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Syndromic Surveillance for Chemical Terrorism Agents:
Concise Clinical Syndrome Descriptions

Nerve agents (e.g., Sarin, Tabun, VX)

Neurological symptoms similar to pesticide poisoning but with no obvious pesticide exposure. Onset is likely to be within minutes of exposure.

  • Mild/Moderate: miosis, dim vision, rhinorrhea, salivation, dyspnea
  • Severe: above plus severe breathing difficulty, muscle twitching or paralysis, convulsions, loss of consciousness.


Eye and airway irritation, dyspnea, chest tightness followed by pulmonary edema, especially if associated with odor of newly mown hay or grass.

Mustard agents

Erythema and blisters on skin, possibly associated with conjunctivitis and respiratory symptoms. May be followed by gastrointestinal effects and bone marrow suppression.

Cyanide vapor

Diaphoresis, dizziness, nausea, vomiting and headache followed by convulsions and cessation of respirations and heartbeat. Skin may appear flushed, but also may be normal or cyanotic. Metabolic acidosis. Reports of almond like odor.

And, any other unusual chemical exposure with no known explanation.

Thanks to the San Francisco Department of Public Health for much of the material provided on these pages.

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