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Trichothecene Mycotoxins

Trichothecene mycotoxicosis, Alimentary Toxic Aleukia was used for the symptoms arising from eating contaminated grains in the Soviet Union.

The effects of trichothecenes at high doses are in part derived from information on yellow rain attacks and animal experiments. These symptoms and effects are distinct from those found in alimentary toxic aleukia that is a result of chronic exposure.

These acute symptoms show variability in the speed and scale of onset that are probably dose-dependent.

The earliest symptoms are seen within half an hour on the skin, in the eyes, and the upper respiratory and upper digestive tracts. Trichothecenes are blistering agents that seem to be about as effective as mustards and Lewisite and the first symptom of an aerosol or spray attack is blistering of the skin, pain in the eyes, blurred vision that can last about a week and pain in the mouth and throat. Other short term symptoms reported include weakness, dizziness, and loss of coordination. Systemic effects begin within a few hours.

The first sign is diarrhea that is often bloody. The victim may have difficulty breathing and will also cough and may cough up blood (hematoptysis). The gums and nose may begin to bleed and there may be vomiting of blood accompanied by abdominal pain. The damage to the digestive tract means that patient loses appetite and becomes dehydrated.

As the poisoning takes its toll, the primary skin effects may worsen and blisters may spread and turn into pathological lesions of the skin, including bullae, pettechiae, and ecchymoses with some areas becoming necrotic (dying) and turning black.

In the terminal stages of the poisoning, the victim’s blood pressure and body temperature drop and the heart races (tachycardia). Blood may ooze from the mouth and nostrils. Tremors, seizures, and coma also occur during the final decline.

Antidote and Specific Treatments

There is no specific therapy for trichothecene exposure and symptoms are treated. Current US practice models treatment for trichothecene poisoning after treatments for mustards. The first concern is to remove as much as possible from those exposed. Vigorous washing with soap and water will clear residues on the skin and contaminated clothing must be removed and disposed of. Delayed mild effects on the skin can be treated with calamine lotion, camphor, or other skin lotions.

Inactivation:

Contaminated individuals can be decontaminated with soap and water.