Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 16 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Module One - Terrorism by Fear and Uncertainty: Delayed Toxic Syndromes 16 . Case Study: A 48 year old chemistry professor at Dartmouth College spilled a drop of methylmercury on her gloved hand while working under a hood in August 1996. She removed the glove, washed her hands, and noted the incident in her logbook. She presented about 5 months later with a progression of symptoms. December 2008 Version 2.0 Page 324
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 17 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Dimethylmercury Toxicity Dr. Karen Wetterhahn • Day 0 : Spills few drops on latex -gloved hand – Initially asymptomatic and continued normal activities. She deli vered a paper at an overseas conference 3 months later. • Day 154: Onset of symptoms – Balance, gait and speech problems • Day 159: Admitted to hospital; symptoms progress – Paresthesias; visual field changes; bilateral high -pitched tinnitus; deterioration of speech, hearing, gait, mental status • Day 176: Persistent vegetative state • Day 298: Dies Module One - Terrorism by Fear and Uncertainty: Delayed Toxic Syndromes 17 Dr. Wetterhahn presented for evaluation in Jan 1997 (159 days after exposure) with a five-day history of progressive deterioration in balance, gait, and speech. A preliminary laboratory report indicated that the whole-blood mercury concentration was more than 1000 µg per liter. Chelation therapy with oral succimer (10 mg per kilogram orally every eight hours) was begun on day 168 after exposure. She had aggressive chelation therapy and other treatments, but she died on June 8, 1997, 298 days after exposure. The delay to onset of symptoms is remarkable in this case, presumably reflecting the time to distribution to the blood from an amount absorbed through the skin. The symptom complex described – affecting the brain, including the cerebellum (balance and gait), the cerebral cortex – higher level functioning (speech, hearing, “coning in” of visual fields – loss of peripheral vision, and change in mental status – vegetative state being unable to communicate or respond to stimuli) as well as peripheral nerves (paresthesias – abnormal sensation) is characteristic of the effects of mercury on the nervous system. December 2008 Version 2.0 Page 325
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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