Great new review of Novichok nerve agents

July 5, 2018, 11:09 am

April 25, 2018: Decontamination efforts in Salisbury U.K. [Photo credit: shutter]


Novichok agents: a historical, current, and toxicological perspective. Chai PR et al. Toxicology Communications 2018;2:45-48. 

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British counter-terrorism officials confirmed yesterday that a critically ill couple who were admitted to hospital in Amesbury U.K. on June 30 had been exposed to Novichok, one of a group of “newcomer” nerve agents developed in Russia over the last several decades.

Novichok is the same class of nerve agent involved in the March 2018 attack on former Russian spy Sergei Skripal and his daughter Yulia. That exposure occurred in the town of Salisbury, located 7 miles south of Amesbury.

It is not yet clear exactly where the exposure in this new episode occurred. Reportedly, the couple — Dawn Sturgess, 44, and Charles Rowley, 45 —had recently visited the Queen Elizabeth Gardens in Salisbury, near where the Skripals became ill in March. It is also not clear if the exposure was to the same type of Novichok agent involved in the previous case.

According to a report in the New York Times:

Sam Hobson, who saw the victims on the day they fell ill, told reporters that Ms. Sturgess was in the bathroom when she went into a seizure, foaming at the mouth. A few hours later, when Mr. Rowley collapsed, he was sweating heavily, making noises and rocking back and forth.

“There was no response for me — he didn’t even know I was there,” Mr. Hobson said. “He was in another world, he was hallucinating.”

With Novichok back in the news, the recently posted review of that class of nerve agents by Chai et al is especially timely and important reading. Since these chemical weapons were developed in secret, very little reliable information is available about their pharmacology, toxic effects, or optimal treatment. This article now brings together much that we do know, and is the best short publication in English on the topic.

Some key points made in the paper:

  • Unlike other nerve agents that primarily affect the central nervous system, the Novichok group is thought to also target peripheral nerves and can cause chronic neuropathy.
  • Hydrolysis of Novichok agents produces hydrofluoric acid, hydrochloric acid, hydrogen cyanide, and various oximes that can prolong cholinergic effects.
  • Since dry bleach powder can accelerate hydrolysis of Novichok agents into toxic byproducts, they should not be used.

Must reading for anyone interested in the topic.

To read my Emergency Medicine Newsi column on Novichok, click here.

[Full disclosure: one of the co-authors of the Chai paper, Dr. Tim Erickson, is a former colleague from the Toxikon group in Chicago.]

Related post:

Novichok: a fourth-generation class of nerve agents