Wiltshire Couple Poisoned by Novichok Spy Nerve Agent

Peter Russell

July 05, 2018

Counter terrorism police have an investigation after two people in Wiltshire were found unconscious as a result of contamination from the nerve agent Novichok – the same agent used to poison former Russian spy Sergei Skripal and his daughter Yulia in Salisbury.

The couple, Charlie Rowley, 45, and Dawn Sturgess, 44, fell ill at a house in Amesbury and were said to be in a critical condition in hospital.

The investigation become a murder inquiry after Dawn Sturgess died from the poisoning. Charlie Rowley has since been released from hospital.

Professor Dame Sally Davies, chief medical officer for England, said officials had a "well-established response" in place because of the original poisoning incident in March".

She added: "I understand that those in Salisbury and in surrounding areas will be concerned at this news, particularly those who recently visited areas now cordoned off by police." However, she advised that the risk to the public remained low and that the response was "highly precautionary".

We asked two experts for their response to the latest situation. Alastair Hay is professor emeritus of environmental toxicology at the University of Leeds, and Dr Christopher Morris is a senior lecturer at the Medical Toxicology Centre at Newcastle University. 
 

Q&A

Medscape UK: Can we start with basics, what is Novichok?

Prof Hay: "They're like all the nerve agents. They belong to this family of chemicals – organophosphates – and they inhibit a specific enzyme – acetylcholinesterase – which regulates messages between nerves and muscles.

And when that enzyme is inhibited, you get over-stimulation of muscles because the regulator is just not removed from the muscle. So, muscles go into spasm; and that's all the muscles, your voluntary and involuntary muscles. So, it's the ones affecting your heart, your gut, your bladder, your eyes, and then the voluntary ones that control whether you stand up or sit down, and your breathing – they're all compromised too.

Medscape UK: And what happens after poisoning?

Prof Hay: So, the most serious one obviously is on breathing, which becomes very difficult and then will eventually stop because you can't inhale and exhale; and you get massive secretions into the lungs as well and down the nose which complicates the breathing.

And then you also have an effect on the brain itself, so people become confused, start to hallucinate, and then will collapse; and there's a massive risk of seizures, which can also affect oxygenation of the brain.

Medscape UK: That sounds extremely serious. Are there any treatment options?

Prof Hay: It's oxygenation of the brain that one has to sustain, and that's the whole purpose of treatment – keeping circulation going and oxygenation working.

And it's the compromised breathing that is the most serious issue for people which can compromise recovery if there's any brain damage.

Medscape UK: Four months on from the original poisoning, how has this happened now several miles away in Amesbury?

Prof Hay: I think everybody will be surprised. I was stunned really. But I suppose when you think about it, what the authorities were able to do was track the movements of the Skripals, and that would have indicated the possible sources of contamination.

But there may have been something leading up to that, and there may have been something discarded after that, and it's possible that there was some contamination in some other source. All the evidence suggests it was probably something resulting from the earlier incident, but until we know more we can't be entirely certain.

Dr Morris added: Like most organophosphate compounds, it will degrade with time. But the possibility of it staying around for months wouldn't surprise me if it was in a pure form, away from any particular contaminations.

If it was in soil, I would expect it to degrade. If it was in water, it would dilute and probably degrade as well. If it was on a hard surface, sunlight would start to degrade it as well.

Medscape UK: Dame Sally Davies said there was no cause for public alarm – is that right?

Dr Morris: I think that's right. I think the assumption has been that the initial poisoning was a very targeted approach and that somebody has come along, they've targeted Sergei Skripal individually, and that's where the exposure has been.

And any compound anywhere else has been because it's been associated with the Skripals and it's just simply moved about and come off clothing hands, etc.

Prof Hay added: But I think for the routine activities that people have done, unless it's something very unusual, then they should be reassured, because if they haven't got symptoms by now, then they're not going to get them.
 

Editor's note: This article was updated to include the news of Dawn Sturgess' death and Charlie Rowley being released from hospital.

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