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The page below is a sample from the LabCE course Preliminary Identification of the Primary Select Agents of Bioterrorism. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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      Toxin Comment Most Likely Means of Dissemination Primary Route of Entry General Signs and Symptoms

      Laboratory Testing

      Botulism toxin:

      Gram stained image of C. botulinum courtesy of CDC

      • Produced by Clostridium botulinum
      • Could be purified and used in a bioterrorist event to contaminate food or aerosolized to cause disease
      • Aerosol
      • Food contamination
      • Inhalation
      • Ingestion
      • Difficulty speaking or swallowing
      • Blurred or double vision
      • Drooping eyelids (ptosis)
      • Dilated pupils
      • Dry mouth, decreased gag reflex
      • Weakening of the reflexes (hyporeflexia)
      • Abnormal sensations such as numbness, tingling, and progressive arm or leg weakness
      • Flaccid paralysis
      • Culture, anaerobic
      • Digoxigen-labeled IgG ELISA to detect A, B, E, and F toxins
      • Mouse Bioassay for all toxin types and to confirm DIG ELISA

      Ricin toxin:

      • Extracted from Castor beans
      • Inhibits protein synthesis
      • Causes death approximately 72 hours after initial exposure
      • As an aerosol
      • Inhalation
      • Fever
      • Cough
      • Chest tightness
      • Dyspnea
      • Cyanosis
      • Gastroenteritis
      • Necrosis
      • Antibody detection in clinical specimens
      • Clinical testing not performed unless known exposure has occurred