<p>Tropane alkaloids and the potential for accidental or non-accidental mass outbreaks of anti-cholinergic toxidrome</p>

Authors

DOI:

https://doi.org/10.31646/gbio.193

Keywords:

Atropine, Scopolamine, Hyoscyamine, Tropane Alkaloids, CBRNE, Anti-cholinergic Toxidrome, Mass Poisoning

Abstract

In December 2022 a large outbreak of anti-cholinergic toxidrome was reported in Australia associated with contamination of baby spinach leaves with Datura stramonium. Over 100 individuals around Australia experienced symptoms consistent with intoxication with the primary plant derived tropane alkaloids scopolamine, hyoscyamine and atropine. Tropane alkaloids are part of a wider group of incapacitating chemical substances that includes the chemical weapon BZ that results in the characteristic anti-cholinergic toxidrome. Human food production and manufacturing processes are prone to accidental and non-accidental contamination with tropane alkaloids, and food quality standards and measures are essential to protecting food security where incorporation of tropane alkaloids is possible. While mass non-accidental contamination of human food production and manufacture is a possibility, historically exposure scenarios involving tropane alkaloids have usually been limited to small scale poisoning events dating back to antiquity. This article summarises the risks of accidental and non-accidental exposure to tropane alkaloids with particular focus on the potential for mass exposure events.

Author Biography

David Heslop, University of New South Wales

FAFOEM FRACGP MBBS PhD MPH BSc (Adv) Hons 1

I am an Associate Professor at the School of Public Health and Community Medicine at UNSW, and retains significant military responsibilities as Senior Medical Adviser for CBRNE to Special Operations Headquarters Australia and to Australian Defence Force (ADF) joint senior leadership. I am a practicing vocationally registered General Practitioner, a Fellow of Occupational and Environmental Medicine with RACP, and a fellowship candidate for the Academy of Wilderness Medicine.

My doctoral research focussed on the central autonomic anatomy and integrative neurophysiology relating to the cardiovascular response to noxious inescapable physiological stimuli such as severe haemorrhage and visceral pain. Utilising my research background and subsequent clinical training, through the ADF I have been fortunate to have extensively deployed into a variety of complex and austere combat environments, and have gone on to undertake advanced training in Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) Medicine and Senior Medical Officer training. Consequently I was appointed as Senior Medical Officer for Special Operations Command for 2014, and was the Officer Commanding and Senior Medical Officer to the ADF CBRNE medical incident response element at Special Operations Engineer Regiment from 2012-2015.

I have extensive experience in the conception, design, planning, delivery and operations of health support systems and capability in remote and austere contexts; incorporating the management of exotic or novel hazards and risks. Extensive actual experience in planning for and management of major disasters, mass casualty and multiple casualty situations. I also have extensive overseas and domestic operational experience in command, personnel management, force protection, health protection systems, resilient systems design and test and evaluation. Direct responsibility and experience with leading deployable expeditionary medical support.

I am regularly consulted and participate in the development and review of national and international clinical and operational CBRNE policy and doctrine. I am additionally a peer reviewer for the journals Military Medicine (AMSUS) and Journal and Military and Veterans Health (AMMA). I also continue to conduct CBRNE medical, and general medical education and ADF GP Registar training within my military capacity, along with civilian instruction of the Major Incident Medical Management System (MIMMS) framework with MIMMS Australia.

My interests lie in health and medical systems innovation and research. I retain linkages with key national civilian and military education, research and development organisations and retain an active involvement in a wide variety of projects and initiatives supporting national public health preparedness goals. My current research effort and interests touch on complexity science, agent based and deterministic modelling, emergent complex adaptive systems phenomena, test and evaluation of systems, policy research, epidemic modelling, exotic and emerging infections, disaster preparedness and response, organisational resilience in health care, development of robust socio-technical systems in health care, and the modelling, simulation and investigation of public health interventions and systems.

Downloads

Published

2023-01-03

How to Cite

Heslop, D. (2023). <p>Tropane alkaloids and the potential for accidental or non-accidental mass outbreaks of anti-cholinergic toxidrome</p>. Global Biosecurity, 5(1). https://doi.org/10.31646/gbio.193

Issue

Vol. 5 (2023)

Section

CBRNE Perspectives and Analytics

License

Copyright (c) 2023 The Author(s)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:
  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).