TY - JOUR
T1 - Multiple poisonings with sodium azide at a local restaurant
AU - Schwarz, Evan S.
AU - Wax, Paul M.
AU - Kleinschmidt, Kurt C.
AU - Sharma, Kapil
AU - Chung, Wendy M.
AU - Cantu, Gabriela
AU - Spargo, Erin
AU - Todd, Elizabeth
PY - 2014/4
Y1 - 2014/4
N2 - Background Sodium azide is a chemical with a mechanism similar to cyanide. There is concern that it could be used as a chemical warfare agent. Objectives We report a cluster of poisonings that occurred at a public restaurant and the subsequent investigation that identified iced tea contaminated with sodium azide (NaN3) and hydrazoic acid, as the foodborne vehicle and agents, respectively. Case Report Five patients became ill within minutes of drinking iced tea at a restaurant. They all presented to the same Emergency Department with similar symptoms, and improved with fluids, antiemetics, and supportive care. A joint investigation by the Dallas County Department of Health and Human Services, the Texas State Health Department, the Dallas County Southwestern Institute of Forensic Sciences, and the medical toxicologists at the University of Texas Southwestern School of Medicine identified iced tea, contaminated with sodium azide (NaN3) and hydrazoic acid, as the foodborne vehicle and agents, respectively. Conclusion The recurrence, and seriousness, of these events suggests a need for continued education of emergency providers. Emergency physicians should consider exposures to toxic chemicals in their differential when a cluster of patients presents with similar symptoms over a short period of time.
AB - Background Sodium azide is a chemical with a mechanism similar to cyanide. There is concern that it could be used as a chemical warfare agent. Objectives We report a cluster of poisonings that occurred at a public restaurant and the subsequent investigation that identified iced tea contaminated with sodium azide (NaN3) and hydrazoic acid, as the foodborne vehicle and agents, respectively. Case Report Five patients became ill within minutes of drinking iced tea at a restaurant. They all presented to the same Emergency Department with similar symptoms, and improved with fluids, antiemetics, and supportive care. A joint investigation by the Dallas County Department of Health and Human Services, the Texas State Health Department, the Dallas County Southwestern Institute of Forensic Sciences, and the medical toxicologists at the University of Texas Southwestern School of Medicine identified iced tea, contaminated with sodium azide (NaN3) and hydrazoic acid, as the foodborne vehicle and agents, respectively. Conclusion The recurrence, and seriousness, of these events suggests a need for continued education of emergency providers. Emergency physicians should consider exposures to toxic chemicals in their differential when a cluster of patients presents with similar symptoms over a short period of time.
KW - hydrazoic acid
KW - metabolic inhibitors
KW - poisoning
KW - sodium azide
KW - terrorism
UR - http://www.scopus.com/inward/record.url?scp=84898597846&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2013.08.082
DO - 10.1016/j.jemermed.2013.08.082
M3 - Article
C2 - 24262061
AN - SCOPUS:84898597846
SN - 0736-4679
VL - 46
SP - 491
EP - 494
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 4
ER -