Trichothecene Mycotoxin

Trichothecene mycotoxins might be used as a weapon and spread through the air or mixed in food or beverages. The effects will vary with the route that is used to spread the mycotoxin.

SYMPTOMS

  • Dermal exposure leads to burning pain, redness, and blisters.

  • Oral exposure leads to vomiting and diarrhea.

  • Eye exposure might result in blurred vision.

  • Inhalational exposure (breathing the material in) might cause nasal irritation and cough.

  • Effects on the entire body can develop with all routes of exposure and might include weakness, ataxia (loss of coordination of your muscles), low blood pressure, problems with blood clotting, and death.

DIAGNOSIS

  • Biologic: Selected commercial laboratories are offering immunoassays to identify trichothecenes or trichothecene-specific antibodies in human blood or urine. However, these procedures have not been analytically validated and are not recommended.

  • Environmental: Detection of trichothecene mycotoxins in environmental samples, as determined by FDA.

  • As a result of indoor air-quality investigations involving mold and potentially mold-related health effects, mycotoxin analyses of bulk environmental samples are now commercially available through environmental microbiology laboratories. Studies have not been done to determine the background level of trichothecenes in non-moldy homes and office buildings or nonagricultural outdoor environments. Therefore, the simple finding of trichothecenes in environmental samples does not always mean an intentional contamination.

CASE CLASSIFICATION

  • Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.

  • Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for trichothecene mycotoxins exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.

  • Confirmed: A clinically compatible case in which laboratory tests of environmental samples have confirmed exposure.

  • The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or a 100% certainty of the cause of the agent is known.

ADDITIONAL RESOURCES

Wannemacher RW Jr, Wiener SL. Trichothecene mycotoxins. In: Zajtchuk R, Bellamy RF, eds. Textbook of military medicine: medical aspects of chemical and biologic warfare. Washington, DC: Office of the Surgeon General at TMM Publications, Borden Institute, Walter Reed Army Medical Center; 1997:655-77.

Croft WA, Jastromski BM, Croft AL, Peters HA. Clinical confirmation of trichothecene mycotoxicosis in patient urine. J Environ Biol 2002;23:301-20.

Vojdani A, Thrasher HD, Madison RA, Gray MR, Heuser G, Campbell AW. Antibodies to molds and satratoxin in individuals exposed in water-damaged buildings. Arch Environ Health. 2003;58:421-32.

Tuomi T, Reijula K, Johnsson T, et al. Mycotoxins in crude building materials from water-damaged buildings. Appl Environ Microbiol 2000;66:1899-904.

This information is courtesy of the CDC and the Department of Health and Human Services