“Crazy Clown” spice, polonium-210 as a poison, deadly sarin attacks in Syria: Weekly Web Review in Toxicology

August 26, 2013, 11:56 pm

Crazy Clown Herbal Incense: Last week, at least 8 people aged 16 to 26 were treated in southern Georgia emergency rooms— some requiring admission to the ICU in critical condition  according to very sketchy news reports — after smoking a form of Spice (synthetic cannabinoid) labelled as “Crazy Clown”. According to one neighbor says he heard “terrifying screams”:

“Three girls foaming out the mouth. One rolling around on the ground and my nephew couldn’t walk.”

According to some accounts, initial symptoms include nausea, vomiting, dry mouth, weakness, and paralysis. Cardiotoxicity may supervene. There are suggestions that the product may also be sold as “Herbal Madness”. So far, there has been no identification of what chemical or chemicals are contained in the product.

Nerve Agent Release in Syria: The Telegraph (U.K.) reports that medical workers from Médecins Sans Frontières have treated almost 4000 patients in Syria who have apparently been exposed to a nerve agent such as sarin. There were at least 355 deaths, although this figure is likely to increase. Another report describes what seems like clear-cut cholinergic toxidrome: miosis, increased salivation, blurred vision, respiratory distress, and seizures. MSF emphasized that they had not been able to demonstrate scientifically what agent was involved, nor who might be responsible. The Washington Post has a good piece on the science of nerve agents.

Polonium-210 and the Murder of Alexander Litvinenko: This week’s absolute must-read is “Bad Blood“, Will Storr’s long, detailed, and superbly written inquiry into the 2006 assassination of Russian dissident Alexander Litvinenko. Litvinenko was poisoned by radioactive polonium-210 while having tea with 2 Russian acquaintances in London. Storr discusses both the science behind polonium-210 as a poison, and also the intrigue and power struggles within the Russian secret services, which were almost certainly responsible for Litvinenko’s death. This is one of the best science pieces I’ve read in a long time. By the way, “Bad Blood” was published by MATTER, and exciting endeavor devoted the support and publishing longform pieces on science, technology, and medicine. It was edited by Deborah Blum (@deborahblum).

To read my Emergency Medicine News column “Five Things Every Toxicologist Should Know About Polonium,” click here.

Ancient Poison Ring Unearthed: NBC News reports that archaeologists digging in Bulgaria have found a ring containing a hollow cavity that they believe may have been used in political murders more than 600 years ago:

The hole would have allowed its wearer to sneakily pour poison into a glass with the flock of his finger . . .

The Daily Mail (U.K.) has more details. Tip o’ the Hat to @deborahblum for linking to this story.

“The six saddest words of the shift-limit era: “I don’t know. T’m just covering”: I highly recommended Lisa Rosenbaum’s New Yorker essay “Why Doesn’t Medical Care Get Better When Doctors Rest More?” Studies indicate that patient outcomes have not improved and the incidence of medical errors has not decreased since the Accreditation Council for Graduate Medical Education enforced rules limiting the number of hours residents could work. These changes have not made teaching hospitals safer. Rosenbaum’s convincing explanation is that the increased number of patient handoffs have made medical care in these institutions “an unending game of telephone.”

 

 

 

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