Case Definition: Ricin Inhalation
Inhalation of ricin typically leads to cough and respiratory distress followed by pulmonary edema, respiratory failure, and multi-system organ dysfunction. Weakness and influenza-like symptoms of fever, myalgia, and arthralgia might also be reported (1-5).
Laboratory criteria for diagnosis
- Biologic: CDC can assess selected specimens on a provisional basis for urinary ricinine, an alkaloid in the castor bean plant. Only urinary ricinine testing is available at CDC or the Laboratory Response Network
- Environmental: Detection of ricin in environmental samples, as determined by CDC. Ricin can be detected qualitatively by TRF in environmental specimens (e.g., filters, swabs, or wipes).
- Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.
- Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for ricin exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
- Confirmed: A clinically compatible case in which laboratory tests have confirmed exposure.
The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or the etiology of the agent is known with 100% certainty.Note: A case should not be considered ricin poisoning if another confirmed diagnosis exists to explain the signs and symptoms.
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- US Army Medical Research Institute of Infectious Diseases. Ricin. In: Eitzen E, Pavlin J, Cieslak T, Christopher G, Culpepper R, eds. Medical management of biological casualties [Handbook]. 4th ed. Fort Detrick: MD: US Army Medical Research Institute of Infectious Diseases, Operational Medical Division; 2001:101-6.
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- Puri P and Kumar O. Integrating immunobased detection and identification methods for ricin analysis: an overview. Journal of Bioterrorism and Biodefense 2011;S2:1-7.
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- Page last reviewed April 22, 2013
- Page last updated April 22, 2013
- Content source: National Center for Environmental Health (NCEH)/Agency for Toxic Substances and Disease Registry (ATSDR)
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