News / Middle East

Long-Term Nerve Damage Feared after Syria Chemical Attack

People, affected by what activists say is nerve gas, are treated at a hospital in the Duma neighborhood of Damascus August 21, 2013.
People, affected by what activists say is nerve gas, are treated at a hospital in the Duma neighborhood of Damascus August 21, 2013.
Reuters
Even those who survived the suspected chemical weapons attack in Damascus - and many hundreds didn't - may have life-long disabilities and health problems for which there are few effective treatments.

The death toll from the incident, the latest grisly episode in Syria's two-and-a-half-year civil war, could well rise in coming days as doctors and other health workers who suffered secondary exposure via the direct victims start to succumb to the agent's poison.

Antidotes and emergency treatments do exist for patients suffering the immediate effects of poisoning by a nerve agent - something many experts fear happened to the thousands affected in rebel-held areas of the Syrian capital on Wednesday.

But if no help comes within the first hour or so, the chances become slim that an antidote drug like atropine or oxime, or the sedative diazepam, will do much good.

“[Treatment] needs to be immediate. The damage is done very quickly,” said Ray Zilinskas, a chemical and biological weapons expert at the Monterey Institute of International Studies in the United States.

“Longer term, the major risk is the result of significant restricted breathing,” which could also lead to brain damage, said Alastair Hay, a professor of environmental toxicology and chemical weapons expert at Britain's Leeds University.

Chemical Weapons Believed to be in Syria

Sarin
  • Man-made nerve agent originally developed as a pesticide
  • Used in 1995 Tokyo subway attack
  • Highly toxic odorless, tasteless, colorless liquid
  • Exposure can be by inhalation, ingestion and skin absorption
  • People can recover with treatment from moderate exposure
     
VX
  • Man-made nerve agent
  • Odorless and tasteless
  • Most potent of all nerve agents
  • Slow to evaporate; can last for days on objects
  • People can be exposed through skin contact or inhalation
  • People can recover with treatment from moderate exposure
     
Mustard Gas
  • Causes blistering of the skin and mucous membranes
  • Sometimes odorless, sometimes smells like garlic, onions or mustard
  • Used in World War One
  • Exposure can be by inhalation, ingestion or skin contact
  • Vapor released in the air can be carried long distances by wind
  • Exposure is not usually fatal

Source: CDC
One breath could be deadly

Nerve gasses are the most potent and deadly of the known chemical agents. “They are rapidly lethal and are hazardous by any route of exposure,” said Sharon Ruetter of the U.S. Army Edgewood Chemical Biological Center in Maryland.

In a review of chemical weapons hazards in the Environmental Health Perspectives journal, Ruetter said it was theoretically possible to release nerve gasses in high enough concentrations that “one breath would be incapacitating or deadly.”

Nerve gasses include tabun, soman and sarin - the agent experts think is most likely to have been used in Syria.

They interfere with transmissions between nerves, or between nerves and muscle cells, causing muscle weakness or paralysis, including paralysis of the diaphragm and heart. They also cause seizures, loss of body control, restricted breathing, sweating, profuse nasal and lung secretions and constricted pupils.

“With the number of casualties we've seen - the figures I'm seeing at the moment are up to 2,000 dead - and the sorts of symptoms, the rapidity of death... the only plausible explanation is a chemical weapon,” said Hamish de Bretton-Gordon, the former commander of the chemical, biological and nuclear counter-terrorism unit at Britain's defense ministry.

“If it is a chemical weapon, it's most likely to be a nerve agent - and we know that sarin has been used in the past in Syria. We know that Assad has very large stockpiles of sarin, and a delivery of sarin would create these kinds of casualties.”

Hay said that from pictures and videos he'd seen, nasal and lung secretions - signs consistent with nerve gas poisoning - were “very evident in many of the victims.”

  • Activists wear gas masks as they look for dead bodies and collect samples to check for chemical weapon use in Zamalka, Damascus, August 22, 2013.
  • An activist wearing a gas mask stands next to a dead dog as he looks for bodies to collect samples to check for chemical weapon use, in Zamalka, Damascus, August 22, 2013.
  • Syrian activists inspect the bodies of people they say were killed by toxic gas near Damascus, August 21, 2013.
  • A man sits in a hospital near two children who activists say were affected by toxic gas near Damascus, August 21, 2013.
  • People, affected by what activists say is toxic gas, are treated at a hospital in the Duma neighborhood of Damascus August 21, 2013.
  • A youth, affected by what activists say is toxic gas, is treated at a hospital near Damascus, August 21, 2013.
  • A Syrian military soldier holds his Ak-47 with a sticker of Syrian President Bashar Assad and Arabic that reads, "Syria is fine," as he stands guard at a check point on Baghdad street, in Damascus, August 21, 2013.
  • A Syrian military soldier checks the trunk of a car at a check point on Baghdad street, in Damascus, August 21, 2013.

Antidote stockpiles?

Then there's the question of whether the antidote is available - and if so, in what quantities.

If the victims - whose writhing bodies and agonized faces shocked the world when Syrian activists published pictures and videos - did suffer a nerve agent attack, then atropine would be the treatment of choice.

A generic medicine, it is used in anesthesia as a premedication, in emergency situations or during surgery to make the heart beat faster, and to reverse the effects of poisons that make people hyper-salivate, or foam at the mouth.

Troops at risk of chemical weapons attacks often carry atropine auto-injectors to administer into thigh muscles.

Since it is a core medicine on the World Health Organization's “Essential Drugs List” - a list of minimum medical needs for any basic healthcare system - hospitals in Syria should have it, but may not have enough to treat a large number of people quickly.

“We have emergency [atropine] stockpiles here in the United States that could be accessed in a short time - and most industrialized countries would be the same,” said Zilinskas.

In Syria, while most hospitals should have small amounts when they are functioning properly, the fear now is that supplies will be severely limited, and that any stockpiles are most likely to be held by the military.

“The question is how quickly would the military share? How quickly would they get it to victims?” said Zilinskas. “It doesn't do much good if it arrives two or three hours later.”

You May Like

WHO: Anti-Ebola Efforts Should Focus on West Africa

Official says WHO is 'reasonably confident' countries bordering those hardest hit by the Ebola outbreak are not seeing the virus crossing their borders More

South Sudan Crisis Threatens Development

Economic costs and lost development opportunities in South Sudan have erased what little progress the country has made since independence in 2011 More

Ukrainian PM Warns: Russia May Try to Disrupt Sunday Poll

Arseniy Yatsenyuk orders full security mobilization for parliamentary election to prevent ‘terrorist acts’ from being carried out More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
After Decades of Pressure, Luxembourg Drops Bank Secrecy Rulesi
X
October 21, 2014 12:20 AM
European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video US ‘Death Cafes’ Put Focus on the Finale

In contemporary America, death usually is a topic to be avoided. But the growing “death café” movement encourages people to discuss their fears and desires about their final moments. VOA’s Jerome Socolovsky reports.
Video

Video Ebola Orphanage Opens in Sierra Leone

Sierra Leone's first Ebola orphanage has opened in the Kailahun district. Hundreds of children orphaned since the beginning of the Ebola outbreak face stigma and rejection with nobody to care for them. Adam Bailes reports for VOA about a new interim care center that's aimed at helping the growing number of children affected by Ebola.
Video

Video Young Nairobi Tech Innovator on 'Track' in Security Business

A 24-year-old technology innovator in Nairobi has invented a tracking device that monitors and secures cars. He has also come up with what he claims is the most robust audio-visual surveillance system yet. As Lenny Ruvaga reports from the Kenyan capital, his innovations are offering alternative security solutions.
Video

Video Latinas Converting to Islam for Identity, Structure

Latinos are one of the fastest growing groups in the Muslim religion. According to the Pew Research Center, about 6 percent of American Muslims are Latino. And a little more than half of new converts are female. VOA’s Carolyn Presutti travelled to Miami, Florida -- where two out of every three residents is Hispanic -- to learn more.
Video

Video Exclusive: American Joins Kurds' Anti-IS Fight

The United States and other Western nations have expressed alarm about their citizens joining Islamic State forces in Syria and Iraq. In a rare counterpoint to the phenomenon, an American has taken up arms with the militants' Syrian Kurdish opponents. Elizabeth Arrott has more in this exclusive profile by VOA Kurdish reporter Zana Omer in Ras al Ayn, Syria.
Video

Video South Korea Confronts Violence Within Military Ranks

Every able-bodied South Korean male between 18 and 35 must serve for 21 to 36 months in the country’s armed forces, depending upon the specific branch. For many, service is a rite of passage to manhood. But there are growing concerns that bullying and violence come along with the tradition. Reporter Jason Strother has more from Seoul.
Video

Video North Carolina Emerges as Key Election Battleground

U.S. congressional midterm elections will be held on November 4th and most political analysts give Republicans an excellent chance to win a majority in the U.S. Senate, which Democrats now control. So what are the issues driving voters in this congressional election year? VOA National Correspondent Jim Malone traveled to North Carolina, one of the most politically competitive states in the country, to find out.
Video

Video Comanche People Maintain Pride in Their Heritage

The Comanche (Indian nation) once were called the “Lords of the Plains,” with an empire that included half the land area of current day Texas, large parts of Oklahoma, New Mexico, Kansas and Colorado.The fierceness and battle prowess of these warriors on horseback delayed the settlement of most of West Texas for four decades. VOA’s Greg Flakus reports from Lawton, Oklahoma, that while their warrior days are over, the 15,000 members of the Comanche Nation remain a proud people.
Video

Video Turkey Campus Attacks Raise Islamic Radicalization Fears

Concerns are growing in Turkey of Islamic radicalization at some universities, after clashes between supporters of the jihadist group Islamic State (IS) or ISIS, and those opposed to the extremists. Pro-jihadist literature is on sale openly on the streets of Istanbul. Critics accuse the government of turning a blind eye to radicalism at home, while Kurds accuse the president of supporting IS - a charge strongly denied. Henry Ridgwell reports from London.

All About America

AppleAndroid