Current Concepts

Sarin Poisoning on Tokyo Subway

Authors: SADAYOSHI OHBU MD, AKIRA YAMASHINA MD, NOBUKATSU TAKASU MD, TATSUO YAMAGUCHI MD, TETSUO MURAI MD, KANZOH NAKANO MD, YUKIO MATSUI MD, RYUZO MIKAMI MD, KENJI SAKURAI MD, SHIGEAKI HINOHARA MD

Abstract

ABSTRACTOn the day of the disaster, 641 victims were seen at St. Luke's International Hospital. Among those, five victims arrived with cardiopulmonary or respiratory arrest with marked miosis and extremely low serum cholinesterase values; two died and three recovered completely. In addition to these five critical patients, 106 patients, including four pregnant women, were hospitalized with symptoms of mild to moderate exposure. Other victims had only mild symptoms and were released after 6 hours of observation. Major signs and symptoms in victims were miosis, headache, dyspnea, nausea, ocular pain, blurred vision, vomiting, coughing, muscle weakness, and agitation. Almost all patients showed miosis and related symptoms such as headache, blurred vision, or visual darkness. Although these physical signs and symptoms disappeared within a few weeks, psychologic problems associated with posttraumatic stress disorder persisted longer. Also, secondary contamination of the house staff occurred, with some sort of physical abnormality in more than 20%.

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References