Ricin

Exams and Tests

Diagnosing an aerosolized attack or a food and water contaminant with ricin primarily depends on symptoms and the likelihood of such an exposure. In cases of an isolated ricin injection, diagnosis is extremely difficult. In addition, diagnostic testing is of limited value, because no test is currently available to confirm exposure to ricin definitively. Nonetheless, in the case of possible exposure to ricin, a person would most likely undergo a complete physical examination by a doctor. Sophisticated diagnostic tests (not widely available) can identify ricin in the body up to 24 hours after exposure.

• If exposure is from an inhaled aerosol, the presentation is similar to a sudden, rapidly worsening lung injury. The most common findings include labored breathing or difficulty in breathing, tightness in the chest, and rapid heart rate. A chest x-ray film shows excess fluid in the lungs.
  
  
• If exposure is through ingestion, the physical findings are usually confined to the GI tract. Symptoms include abdominal pain, vomiting, and diarrhea. Dehydration is common. If the dose was sufficient and the disease has progressed, vomiting blood or passing bloody diarrhea or dark-colored tarry stools may occur.
  
  
• If exposure is from an injection, the skin at the injection site is examined for swelling and redness. The affected area may feel painful. The skin is also examined for the possibility of a retained foreign object. The physical findings on the skin from injected ricin may occur prior to or at the time of other flulike symptoms.

Ricin Treatment

Self-Care at Home

If exposure to ricin is a possibility, the people exposed must seek medical attention immediately. See When to Seek Medical Care.

Medical Treatment

No antidote or vaccine is available for ricin. Regardless of the route of exposure, treatment remains mainly supportive.

 

• If exposure is from inhaled aerosol, the person may need assistance with breathing. If particularly severe, the person who was exposed may require intubation and use of a ventilator. 
  
  
• If ricin was ingested, the stomach may need to be pumped (called gastric decontamination). Superactivated charcoal may also be given to help soak up the poison. To treat dehydration, intravenous fluids may be given.

Medications

Antibiotics serve no role in the treatment of ricin poisoning.
 

• Medications may be given to treat seizures and low blood pressure that are sometimes associated with exposure to ricin.
  
  
• In the case of ricin exposure by injection, antibiotics may serve to prevent infection. A tetanus immunization may also be given as a precautionary measure.

Surgery

Surgical care is not necessary for exposure to ricin, unless the ricin was injected. In this instance, the injection site should be treated to assess whether a foreign object is present. If so, the object should be surgically removed.