Human Rights Watch: Sarin Gas Likely Used by Syrian Gov’t in August Attacks
Sarin gas was likely used by the Syrian government in the recent chemical attacks on civilians in Ghouta, says Human Rights Watch in today’s press release. In its 22-page report, the human rights group charges that Syrian military forces launched the poisonous gas by using rocket warheads in the Damascus suburb on August 21st. The conclusion is based on witness accounts and other evidence, including YouTube videos and knowledge of Syria’s weapons’ capabilities (in contradistinction to those of rebel forces).
Although a UN investigation of environmental and physiologic samples is pending, HRW believes that sarin gas was used on the basis of the observed symptoms in victims—including cyanosis, suffocation, the excessive production of mucous or other bodily fluids from the mouth and nose, convulsions, miosis, nausea, vomiting, and blurred vision. HRW reasonably excluded mustard agents as the likely cause of poisoning and pinpointed an organophosphate, either sarin or VX nerve agent. Given that the chemical poison likely dissipated quickly, shortly after the attack, sarin gas was suspected.
Incidentally the poisonous gas was likely delivered in a so-called binary form, meaning as separate nontoxic ingredients—which are then mixed at the target site and dispersed in droplet form as a result of a warhead explosion. After being inhaled, aerosolized organophosphates like sarin produce their toxicity by irreversibly binding to the enzyme (acetylcholinesterase [AChE]) that breaks down acetylcholine, a ubiquitous neurotransmitter. Symptoms of poisoning are the result of unfettered cholinergic activity throughout the central and peripheral nervous system. Pharmacologic remedies for organophosphate poisoning—after the containment, ventilation, and decontamination (with bleach) of victims—include atropine (which was given to the Ghouta victims), pralidoxime, and benzodiazepines. Pralidoxime specifically removes the organophosphate from AChE.
Photo from cover of HRW’s report, “Attacks on Ghouta: Analysis of Alleged Use of Chemical Weapons in Syria.”
A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on Google + and Twitter.
