There is no antidote for ricin
There is no antidote for ricin

The effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected. Ricin poisoning can eventually lead to multiple organ failure, leading to death within 36-72 hours of exposure, depending on the dosage of ricin and mode of exposure. There is no antidote for ricin; hence, ricin poisoning is mainly treated symptomatically with supportive medical care to reduce the effects of poisoning.

What is ricin?

Ricin is a poison found naturally in castor beans. Ricin poisoning can occur if castor beans are chewed and swallowed, and the released ricin causes complications. Ricin can be made from castor beans in powder, pellets, or mist form and can be dissolved in water or weak acids. It can be used as a bioweapon. Castor beans are used to make castor oil, and ricin is part of the waste material during the process.

How does ricin poisoning occur?

One may be unintentionally exposed to ricin by accidentally ingesting castor beans. Ricin is also used as a bioweapon and used in war or terrorism. Ricin poisoning is not contagious and does not spread through casual contact. Coming in contact with someone who has ricin on their body or clothes can lead to ricin exposure and poisoning. 

Once exposed, ricin enters the cells of the body, preventing the cells from synthesizing proteins needed for their survival. Eventually, ricin poisoning spreads throughout the entire body causing death.

What are the signs and symptoms of ricin poisoning?

The effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected. Ricin poisoning can eventually lead to multiple organ failure, leading to death within 36-72 hours of exposure, depending on the dosage of ricin and mode of exposure.

Inhalation of ricin: Symptoms can develop from four to eight hours up to 24 hours after initial exposure. Poisoning can eventually lead to respiratory failure and death. 

Clinical presentation:

Ingestion: If a significant amount is ingested, poisoning may present with:

Skin and eye exposure: Direct contact with ricin powders or contact with items that have ricin on them can cause ricin poisoning, but it’s rare. Poisoning presents with redness and/or pain of the skin and the eyes.

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How ricin poisoning is treated?

There is no antidote available for ricin to reverse the effects of ricin poisoning; hence, it is advised to try to avoid exposure.

When ricin exposure is suspected, it is important to call for medical help right away (911 in America), after which the following protective measures advised:

  • Leaving the contaminated area right away and getting fresh air.
  • Removing clothing as quickly as possible. Clothes should not be pulled over the head to avoid ricin exposure to the eyes or mouth. Instead, the clothes should be cut off.
  • Washing the body as soon as the clothes are taken off is advised. Washing the entire body with soap and water and washing the hair with shampoo would help protect the body and reduce contamination. If the eyes have been exposed to ricin or in the presence of burning of eyes or vision problems, they should be rinsed with water thoroughly for 10-15 minutes.
  • Disposal of contaminated clothes is important to prevent further contamination and to protect others from exposure. The clothes should be sealed in a plastic bag. Once emergency medical help arrives, the plastic bag should be handed over to them for safe disposal.
Medical treatment: Ricin poisoning is treated symptomatically with supportive medical care to reduce the effects of poisoning. Supportive medical care would depend on whether ricin poisoning was following inhalation, ingestion, or skin/eye exposure. Treatment usually involves providing breathing support, administering intravenous fluids, anti-seizure medications, medications to regulate blood pressure, stomach wash or flushing with activated charcoal, and washing out the eyes if irritated. Sooner the treatment begins, better the prognosis. If there was a wound at the site of contact, wound cleaning and antibiotics may be needed.

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Medically Reviewed on 10/9/2020
References
https://www.webmd.com/first-aid/ricin

https://emedicine.medscape.com/article/830795-overview

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