and the person could die. Ricin in powder or mist form can cause redness and pain of the skin and the eyes.

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. 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. If death has not occurred in 3 to 5 days, the victim usually recovers. Showing the signs and symptoms discussed here does not necessarily mean that a person has been exposed to ricin.

How toxic is ricin? How do people get sick from it?
Ricin is very toxic. It 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. Effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected.

What should I do if I feel I'm experiencing symptoms of ricin exposure?
Seek medical attention right away.

Is it true that there's no cure/antidote for ricin? What can be done to help people who have been exposed to ricin? Are treatments available?
It is true that no antidote exists for ricin. Because no antidote exists, the most important factor is avoiding ricin exposure in the first place. If exposure cannot be avoided, the most important factor is then getting the ricin off or out of the body as quickly as possible. 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.

How are anthrax and ricin similar or different?
Anthrax is the spore form of a bacterium (an organism) that can be dried, purified, and made into a powder that can be inhaled (breathed in).  After anthrax spores are inhaled, they can become active, reproduce in the body, and cause disease.  This process takes at least 24 hours but usually several days.  However, the spore can stay in the body for weeks before becoming active and causing illness, which is why antibiotics to prevent anthrax are given for a long period (60 days) after a person has been exposed.

Ricin is a toxic protein made from castor beans.  The toxin (poison) can be extracted from the beans, purified, and treated to form a powder that can be inhaled.  However, no human cases of ricin inhalation are known to exist.  Most ricin poisonings have occurred when the ricin was injected or when the person swallowed the ricin.  Symptoms of ricin poisoning should occur within 4 to 12 hours if the ricin was inhaled or swallowed.

Is ricin poisoning contagious?
No, ricin poisoning is not contagious. It cannot spread from person to person through casual contact.

Can ricin be "aerosolized" like anthrax?
Yes, ricin in the form of a fine powder can be suspended in air.

Has anyone ever died after being exposed to ricin?
Yes, several deaths have resulted after a victim was injected with ricin. People also have been poisoned with ricin after eating castor beans.  However, most cases of eating castor beans do not result in poisoning, because it is difficult to release the ricin from castor beans. Also, ricin is not as well absorbed through the gastrointestinal tract when compared to injection or inhalation.

What will be done to make sure that the Dirksen Senate office buildings and other closed Senate office buildings are safe for staff to enter?
EPA, FBI, and the U.S. Capitol Police are considering the safety issues and making decisions regarding entry into the building.

How long will cleanup and clearance of the buildings take?
Reportedly, two of the buildings have been reopened as of February 5, 2004.  Dirksen is currently a crime scene under FBI and Capitol Police control. EPA, FBI, and U.S. Capitol Police are examining the extent of contamination and waiting for laboratory analysis of the physical properties of the ricin.

Where can I find general information about ricin?
See the ricin fact sheet.

Where can I find general information about ricin in Spanish?
See the ricin fact sheet in Spanish.

Is there a TTY phone line available where I can get information about ricin?
Yes, you can call the CDC TTY phone line at 866-874-2646.

What form is ricin found in? Is it a powder?
Ricin can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid (from the ricin fact sheet).

Will the irradiation equipment used by the postal service have any effect on ricin?
Postal irradiation may have some effect, but CDC still considers ricin to be fully functional and just as dangerous even after irradiation.

Where can I find information about personal protective equipment and cleanup for ricin?
See the National Institute for Occupational Safety and Health emergency response card.

Could the ricin found on February 2, 2004, at the Dirksen Senate office building have been there earlier?
It may have been. The length of time that it had been there is unknown.

If I was present where the ricin was located, could I have carried it home? Is my house safe?
If ricin was released into the air, some ricin might have gotten onto the clothing of people who were present and might have then been transported on the clothing to their homes. The likelihood is very low in this instance that enough ricin would have gotten onto your clothing and would have been transported home with you for your health to be threatened. However, any exposed clothing should be handled according to the general guidelines given in the “Personal Cleaning and Disposal of Contaminated Clothes” guidelines.

How do I know my family is safe?
Ricin poisoning is not contagious. People who were not present where the ricin was found are not likely to have been exposed at levels high enough to negatively affect their health.

Is anyone communicating with the families?
Employer physicians are keeping watch on employees for symptoms.

What are the long-term effects of ricin exposure?
No long-term direct effects are known to exist from ricin exposure that did not result in symptoms. Following severe ricin poisoning, the damage done to vital organs may be permanent or have lasting effects.

Are certain populations more vulnerable to the health effects of ricin exposure, such as children, pregnant women, the elderly, people who are immunocompromised, or people with respiratory or gastrointestinal (GI) tract illnesses?
Although it is unknown whether these populations are at higher risk, the possibility of higher risk does exist. People who have existing illnesses of the respiratory or GI tract may have pre-existing tissue irritation or damage as a result of their illness. If this damaged or irritated tissue is exposed to ricin, the result may be further injury and greater absorption of the ricin toxin.

Is it possible that health effects may not occur until more than 72 hours after exposure to ricin?
The information that exists on ricin poisoning in humans is extremely limited. Much of what we know about ricin poisoning comes from animal studies and only a few human cases. However, enough information exists on ricin poisoning by ingestion (swallowing) to say that it is extremely unlikely that the onset of signs and symptoms of ricin poisoning by ingestion would occur more than 10 hours after exposure. Much less information exists on ricin poisoning by inhalation (breathing in ricin), but initial poisoning symptoms are very unlikely to begin more than 24 hours after exposure.

What is going to happen to the Dirksen Senate office building?
The building will be closed and evaluated by the local authorities for contamination. The authorities will determine when it is safe to be reopened.

What will happen to personal belongings that were exposed to ricin?
Personal belongings should be handled according to the “Personal Cleaning and Disposal of Contaminated Clothes” guidelines.

What if this happens again? What’s being done to prevent it from happening again?
If there is another event involving ricin, the necessary steps to protect the public’s health and assess for building contamination will be repeated.

These Q&As are based on CDC’s best current information. They may be updated as new information becomes available.

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