Ricin: Suspected Intentional Release Overview for Clinicians

• The covert release of ricin may not be immediately recognized, since the incubation period between exposure and symptom onset ranges from 4 to 12 hours.
• Ricin-exposed persons exhibiting symptoms are likely to present to an emergency department after symptoms have developed.
• Clinicians should be alert to illness patterns and diagnostic clues that might indicate an intentional release of ricin.
• Suspect terrorism release of ricin when there is a sudden unusual temporal or geographic clustering of otherwise healthy persons manifesting a constellation of clinical signs and symptoms/toxic effects typical for ricin exposure.
• The size of an outbreak associated with intentional ricin release would depend upon several factors, including method of release, quantity released, duration of release, environmental conditions, location of exposure, persistence in air, and/or contamination of water or food.
• Chemical Terrorism Event Specimen Collection: emergency.cdc.gov/labissues/pdf/chemspecimencollection.pdf

Mental Health

For information on coping strategies: http://emergency.cdc.gov/masscasualties/copingpro.asp

Mental Health Aspects of Terrorism: http://www.mentalhealth.samhsa.gov/publications/allpubs/KEN-01-0095/default.asp

For additional information:

• MMWR: Recognition of Illness Associated with the Intentional Release of a Biologic Agent
• Bioterrorism Readiness Plan: A Template for Healthcare Facilities
• Emergency Room Procedures in Chemical Hazard Emergencies: A Job Aid
• Self Contained Breathing Apparatus (SCBA)
• NIOSH Protective Clothing
• Safety Management in Disaster and Terrorism Response
• NIOSH Eye Safety
• Coping With a Traumatic Event: Information for Health Professionals
• Mass Casualties Predictor
• Predicting Casualty Severity and Hospital Capacity
• Chemical Agents: Facts About Evacuation
• Chemical Agents: Facts About Sheltering in Place