Introduction
Ricin intoxication is a dangerous and unusual medical condition. Reduced physical and mental control due to the effect of external agents like drugs or alcohol, is termed intoxication. Ricin is a poison that can be used in different forms like powder, pellet, or dissolved in water and weak acid. It is poisonous when inhaled, swallowed, or injected. A dosage of five to ten micrograms per kilogram is considered to be lethal (deadly). It is a strong substance and does not get damaged easily in normal room temperatures.
What Is Ricin?
Ricin is a poisonous carbohydrate-binding, naturally occurring protein found in the seeds of the castor bean plant. These seeds are widely used to produce castor oil. Ricin can be obtained from the leftover waste after castor oil production. It is a stable substance under normal room temperature and can be disabled only at a temperature of 80 degrees centigrade or above.
Where Is Ricin Found?
Castor oil plants grow well in tropical climates. These are the areas that get good exposure to the sun and remain warm throughout the year. About two million tons of castor seeds are produced every year in the world. The castor seeds are processed to get the castor oil which has numerous industrial uses like the production of lubricants, preservatives, pharmaceuticals, and dyes. The waste that is obtained after the production of castor oil is approximately five percent ricin by weight.
What Is Ricin Used For?
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It was used by the United States and the Soviet Union as a biological weapon. Biological weapons are either microorganisms like bacteria, fungi, viruses, or poisonous substances that are man-made to cause diseases or death of humans, plants, or animals. While used as a biological weapon, it is either converted into an aerosol (tiny solid particles or liquid droplets) and inhaled or taken from poisoned food or contaminated water supply.
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The waste obtained after the extraction of castor oil from the castor seeds contains toxic ricin, which can be detoxified and used as a supplement in animal feed or fertilizer.
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Ricin can be used as a chemotherapeutic agent as it has medicinal properties to treat cancer.
How Does Ricin Affect the Human Body?
Ricin is an extremely toxic substance. Once it enters a person’s body, it prevents the cells in the body from manufacturing the required proteins. Due to the lack of proteins, the cells inside the body tend to get destroyed or die. Eventually, it affects the whole body and may lead to the person's death. The effects of ricin exposure may vary from person to person depending on the quantity of ricin, duration, and the way of exposure. The most toxic way of ricin exposure is by injection, followed by inhalation and swallowing.
What Are the Ways of Ricin Exposure?
The ways by which people are exposed to ricin are as follows:
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Unintentional intake of castor beans.
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Swallowing food or water contaminated with ricin.
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Breathing ricin mist or powder.
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In 1978, a Bulgarian journalist, Georgie Markov was exposed to ricin and killed by a man using an umbrella. The umbrella was set up in such a way as to inject a toxic ricin pellet into the skin of the journalist.
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As warfare agents (highly toxic materials dispersed as gas, liquid, or powder form) by the military to attack terrorists.
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Ricin poisoning does not spread from one person to another through direct contact. Hence ricin associated medical condition also does not spread through person-to-person. However, a person would get exposed to ricin if he gets in contact with someone who has ricin on their body or clothes.
What Are the Symptoms of Ricin Exposure?
The signs and symptoms shown by persons who have been exposed to ricin may differ according to the way of exposure and the dose of ricin. The symptoms are as follows:
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Inhalation:
A person who has inhaled ricin may show initial symptoms after four to eight hours of inhalation. Severe symptoms are seen after 24 hours of exposure. Ricin inhalation in persons may show respiratory complications like fever, cough, breathing difficulties, and chest tightness. Severe symptoms may include pulmonary edema (fluid build-up in the chest) and pneumonia. As a result, the skin turns blue, followed by low blood pressure, respiratory failure (severe difficulty in breathing), shock (inadequate oxygen supply in the body), and finally leading to death.
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Ingestion:
This is the exposure to ricin through swallowing. The symptoms seen in people who swallow ricin are vomiting, diarrhea followed by dehydration and low blood pressure. The urine and stool of these patients contain blood. The patient vomits blood as a result of internal bleeding. Eventually, vital organs like the liver, spleen, and kidneys stop functioning, leading to the death of the individual.
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Injection:
Symptoms in persons exposed to ricin through injection may include redness and hardening of the skin at the injection site. The muscles and lymph nodes (cluster of cells containing immune system cells) near the injection site may start to get affected. As a result, the liver, kidneys, and spleen may stop working, leading to heavy bleeding from the intestine and stomach, which may progress to multiple organ failure and death.
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Skin and Eye Exposure:
Normally contact with the skin does not lead to ricin absorption. It may lead to minor complications like redness of the skin and eyes.
How to Diagnose Ricin Exposure?
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If there is suspicion of ricin exposure, public health authorities may conduct preliminary environmental testing which may detect ricin in the materials released into the environment.
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Ricinine Analysis:
Centers for disease control and prevention (CDC) may evaluate urine samples to detect ricinine which is an alkaloid (naturally occurring nitrogen-containing compound seen in plants) seen, specifically in castor bean plants.
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Enzyme-Linked Immunosorbent Assays (ELISA):
This test measures the presence of antibodies in the blood related to certain infectious conditions. Antibodies are proteins produced by the body against harmful substances called antigens. Recent advancement in this method is the comparative indirect ELISA with the usage of fluorescence probes (molecules that absorb light of a specific wavelength and emit a different light with a longer wavelength) in blood and red blood cells.
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Laboratory Tests:
Laboratory tests may show a high white blood cell (component of blood responsible for protecting the body from infections) count in blood, liver failure, kidney failure, excessive bleeding, or prolonged time taken to form a blood clot.
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Chest X-Rays:
Patients with inhalation exposure may show signs of pneumonia or pulmonary edema.
How Is Ricin Exposure Treated?
There is no specific vaccine or medication to treat ricin exposure. Hence care should be taken to avoid ricin exposure. However, if ricin exposure has taken place, the following steps are done:
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If ricin exposure is through the skin or eye contact, wash away the ricin using water and soap. Eyes should be washed using water for almost ten to fifteen minutes.
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Any clothing which has come in contact with ricin should be immediately removed and disposed of by sealing it in at least two plastic bags.
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Symptoms shown after ricin exposure are treated by various medical means to decrease the poisoning.
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Ricin exposure in patients through inhalation may show breathing difficulties. They should be given ventilator support and intravenous fluids (fluids injected into the body through veins to prevent dehydration).
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In patients with ricin exposure through swallowing, activated charcoal is given to flush out the contents of the stomach, followed by the administration of a cathartic agent (a substance that makes defecation easy) like magnesium citrate. After the loss of gastrointestinal fluids, rehydration is done to bring back the lost fluids in the body.
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Medications to control seizures and bring the blood pressure back to normal are given.
Conclusion
Ricin exposure is a very dangerous condition that can lead to death. Once exposed, seeking prompt medical care should be done. Cooperating with the emergency health coordinators in the management of ricin exposure is very important. Awareness among the public should be created to avoid self-prescribed herbal medicines which may contain castor beans.
