Botulinum Toxin Ricin Toxin Staph Enterotoxin B Source Source Source Clostridium botulinum, a large gram- Ricinus communis . seeds commonly called .Staphylococcus aureus, a gram-positive cocci positive, spore-forming, anaerobic castor beans bacillus Characteristics Characteristics .Appears as grape-like clusters on Characteristics .Toxin can be disseminated in the form of a Gram stain or as small off-white colonies .Grows anaerobically on Blood Agar and liquid, powder or mist on Blood Agar egg yolk plates .Toxin-producing and non-toxigenic strains Pathogenesis of S. aureus will appear morphologically Pathogenesis .A-chain inactivates ribosomes, identical interrupting protein synthesis .Toxin enters nerve terminals and blocks Pathogenesis release of acetylcholine, blocking .B-chain binds to carbohydrate receptors .Staphylococcus Enterotoxin B (SEB) is a neuro-transmission and resulting in on the cell surface and allows toxin superantigen. Toxin binds to human class muscle paralysis complex to enter cell II MHC molecules causing cytokine Toxicity release and system-wide inflammation Toxicity .Highly toxic by inhalation, ingestion Toxicity .Most lethal of all toxic natural substances and injection .Toxic by inhalation or ingestion .Groups A, B, E (rarely F) cause illness in .Less toxic by ingestion due to digestive humans activity and poor absorption Symptoms .Low dermal toxicity .4-10 h post-ingestion, 3-12 h post-inhalation Symptoms .Flu-like symptoms, fever, chills, .24-36 h (up to 3 d for wound botulism) Symptoms headache, myalgia .Progressive skeletal muscle weakness .18-24 h post exposure .Nausea, vomiting, and diarrhea .Symmetrical descending flaccid paralysis .Fever, cough, chest tightness, dyspnea, .Nonproductive cough, chest pain, .Can be confused with stroke, Guillain- cyanosis, gastroenteritis and necrosis; and dyspnea Barre syndrome or myasthenia gravis death in ~72 h .SEB can cause toxic shock syndrome + + + Gram stain Lipase on Ricin plant Castor beans S. aureus Gram stain Growth on egg yolk plates Blood Agar Botulinum Toxin Ricin Toxin Staph Enterotoxin B Transmission Transmission Transmission .Aerosol release .Aerosol release .Aerosol release .Food contamination .Food contamination .Food contamination .Wound contamination .Injection .Toxin not transmitted person to person .Toxin not transmitted person to person .Toxin not transmitted person to person Clinical Specimens Clinical Specimens Clinical Specimens .Serum: > 5 ml (10 ml preferred) .Serum to test for circulating antibody .5-10 ml blood in EDTA .Feces and gastric contents: >10 g (>5ml) (Tested at CDC) .Urine: > 5 ml (10 ml preferred) .Clinical swab specimens: Place swabs in .Urine: >5 ml (10 ml preferred) .Respiratory secretions, or nasal swabs an anaerobic transport media .Storage: Room temperature, in plastic .Bacterial isolates .Autopsy: contents from small and large containers (do not use glass) .Storage: Refrigerate intestines .Note: Ricin toxin can be denatured by .Storage: Refrigerate, preferably in plastic freezing or excess heat containers Environmental Samples Environmental Samples Environmental Samples .All environmental samples: 100 ml or 2 g .All environmental samples: 100 ml or 2 g .All environmental samples: 100 ml or 2 g .Food, drinks: Send entire item .Food, drinks: Send entire item .Food, drinks: Send entire item .Storage: Room temperature, in plastic .Storage: Refrigerate .Storage: Refrigerate, preferably in plastic containers (do not use glass) containers .Note: Ricin toxin can be denatured by freezing or excess heat Detection Detection Detection .Time-resolved fluorescence (TRF) .Mouse neutralization assay Time-resolved fluorescence (TRF) .Gel diffusion assay .Enzyme-linked immunosorbent assays . PCR .Latex agglutination test (ELISA) . Ricinine detection by chemical analysis .PCR .PCR . If any of these toxins are suspected immediately contact the Wadsworth Center, NYSDOH to refer the specimen/sample 518 - 474 - 4177 if within the 5 boroughs of NYC, please call (212) 447-1091 6/06.