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Adamsite (DM)

Case Definition: Adamsite (Diphenylaminechloroarsine or DM)

The majority of exposures occur by inhalation and typically lead to symptoms of ocular, nasal, and respiratory tract irritation. Nonspecific gastrointestinal symptoms (e.g., vomiting or diarrhea) might also occur. The effects of adamsite poisoning take minutes to begin and might last for hours (1). If a rapid onset of manifestations of one of the following respiratory effects occurs, the clinical description for adamsite poisoning has been met: nose or throat irritation, cough, or dyspnea.

Laboratory criteria for diagnosis

  • Biologic: No biologic marker is available for adamsite exposure.
  • Environmental: No method is available to detect adamsite in environmental samples.

Case classification

  • Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.
  • Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for adamsite exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
  • Confirmed: A clinically compatible case in which laboratory tests (not available for adamsite) have confirmed exposure.

The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or a 100% certainty of the etiology of the agent is known.

Characteristics

  • APPEARANCE: Light green to yellow crystals (solid) at room temperature. When dispersed by heat, fine particulate smoke; canary yellow when concentrated, colorless when diluted with air.
  • DESCRIPTION: Adamsite (DM) is a vomiting compound that has been used as a riot-control agent (military designation, DM). It is released as an aerosol. Adverse health effects due to exposure to adamsite (DM) are generally self-limited and do not require specific therapy. Most adverse health effects resolve within 30 minutes. Exposure to large concentrations of adamsite (DM), or exposure to adamsite (DM) within an enclosed space or under adverse weather conditions, may result in more severe adverse health effects, serious illness, or death.
  • METHODS OF DISSEMINATION:
    • Indoor Air: Adamsite (DM) can be released into indoor air as fine particles (aerosol).
    • Water: Adamsite (DM) is not soluble in water and cannot be used to contaminate water.
    • Food: Not established/determined
    • Outdoor Air: Adamsite (DM) can be released into outdoor air as fine particles (aerosol).
    • Agricultural: If adamsite (DM) is released into the air as fine particles (aerosol), it has the potential to contaminate agricultural products.
  • ROUTES OF EXPOSURE: Adamsite (DM) can affect the body through inhalation, ingestion, skin contact, or eye contact. Ingestion is an uncommon route of exposure.

Additional resources

  1. Sidell FR. Riot control agents. In: Zajtchuk R, Bellamy RF, eds. Textbook of military medicine: medical aspects of chemical and biological warfare. Washington, DC: Office of the Surgeon General at TMM Publications, Borden Institute, Walter Reed Army Medical Center; 1997:307-24.

Source: https://emergency.cdc.gov Page last reviewed: April 4, 2018

November 12, 2018
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