Thursday, July 5, 2018

PRO/AH/EDR> Nerve agent poisoning - UK (03): (England) Novichok

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Wed 4 Jul 2018 01:41 BST
Source: Daily Mail [edited]

A couple rushed to hospital by paramedics dressed in hazmat suits were
poisoned by the same nerve agent used against former Russian spy
Sergei Skripal, police confirmed.

Female victim DS, 44, and her partner male victim CR, 45, are fighting
for life after they were exposed to the deadly Novichok substance in
Amesbury [England] on [Sat 30 Jun 2018].

They were exposed just 300 yards [275 m] from where Mr Skripal and his
daughter ate on the day they were poisoned 4 months ago, and it was
feared this could be leftover toxin from then. [This seems unlikely -

Confirmation of the poisoning came hours after dramatic video emerged
of one of the victims being loaded into an ambulance by a paramedic
wearing hazmat gear.

CR, a registered heroin addict, was lying on his back in a stretcher
as the paramedic in a white protective suit pushed it inside as 2
police officers watched on.

DS lives in a homeless shelter close to the Zizzi's restaurant in
Salisbury where the Russian spy and his daughter were targeted 4
months ago.

Assistant Commissioner of Specialist Operations [ACSO] Neil Basu said
blood samples were tested at the UK's Defence Science and Technology
Laboratory at Porton Down and confirmed to be Novichok.

'Following the detailed analysis of these samples, we can confirm the
man and woman have been exposed to the nerve agent Novichok, which has
been identified as the same nerve agent that contaminated both [Sergei
Skripal and his daughter],' he said.

'The latest update we have from the hospital is both patients remain
in a critical condition. Both are British nationals and are local to
the area. Officers are still working to identify their next of kin.

'The priority for the investigation team now, is to establish how
these 2 people have come into contact with this nerve agent.'

[ACSO] Basu said no one else had presented with the same symptoms so
far. He said about 100 detectives from the Counter Terrorism Policing
Network were investigating along with local Wiltshire Police, and had
already locked down areas they were believed to have been. They
included a public rubbish bin in the corner of Street just yards from
the John Baker House homeless shelter where DS lives.

A Boots [pharmacy] where CR picked up his prescription after his
exposure, and the Amesbury Baptist Church were also locked down by

It was believed the couple may have attended a village fete on [Sat 30
Jun 2018], run by the church, on Raleigh Crescent.

'I do want to reassure the public, however, that there is no evidence
either the man or woman recently visited any of the sites that were
decontaminated following the attempted murders of [the Skripals],'
[ACSO] Basu said.

Initially police believed the pair, understood to be recreational drug
users, had come into contact with a contaminated batch of class A

But on [Wed 4 Jul 2018] a major incident was declared after it emerged
the substance could be poison -- with Scotland Yard and the Ministry
of Defence drafted in to help investigate.

Wiltshire Police said it was 'open-minded' about the cause and said it
was not clear whether a crime had been committed.

[ACSO] Basu said police presence would be beefed up in Salisbury and
Amesbury similar to how it was when the Skripals were attacked.

Officers would be wearing protective clothing and testing various
sites -- likely the ones already cordoned off -- but this was just a
precaution. 'This is a precautionary, but necessary measure that
allows officers to safely carry out meticulous and systematic searches
for evidence to support the investigation,' he said. 'This must be
done with great care as you will appreciate, to ensure there is no
outstanding risk to both those brave officers and the public.'

[ACSO] Basu said he understood there would be speculation the 2
poisonings were linked but the 'complex' investigation into the
Skiprals' attempted murders was still ongoing.

'Detectives continue to sift through and assess all the available
evidence and are following every possible lead to identify those
responsible, for what remains a reckless and barbaric criminal act,'
he said.

'We are not in a position to say whether the nerve agent was from the
same batch that the Skripals were exposed to. The possibility these 2
investigations might be linked is clearly a line of enquiry for us.

'It is important, however, the investigation is led by the evidence
available and the facts alone and we don't make any assumptions.'

He said Public Health England (PHE) said, based on the number of
casualties affected, it was not believed there was a significant
health risk to the wider public from either poisoning. England's chief
medical officer Dame Sally Davies told residents not to be alarmed,
even if they had visited the areas now cordoned off since the couple
were exposed.

'My advice for any individual who may have been in any of the areas
now cordoned off from 10 pm on Friday evening [29 Jun 2018] onwards is
highly precautionary,' she said.

'As before, my advice is to wash your clothes and wipe down any
personal items, shoes, and bags with cleansing and baby wipes before
disposing of them in the usual way.

'This is the same public health advice I gave during the previous
incident, but now as a belt and braces approach.

'I should also warn the public to be careful, as always of picking up
any unknown or already dangerous objects such as needles and

'You do not need to seek advice from a health professional unless you
are experiencing symptoms as any individual, who had been
significantly exposed at the same time, would by now, have symptoms.'

What is the Novichok nerve agent used against the Skripals?
- The Novichok nerve agent is among the most deadly poisons ever
- They were secretly developed by the Soviet Union during the height
of the Cold War in the 1970s and 1980s.
- Communist scientists developed the poison so it would not be able to
be detected by NATO's chemical detection equipment.
- They come in the form of a ultra-fine powder; Novichok is up to 8
times more potent than the deadly VX gas.
- Victims who are poisoned by the powder suffer muscle spasms,
breathing problems and then cardiac arrest.
- There is a known antidote to the nerve agent -- atropine can block
the poison.
- But doctors find it very tricky to administer the antidote because
the dose would have to be so high it could prove fatal for the
- Novichok poisons are highly dangerous to handle, requiring the
expertise of skilled scientists in a sophisticated lab.
- Dr Vil Mirzayanov, former Chief of the Foreign Technical
Counterintelligence Department at Russia's premiere, was among the
team of scientists who helped develop the agent.
- In an article about the lethal weapon, he wrote: 'They are extremely
dangerous -- most likely lethal -- for people who would try to
synthesise or manipulate them without the help of highly experienced
scientists and engineers in special laboratory installations observing
extreme safety measures.
- "Without exception, Novichok weapons cannot be used for any reason
without specially trained military personnel under medical

Communicated by:

Date: Wed 4 Jul 2018
Source: Fox News [edited]

A British couple hospitalized in critical condition were exposed to
the same nerve agent that nearly killed former Russia spy Sergei
Skripal and his daughter in March [2018], London's Metropolitan Police
said [Wed 4 Jul 2018].

Authorities did not say whether the couple, identified by multiple
media outlets as 45-year-old CR and 44-year-old DS, were exposed to
the same batch of Novichok that poisoned [the Skripals]. Samples from
both patients had been sent to the Porton Down defense research
laboratory for testing.

Metropolitan Police spokesman Neil Basu said the agency's
counterterrorism officers were leading the investigation.

"The possibility these 2 investigations might be linked is clearly a
line of enquiry for us," said Basu, who added that there was "nothing"
in the couple's background to suggest that they were targeted for
poisoning. No one else has reported similar symptoms to the victims.

Wiltshire Police declared a "major incident" earlier [Wed 4 Jul 2018],
4 days after the couple were found unconscious at a home in Amesbury.
Amesbury is 8 miles [about 13 km] from Salisbury, where the Skripals
were found unconscious 14 Mar 2018.

Authorities said they initially believed the couple fell ill after
using heroin or crack cocaine from a contaminated batch of drugs.

Prime Minister Theresa May's office said she was being kept updated on
the case, "which understandably is being treated with the utmost

Sergei Skripal, a former Russian intelligence officer, was convicted
of spying for Britain before coming to the UK as part of a 2010
prisoner swap.

After spending weeks in critical condition, the Skripals were released
from the hospital and taken to an undisclosed location for their
protection. Doctors say they don't know what the long-term prognosis

Britain accuses Russia of poisoning the Skripals, a claim Moscow
strongly denies. The case sparked a diplomatic crisis between Russia
and the West, including the expulsion of hundreds of diplomats from
both sides.

The 2 Amesbury victims were at Salisbury District Hospital, which also
treated the Skripals.

SH, a friend of the couple, told the Associated Press that he was with
the couple on [Sat 30 Jun 2018] when they fell ill. He said CR told
him that "DS was complaining of a headache, so she went to have a bath
and then he [heard] a thump in there and she was on the floor having a
fit and foaming at the mouth."

Hours later, SH said CR was packing his belongings to visit DS in the
hospital when "he started sweating really badly, so he had a shower,
and then he went to his room for a bit, got to rest, come out and he
was a bit tired and sat down for a bit and then that's when he got up
and started acting weird and he said he felt he had been poisoned and
then he was rocking against the wall making funny noises and his eyes
were wide open, glazed, red, and pinpricked and he was just sweating,
dribbling, making weird noises, I was speaking to him and was getting
no response."

The day before, SH said he and the couple were in Salisbury's Queen
Elizabeth Gardens, not far from where the Skripals were found foaming
at the mouth and slipping in and out of consciousness.

"They must have picked up something ... and got contaminated because
no one else we were with had been poisoned and no one else is sharing
the symptoms," SH said. "It's just them 2."

Police have cordoned off the park as well as a home in Amesbury,
believed to be CR's, and other places the pair visited that day,
including a church and a pharmacy. Basu described the cordon as a
"precautionary measure while we continue to investigate how they came
into contact with the substance."

Salisbury and surrounding towns have only recently begun to recover
from the frightening weeks at the center of an international spy

Police from 40 departments in England and Wales returned home in June
[2018] after months working on the Skripal case, and specially trained
workers have spent months decontaminating sites around the city.

The British government has pledged 2.5 million pounds (USD 3.3
million) to local businesses to make up for lost revenue in the area,
which is a gateway to Stonehenge, the ancient stone circle that is a
huge tourist destination.

"Amesbury's a lovely place -- it's very quiet, uneventful," said a
resident. "So for this to happen, and the media response and the
uncertainty, it's unsettling."

[Byline: Samuel Chamberlain]

Communicated by:

[In the March 2018 case the agent was determined to be Novichok [early
reports also said the sample included another agent, BZ (or 3Q, a BZ
precursor), but that has been denied by the Organisation for the
Prohibition of Chemical Weapons, as noted here:
- Mod.JH] There was also a determination that the agent was somewhat
aged and perhaps not as powerful, thereby possibly allowing the
Skripals to survive. If this was the case, then if this incident were
caused by part of the same batch, it may be perhaps weaker or more
deteriorated. It could also be the same substance but a newer batch,
making it as, or perhaps more potent than what the Skripals

Regardless, we wish these victims the best of care and a speedy

The perpetrator may have selected this couple by accident or because
DS lived at a homeless shelter, perhaps implying she might not be as
likely to have some one to help her. But as she had moved in with CR,
this clearly was not the case. Whether one or both of these
individuals was exposed at the same time or one was exposed initially
and the other as a secondary contact has not been determined. What is
pretty certain is this was not the illicit drugs which may have
initially been suspected.

The close proximity of this case to the previous case is concerning
and understandably may have residents in the area nervous. However,
this may indicate the perpetrator lives in the area. Or perhaps one of
the individuals is believed, rightly or wrongly, to have an
association with the previous victims. Alternatively, these victims
may have nothing to do with the previous victims but were exposed by
eating or touching something the previous investigation had failed to
notice, or it was placed a 2nd time to see the response.

This last suggestion is worrying as the perpetrator may be gauging the
response and learning from it. These 2 incidents make me wonder
whether a larger event is being planned. Or was this mere

To understand what Novichok is, and what it does, readers are directed
to the moderator's comments on ProMED-mail archive no. - Mod.TG

HealthMap/ProMED-mail maps:
Amesbury, England, United Kingdom:
Salisbury, England, United Kingdom:

[See Also:
Undiagnosed toxic agent - UK (02): (England) nerve agent
Undiagnosed toxic agent - UK: (England) nerve agent susp]
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