USE OF TOXINS AND OTHER LETHAL CHEMICALS IN SOUTHEAST ASIA AND AFGHANISTAN

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 05184036
• Release Decision: RIFPUB
• Original Classification: U
• Document Page Count: 88
• Document Creation Date: December 28, 2022
• Document Release Date: September 26, 2017
• Case Number: F-2012-01432
• Publication Date: February 16, 1982

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SECRET
USE OF TOXINS AND OTHER LETHAL CHEMICALS
IN SOUTHEAST ASIA AND AFGHANISTAN
16 February 1982
This document is UNCLASSIFIED after NFIB approval,.
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CONTENTS
KEY JUDGMENTS
Page
1
Laos
1
Kampuchea
1
The Soviet Role in Southeast Asia
1
Afghanistan
1
DISCUSSION
3
Background
3
Methodology
4
Laos
5
Kampuchea
8
Afghanistan
10
What Chemical Agents Are Being Used'
12
Soviet Chemical Warfare Activities
14
CONCLUSIONS
17
ANNEXES
A. Tabulations of Reported Chemical
Warfare Attacks
A-1
B. A Lao Pilot's Story
B-1
C. US Army Surgeon General's Investigative
Team Report
C-1
D. Analysis and Review of Tricothecene
Toxins
D-1
E. Medical Evidence
E-1
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KEY JUDGMENTS
Laos
Lao and Vietnamese forces, assisted by Soviet logistics
and Supervision, have used lethal chemical agents against
H'Mong resistance forces and villages, causing thousands of
deaths since at least 1976. Trichothecene toxins have been
positively identified as one of the classes of agents used,
but medical symptoms indicate that irritants, incapacitants,
and nerve agents also have been employed.
Kampuchea
Vietnamese forces have used lethal trichothecene toxins
on Democratic Kampuchean troops and Khmer villages since at
least 1978. Again, medical symptoms indicate that irritants,
incapacitants, and nerve agents also have been used.
The Soviet Role in Southeast Asia
The one hypothesis that best fits all the evidence
is that the trichothecene toxins were developed in the Soviet
Union, provided to the Lao and Vietnamese either directly
or through transfer of technical know-how, and weaponized
with Soviet assistance in Laos, Vietnam, and Kampuchea.
There is no intelligence at hand to support alternative
explanations, such as completely independent manufacture
and use by the Vietnamese. It is highly probable that the
USSR also provided other chemical warfare agents. While the
evidence on the Soviet role does not constitute proof in the
scientific sense, the Intelligence Community finds the case
to be thoroughly convincing.
Afghanistan
Soviet forces in Afghanistan have used lethal and casualty-
producing agents on Mujahedin resistance forces and Afghan
villages since the December 1979 invasion. There is some
Note: This paper is Unclassified.
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evidence that Afghan Government forces may have used chemical
weapons provided by the USSR against the Mujahedin even
before the invasion. No agents have been identified through
sample analysis, but we conclude from analysis of all the
evidence that attacks have been conducted with irritants,
incapacitants, nerve agents, phosgene oxime, and perhaps
trichothecene toxins, mustard, lewisite, and unidentified
toxic smokes.
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DISCUSSION
Background
1. In September 1981 the US Government in a public
declaration raised the probability that the trichothecene
class of toxins*--poisonous chemical substances extracted
from biological material (specific molds)--was the mysterious
lethal agent that had been used for many years in Laos and
Kampuchea. This significant statement was precipitated by the
discovery of high levels of trichothecene toxins in a vege-
tation sample collected shortly after a March 1981 Vietnamese
chemical attack in Kampuchea. That public declaration, how-
ever, rested on a much broader base of evidence than the
analysis of that sample.
2. In April 1980 the Intelligence Community had al-
ready concluded that lethal agents had almost certainly
been used against H'Mong tribespeople in Laos. There was
less certainty about the use of lethal agents in Kampuchea,
mainly because of suspicions about the propaganda campaign
of Pol Pot's Democratic Kampuchean (DK) forces. The DK
claims were subsequently shown to be valid. It was also
concluded that chances were about even that lethal agents
had been used in Afghanistan. There was little doubt by
this time that riot control agents and some form of incapac-
itants had been used in all three countries. Since mid-1980,
sufficient additional evidence has allowed a much firmer
Intelligence Community judgment than that stated in the April
estimate. There is now no doubt that deaths and casualties
have resulted from chemical attacks in all three countries.
3. Analysis of additional samples from Laos and
Kampuchea has revealed at least four trichothecenes, further
supporting our conclusion that toxins were used. A review
of all the reports indicates the use of many different
chemical agents, means of delivery, and types of chemical
attacks. In some cases, the symptoms are typical of those
caused by trichothecenes, but in many cases the symptoms
suggest other agents, which we have not been able to identify
* Trichothecene toxins, like all other toxins, are chemical
compounds derived from biological material. For purposes
of this assessment, toxins are characterized as chemical
warfare agents. Their manufacture, however, would most
likely take place in biological warfare facilities, even
if the toxins were synthetically produced.
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through sample analysis. Significant differences as well as
similarities have surfaced in the reports from the three
countries. The evidence from each country, therefore, is
described separately, with attention drawn to similarities
where appropriate.
Methodology
4. The intelligence judgments of this study were ar-
rived at through the following analytic process:
Every relevant piece of information oh reported
chemical warfare incidents was reviewed, recorded,
and tabulated (see annex A). Numbers, of attacks
and deaths were screened for pdtential duplication.
An extensive data base on the Soviet chemical and
biological warfare program was also searched.
All the physical evidence available to the US
Government--including environmental samples and
background controls--was reviewed (see annex D).
mmt
11/01,
spa ea/
A scientific report on toxins was prepared, in-
cluding the analysis leading to the conclusion
that trichothecenes were probably among the
agents used in Southeast Asia. The report also
documents the extensive toxin research conducted
in the USSR (see annex D).
An analysis of the medical evidence was prepared,
drawing on all available infOrmation from Southeast
Asia and Afghanistan (see annex E). This incor-
porated the findings of the Department of Defense
medical team (see annex C), which concluded that at
least three types of agents were used in Laos.
Extensive consultations were held with government
and nongovernment scientists and medical authori-
ties, many of whom were asked to review our evi-
dence. Experts from other countries were also
consulted.
5. After the data base was organized to permit com-
parative analysis, the study focused on three separate ques-
tions:
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Have lethal and other casualty-producing agents
been used in Southeast Asia and Afghanistan?
-- What are these agents and how and by whom are
they employed?
-- Where do these agents originate and how do they
find their way to the field?
6. Although the evidential base differs for each coun-
try, the analytic approach used was the same. The testimony
of eyewitnesses--date, place, and type of attack--was matched
against information from defectors, journalists, and inter-
national organizations and sensitive information that often
pinpointed the time and place of chemical attacks. In addi-
tion, the intelligence files on military operations in the
areas where chemical attacks had been reported were searched
to establish whether air or artillery strikes took place
or whether there was fighting in the areas where chemical
agents were reportedly used. In all three countries, we
identified a number of instances in which eyewitness ac-
counts could be directly correlated with information from
other sources.
7. There is no evidence of any systematic propaganda
campaign having been mounted by the H'Mong or the Afghan
resistance forces to promote the allegation that chemical
agents have been used on their people. Rather it was
the US Government, other governments, and private indivi-
duals from many countries that publicized the use of chemi-
cal agents and that provided the evidence to international
organizations. On the other hand, there were early indica-
tions that Pol Pot's Democratic Kampuchean resistance did
engage in an organized propaganda campaign on chemical agent
use. These indications made us very cautious about accept-
ing DK allegations, which increased markedly after the
chemical attacks in Laos were publicized. For Kampuchea,
therefore, we were particularly insistent in our efforts
to confirm allegations made with sources of information
that in no way could be part of a propaganda or deception
campaign.
Laos
8. Reports of chemical attacks in Laos date from the
summer of 1975 to the present. These reports describe
261 separate attacks in which at least 6,504 deaths were
cited as having resulted directly from exposure to chemical
agents.
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9. The actual number of deaths is almost certainly
much higher, since the figure above does not take account
of deaths in attacks for which no specific casualty numbers
were reported. The greatest concentration of reported use
of chemical agents occurred in the area where the three prov-
inces of Vientiane, Xiangkhoang, and Louangphrabang adjoin
(see map, figure 1). This triborder region accounted for
77 percent of the reported attacks and 83 percent of the
chemical-associated deaths. Most of the reported attacks
took place in 1978 and 1979. In the past two years, the
incidence of chemical attacks appears to have been lower,
but reported death rates among unprotected and untreated
victims higher--only seven chemical attacks were reported
in the fall of 1981, for example, but 1,034 deaths were
associated with those incidents.
10. Evidently the fact that chemical agents were being
used in Laos was not widely known among units of the Lao
People's Liberation Army (LPLA). In June 1981, a group of
refugees from a village in Vientiane Province reached Thailand
and described attacks against them carried out a month earlier
by helicopters "dropping poison" into their water supply.
Lao field units that subsequently entered the village were
surprised at the sight of many villagers still suffering from
symptoms of acute poisoning. According to the villager, when
the Lao military personnel saw the "small yellow grains"
spread around the village, they were convinced that toxic
chemicals had been used on the village and requested medical
assistance for those villagers still suffering from nausea
and bloody diarrhea.
11. In a 15 December 1981 press conference in Beijing,
former Lao Health Ministry Bureau Director Khamsengkeo
Sengsthith--who had defected to China--claimed that the
Vietnamese were using chemical weapons "in the air and on
the ground" in Laos, killing "thousands." He asserted
that the Vietnamese alone were using such weapons, keeping
the matter secret from the Lao. He also stated that 3,000
Soviet advisers are in Laos and "have taken control" of
the Lao Air Force, while 40,000 to 50,000 Vietnamese troops
have reduced Laos to the status of a colony.
12. Obtaining corroborative data for Laos has been
difficult simply because of the nature of the fighting there.
There have been few major operations. Rather, the reports
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reflect numerous minor engagements between the opposing forces,
and results of these encounters are rarely reported. This is
consistent with the observation that the resistance forces are
splintered, operating in small, discrete units that emphasize
sabotage and unconventional warfare. Finally, in nearly all
cases, the chemical use reported has been directed against
villages, in the absence of obvious combat operations. This
substantiates a Lao pilot's claim that the Vietnamese and
Laotian military commands were engaged in a "H'Mong exterm-
ination." campaign.
13. Of particular interest are the circumstances sur-
rounding the collection of two physical samples that were
found to contain lethal toxins. The first sample was col-
lected after a 13 March 1981 attack on a village between the
villages of Muony Chai and Phakhao in the Phou Bia region.
In this case, a large two-engine plane reportedly sprayed
a mist of a moist, yellow, sticky substance; two villagers
and all village animals died. The second sample is from
Ban Thonghak, another village in the Phou Bia region. That
sample was collected following a 2 April 1981 attack in
which an jet aircraft reportedly sprayed a yellow substance;
24 of the 450 villagers died. Seven separate chemical at-
tacks, resulting in 218 deaths, were reported to have occurred
in this region in the spring of 1981.
14. It is significant that these attacks took place
following a period of escalation in overall resistance activ-
ities in the Phou Bia area in the winter of 1980-81. During
that period, suppression operations by LPLA and Vietnamese
Army (PAVN) forces had achieved only limited success, perhaps
spurring both forces on to greater effort. The more intense
use of chemical weapons may have been part of this effort.
15. Every qualified interrogator who systematically
interviewed the H'Mong refugees concluded that the latter had
been subjected to chemical attacks. For example, the US
Government medical team returned from Thailand in 1979 con-
vinced that several unidentified chemical warfare agents had
produced the symptoms described by the refugees. It was the
testimony of a Lao pilot who flew the chemical warfare
missions that helped dispel any lingering suspicions that
the refugees had fabricated or embellished the stories.
His detailed description of the Lao, Vietnamese, and Soviet
program to defeat the H'Mong resistance with chemical agents
appears in annex B.
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16. The Lao pilot described the chemical rocket he
had fired as having a more loosely fitting warhead than a
conventional rocket. In 1977 a H'Mong resistance leader
found a US 2.75-inch rocket with a modified Soviet warhead
that fits this description. In further corroboration, other
sources reported that US 2.75-inch rockets were fitted with
lethal chemical warheads by Soviet and Vietnamese technicians
at facilities in three Laotian provinces. Munitions storage
facilities suitable for storing chemical agents and weapons
have been identified in each of these provinces. The aircraft
types--L-19s, T-41s, T-28s, and AN-2s--most often reported by
the H'Mong refugees as being used to deliver chemical agents
have been identified as based on airfields in northern Laos
throughout this period.
Kampuchea
17. For Kampuchea we have reports of 124 separate at-
tacks, from 1978 to the present, in which lethal chemicals
caused the deaths of 1,014 individuals. Here again, the
mortality figure represents a minimum because some reports
state only that there were deaths and do not provide a
number. The earliest reports cite attacks in Ratanakiri
Province, in the northeastern corner of the country (see
map, figure 2). Reports from 1979 to the present show the
use of lethal chemicals primarily in the provinces border-
ing on Thailand. The greatest use of chemical agents
apparently has been in Battambang Province (51 reported
incidents); Pursat Province has suffered the next highest
frequency, with 25 reported incidents. These numbers are
consistent with the overall high level of military activity
reported in the border provinces.
18. A review of reports from all sources provides specific
support for 28 of 124 reported attacks. There is, in addition,
some circumstantial evidence that in all reported instances some
form of attack took place. This evidence includes reports of
troop movements, supply transfers, operational plans, postoper-
ation reporting, and air activity reports. It indicates that
military activity took place al: the time and place of every
incident reported to involve lethal chemical agents. In some
cases, it provides strong circumstantial indications that the
action involved chemical substances--for example, the movement
of chemicals and personal protection equipment in the area.
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19. US analysis of contaminated vegetation samples from
a March 1981 attack showed high levels of three trichothe-
cene toxins in a combination that we would not expect to be
found in a natural outbreak in this environment. These
three trichothecenes at the levels found on the vegetation
would produce the vomiting, skin irritation and itching, and
bleeding symptoms. Water samples taken from the area of the
same attack also contained trichothecene toxins. Control
samples from nearby areas confirmed that these toxins are
not indigenous to the locale. (Details on the sample analy-
sis appear in annex D.)
20. There is also ample evidence of military activ-
ity at the place and time of the acquisition of the samples.
PAVN defectors described plans for multiregimental sweep
operations to be conducted along the border in north-western
Battambang Province before the end of the dry season in May.
Actual fighting, however, continued to be characterized by
guerrilla tactics on both sides, including, according to one
PAVN defector, "staging ambushes, laying minefields, and use
of deception." Indeed, DK forces were ordered to avoid large-
scale operations, to limit combat operations to scattered
sapper attacks. Such information is consistent with other
reports of PAVN forces spreading toxic chemicals along streams
and roadsides and around villages, and firing toxic gas shells
against enemy positions. In sum, the Phnom Melai sector (in
which Phnom Mak Hoeun is located) was described as an "anthill
of DK activity," and actions reported during March were
"sporadic firefights" around Phnom Mak Hoeun involving PAVN
forces.
21. In Kampuchea as in Laos, the period of late 1980
through spring 1981 was one of intensified Vietnamese opera-
tions to suppress the resistance, and the Vietnamese may
have considered the use of toxins an effective means of
breaking the will of the opposing forces.
22. Additional supporting evidence was derived from
blood samples drawn from victims of PAVN chemical use
that reportedly occurred on 19 September 1981 in the Takong
area. (Blood analysis appears in annex E.) Takong is in
the same general area as Phnom Mak Hoeun--that is, the central
region of the Battambang Province - Thailand border. Again,
there is no independent confirmation of the accounts of the
attacks, but medical personnel visiting the DK field hospital
examined the victims and obtained blood samples. Analysis of
these samples suggested the use of tricothecenes.
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23. The chemicals used in the 19 September Takong at-
tack were dispersed (according to the DK soldiers affected)
as a gas or powder, and as a poison to water. The gas or
powder was released from containers by tripwires in the
area of the rear forces. This description is consistent
with the other reporting in this area and time.
24. In sum, substantial evidence on the Vietnamese
use of chemical weapons existed before the discovery of
trichothecene toxins in vegetation and water samples. We
share the Thai's concerns about chemical attacks against their
own people, especially after one Thai died and others became
ill from Vietnamese poisoning. In May 1981 the Thai captured
two Vietnamese in the act of poisoning water with cyanide in
a Thai relocation camp. A number of reliable reports indicate
that it is common practice for PAVN units to poison water and
food used by the DK forces.
Afghanistan
25. Attacks with chemical weapons against the Mujahedin
guerrillas in Afghanistan were reported as early as six months
before the Soviet invasion on 27 December 1979. The reports
specify only that Soviet-made aircraft were used to drop
chemical bombs, with no clear identification of Soviet or
Afghan pilots, or of the specific agents used. A number of
Afghan military defectors stated that the Soviets provided
the Afghan military with chemical warfare training as well
as supplies of lethal and incapacitating agents.
26. For the period from the summer of 1979 to the pres-
ent, we have reports of 43 separate chemical attacks with more
than 3,000 chemical-associated deaths (see map, figure 3).
Ten separate chemical attacks, killing considerable numbers
of persons, were reported in the first three months of 1980.
All of the reports came from northeastern Afghanistan and
provide the highest percentage of reported deaths. By the
spring and summer of 1980, chemical attacks were reported
to have occurred in all areas of concentrated resistance
activity. Reports of chemical weapon use in 1981 essenti-
ally parallel 1980 reporting with respect to frequency and
location of attack. Of the 43 chemical attack reports, 36
have come from human sources, including Afghan Army desert-
ers, Mujahedin resistance fighters, journalists, and US
physicians. For 24 of the reported 43 attacks we have
additional independent evidence supporting allegations of
chemical attacks. In seven instances we have additional
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human reporting. For example, an Afghan insurgent provided
an eyewitness account of a 6 July 1980 attack on a village
10 kilometers east of Darae Jelga in Vardak Province. The
insurgent reported that a Soviet MI-24 helicopter gunship
dropped a bomb that, upon explosion, released a lethal chem-
ical. A separate report from a reliable source confirmed
that Soviet aerial bombing attacks were taking place during
this period on villages in Vardak (as well as Lowgar and
Parvan Provinces.)
27. Support for 20 of the reported incidents comes from
ihformation on Soviet or Afghan Army combat operations that
were in progress in areas at times approximating those of a
reported chemical attack. In a few cases, reporting is quite
specific. The following sequence, for example, occurred in
a small valley in Qandahar Province in early June 1981:
Soviet combat groups engaged rebel forces in that valley
during a two-week period, according to an Afghan exile.
The situation worsened for the Soviets and an airstrike was
conducted. The Afghan exile reports that a Soviet helicopter
delivered a single rocket, which released a chemical that
killed 16 insurgents. Nearly all reports state that chemicals
were delivered by aircraft or helicopters, with a few reports
describing chemical artillery rounds.
28. Many reports from different sources strongly support
the use of irritants to drive the insurgents into the open to
expose them to attack with conventional weapons, and incapaci-
tants to render them tractable for disarming and capture. On
several occasions in April 1980, for example, Soviet helicopter
pilots dropped "gas bombs" on insurgents, evidently to drive
them from caves.
29. Victims of Soviet attacks, conducted to flush
them from caves, describe symptoms that cannot be asso-
ciated with riot control agents like CN and CS or even
Adamsite. Medical examinations of some of the victims include
reports of paralysis, other neurological effects, blisters,
bleeding, and sometimes death. While none of the agents being
used in Afghanistan have been positively identified through
sample analysis, it seems clear that the agents being used
are far more toxic than the irritants cited above.
30. Afghan military defectors have provided lists of
the Soviet agents stockpiled in Afghanistan and described
where and when some of them have been used. The list
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included nerve agents, phosgene, phosgene oxime, sulfur
mustard, nitrogen mustard, and lewisite; The agents used,
plus the time and location of the attacks, generally
correspond to the refugee reports and recorded military
operations. Afghan military defectors have also pinpointed
where they are stored.
31. Soviet operational personnel decontamination sta-
tions were observed at two locations in Afghanistan and a
chemical decontamination field unit was deployed during a
sweep operation of the Konar Valley in 1980. In addition,
Soviet personnel have been observed wearing chemical protec-
tive equipment. At Shindan, TMS-65 decontamination units were
deployed in a classical operational mode. This suggests that
the chemical battalions have performed an operational role in
Afghanistan connected with offensive chemical use. A Soviet
chemical specialist told an American news correspondent that
his mission was to examine villages after a chemical attack
to determine whether it was safe to enter or required decon-
tamination. An Afghan pathologist who defected described
how he accompanied Soviet chemical warfare personnel into
contaminated areas to collect soil, vegetation, and water
samples after Soviet chemical attacks. The Soviets, accord-
ing to firsthand experience of former Soviet chemical personnel,
do not require decontamination equipment in an area where
chemical bombs are stored or loaded on aircraft. We thus
associated the deployment of this equipment in Afghanistan with
the active employment of casualty-producing chemical agents.
32. In sum, the eyewitness testimony of Afghan refugees
and journalists about chemical warfare activities is supported
by defectors, as was the case in Laos and Kampuchea. Other
evidence supports the judgment that chemical agents have been
used and that Afghan and Soviet military operations took place
in almost every area where we have reports of chemical attacks.
What Chemical Agents Are Being Used?
33. The specific chemical agents being used in Laos,
Kampuchea, and Afghanistan cannot be determined without
collection and analysis of at least one of the following:
environmental samples contaminated with agent, the muni-
tions used to deliver agents, or biological specimens from
victims of an attack. A study by medical-toxicological
experts of symptoms exhibited by individuals exposed to
toxic agents does provide a good indication of the general
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class of chemical agent used. Thus, the range of clinical
manifestations from chemical agents as reported by a US
Army investigative team resulted in the determination that
nerve agents, irritants such as CS, and a highly toxic
hemorrhaging chemical or mixture of chemicals were used in
Laos. Other medical-toxicological personnel arrived at the
same determination and further indicated that toxins such
as the trichothecenes were a probable cause of the lethal
hemorrhaging effect seen in Kampuchea as well as Laos.
Symptoms reported by the DK in Kampuchea and the Mujahedin
in Afghanistan were in many cases similar to those reported
by the H'Mong in Laos. In addition, symptoms reported from
Afghanistan and Kampuchea indicated that a highly potent,
rapid-acting incapacitant "knockout" chemical also was
being used. Mujahedin victims and witnesses to chemical
attacks reported other unusual symptoms, including a black-
ening of the skin, severe skin irritation with multiple
small blisters and severe itching, severe eye irritation,
and difficulty in breathing--suggesting that phosgene oxime
or a similar substance was used.
34. Collecting samples possibly contaminated with a toxic
agent during or after a chemical assault is difficult under
all circumstances but particularly when the assault is against
ill-prepared people without gas masks and other protective
equipment. Obtaining contaminated samples that will yield
positive traces of specific chemical agents is dependent on
a number of factors. These include the persistency of the
chemical, the ambient temperature, rainfall, wind conditions,
the media on which the chemical was deposited, and the time,
care, and packaging of the sample from collection to analys-
is in a laboratory. Many standard chemical warfare agents
are nonpersistent and disappear from the environment within
a few minutes to several hours after being dispersed. These
include, for example, the nerve agents Sarin and Tabun; the
blood agents hydrogen cyanide and cyanogen chloride; the
choking agents phosgene and diphosgene; and the irritant
phosgene oxime. Other standard CW agents--such as the nerve
agents VX and thickened Soman and the blistering agents sul-
fur mustard, nitrogen mustard, and lewisite--may persist
for several days to weeks depending on weather conditions.
The trichothecene toxins have good persistency but may be
diluted to below detectable concentrations by adverse weather
conditions. To maximize the chances of detection, sample
collections should be made as rapidly after a chemical
assault as possible, and with many agents this means minutes
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to hours. Under the circumstances of Southeast Asia and
Afghanistan this has simply not been possible. While
numerous samples were collected, few of them held any rea-
listic prospect of yielding positive results. It is fortu-
nate that trichothecenes are sufficiently persistent to
allow detection several months after the attack.
35. Samples have been collected from Southeast Asia
since mid-1979 and from Afghanistan since May 1980. To date
about 50 individual samples--of greatly varying types and
usefulness for analytical purposes--have been collected and
analyzed for the presence of traditional CW agents, none of
which have been detected. On the basis of recommendations by
medical and toxicological experts and of findings by the CSL,
many of the samples have been analyzed for the trichothe-
cene group of mycotoxins. Four samples, two from Kampuchea
and two from Laos, were found to contain high levels of
trichothecene toxins. Preliminary results of the analysis of
blood samples drawn from victims of an attack indicate the
presence of trichothecene (T-2) metabolite, but quantifica-
tion of their levels is pending.
36. The accompanying table lists the chemicals and their
probability of use in Afghanistan by Soviet and, in Southeast
Asia, by Vietnamese and Laotian forces. The judgments shown
in this table are based on sample analysis, on collateral and
special intelligence, and on medical and toxicological evalua-
tions.
Soviet Chemical Warfare Activities
37. Evidence accumulated since World War II clearly
shows that the Soviets have been extensively involved in
preparations for large-scale offensive and defensive chemi-
cal warfare. We have identified the chemical warfare agents
and delivery systems they have developed, probable pro-
duction and storage areas within the USSR, and continuing
research, development, and testing activities at the major
Soviet chemical proving grounds. None of the evidence
indicates any abatement in this program. The Soviets have
shown a strong interest in improving or enhancing their
standard agents for greater reliability and effect. Their
large chemical and biological research and development effort
has led them to investigate other kinds of CW agents, partic-
ularly the toxins. A bibliography on Soviet research in the
toxin field is included in annex D.
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Degrees of Confidence in
Identification of Specific
Classes of Chemicals Used in a
Southeast Asia and Afghanistan
Laos
Kampuchea
Afghanistan
Trichothecene
toxins
Confirmed
Confirmed
Suspected
Nerve agents
Probable
Probable
Probable
Irritants
Probable
Probable
Probable
Vesicants and
urticants
Suspected
Suspected
Probable
Incapacitants
Suspected
Probable
Probable
a
The confidence levels shown refer to the identification of
specific chemicals used, not to the probability that some
form of lethal chemical was used. We consider the latter
a certainty.
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38. To our knowledge, none of the four countries--
Vietnam, Laos, Kampuchea, and Afghanistan--has any large-
scale facility or organization for the manufacture of chem-
ical and biological materials. Nor are they known to have
produced even small quantities of chemical warfare agents
or munitions. The technical problems of producing large
quantities of weapons-grade toxin, however, are not so great
as to prevent any of the four countries from learning to
manufacture, purify, and weaponize these materials. It is
highly unlikely, however, that they could master these func-
tions without acquiring outside technical know-how. The only
country known to be providing chemical warfare assistance to
these countries is the Soviet Union.
39. The Soviets have had advisers and technicians work-
ing in Vietnam, Laos, and Kampuchea for many years, but not
until early 1979 did evidence connect the Soviet military
directly with chemical warfare activities. The evidence is
quite conclusive. For example, in early 1979, Soviet military
personnel inspected chemical storage facilities in Paxse. The
chemicals inspected were reportedly those that cause "stomach
sickness and death." This important piece of evidence was
supported by several reliable reports that provided more detail
on the mid-February visit and on another Soviet inspection by
chemical warfare experts in June 1979.
40. Another reliable report stated that the chemical
section in one Lao province prepared Soviet-manufactured
chemical items for inspection by a Soviet military team in
early 1979. A seven-man team of Soviet chemical artillery
experts, accompanied by Laotian chemical officers, inspected
chemical supplies and artillery rounds at the Xeno storage
facility in mid-1979. One report stated that the Soviet team
would be inspecting the same chemical explosives used to sup-
press the H'Mong resistance in the Phou Bia area.
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CONCLUSIONS
Laos. We conclude from all the evidence that
selected Lao and Vietnamese forces, under direct Soviet
supervision, have employed lethal trichothecene toxins and
other combinations of chemical agents against the H'Mong
resistance forces, including their villages, since at least
1976. Thousands have died, have been severely injured, or
were driven from their homeland by the use of these agents.
Kampuchea. The evidence strongly supports the con-C
clusion that the Vietnamese have similarly been using lethal
trichothecene toxins and other combinations of chemical warfare
agents on Democratic Kampuchean forces and other resistance
groups since at least 1978.
Afghanistan. We conclude that Soviet forces in
Afghanistan have used a wide variety of lethal and nonlethal
chemical agents on Mujahedin resistance forces and Afghan
villages since the Soviet invasion.in December 1979. Afghan
Government forces probably used chemical weapons before the
Soviet invasion, but we cannot identify the types of agents
used. It has not been possible to identify the agents used
by the Soviets through sample analysis, but a number of
Afghan military defectors have named the agents brought into
the country and have described where and when they were used.
That information has been correlated with all other evi-
dence, including the reported symptoms. We conclude that
nerve agents, phosgene oxime, and various incapacitants,
and irritants have been used. Other agents and toxic smokes
are also available in country, but we cannot state confi-
dently that they have been used. Some of the reported symptoms
are consistent with those produced by lethal or sublethal
doses of trichothecene toxins, but our evidence is not
conclusive.
The Soviet Role. We conclude that the Soviets
either provided the toxin weapons directly or provided the
toxins for weaponization in Vietnam and Laos. A common
practice in the Soviets' own military forces is to store
agents in bulk and move them to the field for munitions fill
as needed. Our assumption that this practice is also followed
in Indochina and Afghanistan is supported by a number of
reports, which specify that Soviet technicians supervise the
shipment, storage, filling, and loading on aircraft of the
chemical munitions. The dissemination techniques reported
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and observed are evidently drawn from years of Soviet chemi-
cal warfare testing and experimentation. No intelligence
is at hand to support any alternative explanation, but we
cannot completely rule out the possibility that Soviet tech-
nical assistance has enabled at least the Vietnamese to
conduct an indigenous toxin production program.
Motivation for Chemical Weapons Use. In the course of
the analysis, we have posed the question: "Is there a
military-strategic or tactical rationale for the systematic
use of chemical weapons in Laos, Kampuchea, and Afghanistan?"
We conclude that the military problems faced in all three
countries--as viewed from the perspective of the Soviets and
their allies--make the use of chemical weapons a militarily
effective way of breaking the will and resistance of stubborn
guerrilla forces operating from relatively inaccessible pro-
tected sanctuaries. These weapons offer substantial advantages
over conventional weapons. In all three countries the resist-
ance was able through conventional means to frustrate Soviet
and client-state objectives of extending and consolidating
control over the countries attacked. The Soviets probably
reasoned that attainment of these objectives--as quickly and
cheaply as possible--justified use of chemical weapons and
outweighed a small risk of exposure and international con-
demnation. They may well have calculated that they and their
allies could successfully deny or counter charges that chemical
weapons had been used, recognizing that it would be most
difficult to compile incontrovertible evidence from inassessible
areas of Southeast Asia and Afghanistan. In addition, the Soviet
military very likely consider these remote areas as providing
unique opportunities for the operational testing and evaluation
of chemical weapons under various tactical conditions.
We found support for this conclusion from Third World
officers who had attended the Soviet Military Academy of
Chemical Defense in Moscow. According to their Soviet
instructor, three types of chemical agents may be used during
the "initial stages" of local wars: "harassing agents
(CS, CN, DM), incapacitants such as psychochemicals (BZ) or
intertoxins [sic (possibly enterotoxins)], and herbicides."
During the "decisive phase, lethal agents can be employed
under certain circumstances." In a "local war, chemical
weapons can be used to spoil enemy efforts to initiate opera-
tions, even if the enemy has not used them first." The
foreign officers' accounts, including detailed descriptions of
the Soviet chemical warfare program, supports the conclusion
that the Soviets consider chemical weapons an effective and
acceptable means of warfare in local conflicts.
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Annex A
Tabulations of Reported Chemical Warfare
Attacks in Laos, Kampuchea, and Afghanistan
This annex comprises three tables summarizing chrono-
logically, by location, number, and associated deaths, the
chemical attacks reported to have occurred in Laos, Kampuchea,
and Afghanistan between 1975 and 1981. The tables were
compiled from a large volume of intelligence reports on such
attacks. Every effort was made to correlate individual
allegations with collateral information and to eliminate
double counting. The number of fatalities shown almost
certainly fall short of actual totals, because our coverage
is inevitably incomplete, and many reports failed to provide
casualty numbers.
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Table A-1
Laos:
Time Period
Summary of Reported Chemical Attacks
and Associated Deaths, 1975-81
Area Attacksa Deathsb
Summer 1975
Vientiane
2
25+
Fall 1976
Phou Bia
8
10
Savannakhet
1
10
Winter 1976-77
Phou Bia
2
16
Spring 1977
Phou Bia
6
66+
Khammouan
2
1
Summer 1977
Phou Bia
6
95
Fall 1977
Phou Bia
1
25
Winter 1977-78
Phou Bia
10
1,328+
Savannakhet
6
224
Spring 1978
Phou Bia
34
969+
Summer 1978
Phou Bia
22
664+
Fall 1978
Phou Bia
19
572
Winter 1978-79
Phou Bia
5
15+
Spring 1979
Phou Bia
36
257+
Summer 1979
Phou Bia
5
239+
Fall 1979
Phou Bia
10
56
Xaignabouri
2
24+
Winter 1979-80
Phou Bia
4
10+
Spring 1980
Phou Bia
3
24
Summer 1980
Phou Bia
6
187+
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Time Period
Table A-1 (continued)
Area Attacksa
Deathsb
Fall 1980
Xaignabouri
1
12
Phou Bia
7
88+
Savannakhet
3
1+
Winter 1980-81
Xaignabouri
2
57
Phou Bia
4
82
Vientiane (SE)
1
1+
Spring 1981
Houaphan
2
?
Phou Bia
7
218
Vientiane (S)
1
mi�
Summer 1981
Phou Bia
1
?
Fall 1981
Phou Bia
4
500+
Khammouan
3
534+
226
6,310+
a
This tabulation omits 35 attacks, accounting for 194 deaths,
that were not located in the reports. The totals overall
were 261 attacks and more than 6,504 deaths.
A plus sign indicates that the report(s) of deaths gave a
minimum figure. In some cases (shown with a question mark)
deaths were reported, but no number was given. Other reports
(signified with a dash) gave no information on fatalities'.
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Table A-2
Kampuchea: Summary of Reported Chemical Attacks
and Associated Deaths, 1978-81
Time Period Area Attacks
Deathsa
1978
Ratanakiri
5
?
Summer 1979
Kampong Speu
4
37
Fall 1979
Siem Reap
1
MIR Wall
Battambang
4
22+
Pursat
2
1+
Koh Kong
2
6+
Kampot
1
3
Kampong Chhnang
2
118
Winter 1979-80
Battambang
12
64+
Pursat
5
21+
Koh Kong
2
4
Spring 1980
Battambang
3
20+
Pursat
8
24+
Koh Kong
5
13
Summer 1980
Siem Reap
1
82+
Battambang
3
23+
Pursat
2
7
Koh Kong
3
dos am
Winter 1980-81
Battambang
8
Pursat
2
3
Spring 1981
Preah Vihear
1
--
Battambang
12
163+
Pursat
3
42+
Koh Kong
1
Kampot
1
WPM AM
Summer 1981
Battambang
3
7+
Kampong Thom/Chain
1
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Table A-2 (continued)
Time Period Area Attacks Deathsa
Fall 1981 Siem Reap 16 305
Battambang 6 16 .
Pursat 3 --
Koh Kong 1
Kampot 1
124 981
NIP
a
A plus sign indicates that the report(s) of deaths gave a
minimum figure. In some cases (shown with a question mark)
deaths were reported, but no number was given. Other reports
(signified with a dash) gave no information on fatalities.
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Table A-3
Afghanistan: Summary of Reported Chemical Attacks
and Associated Deaths, 1979-81
Time Period Province Attacksa Deathsb
' Summer 1979
Badakhshan
1
2,000
Parvan
1
8
Bamian
1
--
Fall 197'9
Konarha
1
350
Farah
1
?
Herat
1
?
Badghisat
1
?
Winter 1979-80
Badakhshan
5
130+
Takhar
1
--
Konarha
2
10+
Nangarhar
1
?
Bamian
1
?
Spring 1980
Badakshan
1
1+
Konarha
2
?
Oruzgan
1
Qandahar
1
Summer 1980
Nangarhar
2
1
Vardak
1
3
Herat
2
300+
Kabul
2
MN. kim
Fall 1980
Konarha
1
?
Lowgar
1
4
Ghazni
1
100
Winter 1980-81
Lowgar
2
Spring 1981
Parvan
2
Lowgar
3
Ghazni
2
Qandahar
1
ME Om
Summer 1981
Nangarhar
2
?
Qandahar
2
16
Herat
1
119
47
3,042
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a
This tabulation omits some attacks described in the text
because they could not be dated or located with high
confidence.
A plus sign indicates that the report(s) of deaths gave
a minimum figure. In some cases (shown with a question
mark) deaths were reported, but no number was given. Other
reports (signified with a dash) gave no information on
fatalities.
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ANNEX B
A LAO PILOT'S STORY
The most complete description of the period 1976-78
came from a Lao pilot who was directly involved in chemical
warfare. The pilot, a former LPLA officer who defected in
1979, reported that he flew L-19 and T-41 aircraft equipped
to dispense toxic chemical agents on H'Mong villagers in the
Phou Bia area of northern Laos. He said that the LPLA, in
cooperation with the PAVN, had conducted CW operations in
Laos since April or early May 1976. At that time, two LPLA
H-34 helicopters conducted a series of shuttle flights
transporting rockets to an airfield in Xiangkhoang Province.
Between June and August 1976 the LPLA launched attacks
in the area of Bouamlong--in Xiangkhoang Province--that was
a stronghold for remnants of the forces of former H'Mong Gen.
yang Pao. The LPLA used L-19 aircraft for rocket attacks in
that area aimed at eliminating the H'Mong resistance. LPLA
crews responsible for loading rockets on the attack aircraft
noted, however, that they were not allowed to use the rockets
that had been moved from Long Tieng to Phonsavan, even though
Phonsavan was much closer to the Bouamlong target area than
Long Tieng, where LPLA aircraft had to rearm. The pilot said
that, during nearly three months of flying missions against
the Bouamlong area, he flew his L-19 airckaft to Long Tieng
to be armed with rockets.
In late 1976 the pilot's L-19 aircraft was rearmed with
rockets stored at Phonsavan. Initially, H-34 helicopters
were used to transport the rockets from Phonsavan to a depot
near the Ban Xon airfield, Vientiane Province, where they were
fitted onto racks of the L-19 aircraft for missions in the
Phou Bia area. Later, the rockets from Phonsavan were trans-
ported to Ban Xon by trucks. All US-manufactured rockets
were stored with the tip and canister kept apart; in other
words, the two parts had to be joined before being fitted
to the racks on the aircraft. The pilot observed, however,
that all the rockets transported from Phonsavan to Ban Xon
were already assembled.
As part of his routine flight activities, the pilot
would check over his aircraft and, in doing so, examine the
tip portion of new smoke rockets that had been transported
from Phonsavan. He said that most of them appeared "loose"
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in the portion where the tip and canister joined, whereas
the tip and canister of the ordinary explosive-type rockets
at Long Tieng were noticeably more tightly connected.
In late 1976, preparation for airstrikes on Kasy
(Louangphrabang Province) and in new areas of Phou Bia,
the pilot said he began carrying two or three PAVN staff
officers, sometimes accompanied by an LPLA staff officer, in
T-41 aircraft for reconnaissance over the target areas. When
these airstrikes were launched, the defector pilot initially
flew his L-19 aircraft on missions with another pilot and an
LPLA staff officer sitting in the rear seat. After two or
three weeks, however, PAVN staff officers, who spoke excellent
Lao, began alternating in the rear-seat role with the LPLA
officers. Before each mission, the PAVN or LPLA staff officer
would go over target areas outlined on situation maps--which
then were taken along--and would point out the targets to be
attacked. The source noted that at no time did the PAVN
staff officer sitting in the back seat of his aircraft
communicate with LPLA officers on the ground, as did the
LPLA staff officers. A new PAVN officer was used on each
mission always assigned for each of the T-41 reconnaissance
and L-19 airstrike missions in the H'Mong areas. The aver-
age age of these PAVN staff officers was midfourties.
The source related that before flying L-19 airstrike
missions with a full load of rockets he was often warned by
an LPLA commander to fly at above-normal altitudes when
firing rockets to preclude hazard to the occupants of the
aircraft. For this reason the pilot surmised that the
"smoke" rockets fired at the H'Mong people were unusual.
He was able to observe that the "smoke" rockets detonated
in the air and that some produced white smoke with a mixture
of blue, while others produced red smoke with a mixture of
yellow. The ordinary, explosive-type rockets detonated on
impact. The commander or his designated representative told
the pilot before every mission that the operations--called
Extinct Destruction Operations--were intended to "wipe
out" the reactionary H'Mong people.
Before a mission involving "smoke rockets," the
commander warned the pilots to keep the operation secret.
The source said that, during the nearly two years in which he
flew rocket missions, he learned from the LPLA staff officers
accompanying him that there were two types of rockets. The
first, mostly "smoke" rockets, were to be fired at targets
far away from LPLA and PAVN troops to avoid exposing them
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to the poison smoke. The second was of the ordinary explo-
sive type, considered a "close support" rocket that could
be fired near LPLA and/or PAVN troop positions. Initially,
the L-19 aircraft carried eight rockets--five "close support"
and three "smoke" rockets. Later, only four rockets, mainly
of the "smoke" type, were carried.
After each mission in which chemical warfare rockets were
used, the pilot was returned to a "rest house" at Phonsavan,
where an LPLA doctor and nurse would examine him. He said
that after his missions, especially in 1978, he was partic-
ularly well treated by the examining doctor and watched very
closely by the LPLA nurse. Those L-19 aircraft pilots
assigned to missions utilizing chemical warfare rockets had
special privileges, including additional flight pay and free
meals at the Phonsavan cafeteria. In October 1978 the LPLA
stopped using L-19 aircraft on combat missions and began
using Soviet MIG-21s for chemical attacks on the Phou Bia
areas.
Corroborating Evidence. Several H'Mong reports
provide significant substantiation of the testimony of the
Laotian pilot. The chief of eight villages, for example,
described attacks covering all seven days of the week of
5 June 1976 in the Bouamlong area, Xiangkhoang Province.
He described L-19 aircraft firing rockets that produced
red and green smoke. Ten villagers were killed by gas and
30 by shrapnel. Most of the H'Mong reports documented by
a US foreign service officer in June 1979 and a Department
of Defense medical team in October 1979 are consistent with
the Laotian pilot's testimony. H'Mong observers familiar
with military aircraft reported L-19s until late 1978.
After that time, reports described jets or "MIGs" and
some accurately described Soviet AN-2s.
A review of information back to 1975 shows L-19 and
T-28 or aircraft were operating from airfields in northern
Laos--including the one at Phonsavan, where AN-2s were seen
in 1978. Our failure to observe chemical decontamination
equipment at the airfields, moreover, does not rule out the
handling of chemical munitions. The Soviets supervise the
chemical warfare activities in Laos; we assume, therefore,
that chemical munitions are handled in about the same manner
as in the USSR. No protective clothing or special decontam-
ination equipment is required for loading chemical bombs on
aircraft and helicopters at chemical munitions test ranges,
according to former Soviet chemical warfare personnel.
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The Laotian pilot's description of the rockets used on
the L-19 was corroborated by other sources. An H'Mong
refugee, a former commmander of a 500-man resistant force,
reported that in 1977 he found a rocket canister and a
separated warhead that he believed were the kinds used by
the Vietnamese and Laotians. The canister, he said, had
authentic US markings identifying it as a US-manufactured
2.75-inch rocket, as well as reportedly three lines of
Russian writing (which he could not translate). Another
H'Mong source, who reportedly had been trained as a liaison
officer and ordnance expert before the Communist takeover
of Laos in 1975, stated that he too believed the rocket
canister was of US manufacture and that the Soviet techni-
cians in Laos had modified the upper stage to contain a
poisonous (lethal) chemical.
The diameter of the warhead was reported to be 12.5
centimeters (5 inches), probably a measurement taken on a
modified warhead because the United States does not have a
5-inch warhead for the 2.75-inch "rocket motor." During
the Vietnam conflict, about 35 million US-manufactured,
conventional 2.75-inch rockets were sent to the war zone, and
many tens of thousands of these no doubt fell into North
Vietnamese hands when South Vietnamese forces collapsed.
The Vietnamese may be using some of these rockets with existing
loads, but modified warheads for the 2.75-inch rocket motor
could easily be fabricated in Vietnam and filled with a lethal
or nonlethal agent in Laos, especially with Soviet assistance.
According to US experts, fabrication of a warhead 5 inches in
diameter, necked down to fit the 2.75-inch rocket, could be
accomplished by trained technicians in a small, well-equipped
machine shop and laboratory.
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Annex C
Final Report of DASG Investigative Team:
Use of Chemical Agents Against the H'Mong in Laos
Authors:
Charles W. Lewis, M.D., COL, MC
Chief, Dermatology Service, Brooke Army
Medical Center, Fort Sam Houston, Texas
Frederick R. Sidell, K.D., Chief, Clinical
Resources Group, US Army Biomedical Laboratory,
Aberdeen Proving Ground, MD. 21010
William D. Tigertt, M.D. (Brigadier General, RET, USA)
Professor of Pathology, University of Maryland,
Baltimore, Maryland
Charles D. Lane, LTC, Southeast Asia Desk Officer,
OACSI, Department of the Army, Washington, D.C.
Burton L. Kelley, SP5, USA, Dermatology Technician,
Brooke Army Medical Center, Fort Sam Houston, Texas
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From 28 September to 12 October 1979 a team from the
office of The Surgeon General was in Thailand to investigate
allegations of the use of chemical agents against H'Mong
tribesmen in Laos.
The team visited the following H'Mong refugee camps
of northern Thailand: the detention center at Nhong Khai,
the large H'Mong camp at Ban Vanai, and two smaller camps
at Nam Yao and Mae Charmin. As the great majority of
refugees as well, as the H'Mong leadership are at Ban Vanai
most of the interviews were obtained there.
Entrance and exit briefings concerning the team's mission
were held at the US Army Biomedical Laboratory, Aberdeen
Proving Ground; the State Department, Washington, D.C.;
the U.S. Embassy, Bangkok; the Thailand Army Surgeon General;
refugee camp officials, as well as the U.S. Army Surgeon
General and Assistant Chief of Staff for Intelligence.
The team was prepared to obtain blood and skin samples
(for cholinesterase activity and study of pathological changes
respectively) from those exposed to chemical agents. For
such samples to yield meaningful results they must be taken
within 6-8 weeks of exposure. Since the last reported exposure
was in May 1979 no samples were collected.
Interviews were conducted through interpreters; one
interpreter was an employee of the U.S. Consulate at Udorn,
and the remainder were hired from among the refugees. The
interpreters screened those refugees who volunteered to
talk to the team and selected only those who had or been
eyewitnesses to or had themselves been exposed to an agent
attack. Team members interviewed 40 men, 2 women, and a
12 year old girl. Each interview took 1-2 hours. To achieve
conformity a prepared questionnaire was used as a guide.
The chemical attacks reportedly occurred between June
1976 and May 1979 (table C-1). The absence of reports of
attacks after May 1979 may be because very few refugees
crossed the Mekong River after that time because of heavy
rains and flooding from June to September 1979. Most of
the early reports were of the use of rockets releasing the
agent, but beginning in the fall of 1978 the majority of
the attacks were carried out by aircraft spraying a yellowish
substance which "fell like rain." The sites of the attacks,
which were concentrated around the H'Mong stronghold in
the mountainous Phou Bia area, are also listed in table
C-1.
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The team was given a plastic vial containing pieces
of bark stained by a yellow substance which several HiMong
refugees claimed was residue from an aircraft spray attack
in April 1979. Preliminary chemical analysis of the sample
indicates that no standard chemical agent is present, i.e.,
an agent listed in TH 8-285 (U.S. Army, May 1974). A complete
report of this analysis will be submitted upon completion
of further studies.
A similar series of interviews was conducted by State
Department Officials in June 1979. From the signs/symptoms
described and observed the following is suggested:
1. At least two, and possibly three, different chemical
agents may have been used, such as:
(a) A nerve agent (five or six individuals reported
symptoms that could be attributed to a nerve agent).
(b) An irritant or riot control agent (1/3 of
the interviews).
(c) over half of the interviews indicated such
a variety of signs and symptoms that it is difficult
to attribute them to a single known agent.
2. It is possible that in some cases, two or more
agents were combined.
(a) Reported signs and symptoms suggesting a
nerve agent include sweating, tearing, excessive sali-
vation, difficulty in breathing, shortness of breath,
nausea and vomiting, dizziness, weakness, convulsions,
and death occurring shortly after exposure.
(b) Reported signs and symptoms suggesting a riot
control or irritant agent include marked irritation or
burning of the eyes with tearing and pain; irritation
and burning of the nose and throat; coughing, burning
and tightness in the chest; headache; and nausea and
vomiting in a few cases.
(c) Reported signs and symptoms not related to
any known single agent include a mixture of the above
plus the features of profuse bleeding from mucous mem-
branes of the nose, lungs, and gastrointestinal tract
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with rapid death of the affected individuals in some
instances. Many of these effects were similar to those
described in attacks during the war in Yemen.*
Estimates from the H'Mong interviewed indicate that
approximately 700-1,000 persons may have died as a result of
the use of chemical agents, and that many times this number
were made ill. It was reported that on numerous occasions
entire villages were devastated by these agents leaving no
survivors.
In the episodes described most of the animals exposed
to the chemical agents were killed. Generally, all chickens,
dogs, and pigs died, and to a lesser extent, the cattle and
buffalo.
On several occasions it was reported that where these
agents settled on tree and plant leaves, many small holes
appeared in the leaves within two or three days. Rarely did
agent exposure result in the defoliation or death of the plants.
CONCLUSIONS:
The conclusions of the team based upon interviews
obtained from H'Mong refugees are as follows:
1. Chemical agents have been used against the H'Mong.
2. The reported effects of these agents suggest the use
of a nerve agent, a riot control agent, and an. unidentified
combination or compound.
* SIPRI The Problem of Chemical and Biological Warfare,
Volume 5, The Prevention of CBW, page 255, Humanities
Press, Inc., 300 Park Avenue South, New York, N.Y. 10010
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DATE
Table C-1
REPORTS OF PROBABLE CHEMICAL AGENT ATTACKS
LOCATION METHOD OF ATTACK MATERIAL USED (SMOKE OR GAS)
Jun 76
Jan 77-
Oct 78
Mar 77
Apr 77
May 77
May 77
Pou Mat Sao
Pha Khao
Nam Theuna
Houi Kam Lang
Pha Khae
Nam Moh
Plane, rockets
Plane, rockets
Plane, rockets
Plane, rockets
Plane, rockets
Plane, rockets
Red and green
Yellow, red, green
Red and yellow
Yellow
Red
Yellow
May 77
Pha Ngune
Bi-plane spraying
Yellow gas
Plane, rockets
Yellow
1977-78
x3
Phu Seu
Plane, rockets
Red, green, yellow
Jan 78
Houi Xang
Plane, rockets
Red and green
Feb 78
Sane Mak Ku
Plane, rockets
Yellow
Feb 78
Tham Se Sam
Plane, rockets
Yellow and black
Lein
Feb 78
Kio Ma Nang
Plane, rockets
Yellow
Mar 78
Mouong Ao
Plane, rockets
White
Mar 78
Khieu Manang
Plane, rockets
Green
Apr 78
Tha Se
Plane, rockets
Yellow
Jun 78
Pha Phay
Plane, rockets
Yellow
Jun 78
Phou Seng
Plane, rockets
Red, white, black
Jul 78
Phou Bia
Plane, rockets
Red
Jul 78
Ban Nam Mo
Plane - spray
Yellow
Jul 78
Phou Lap
Plane - rockets
Yellow
Aug 78
Pha Houai
Plane - rockets
Red and green
Aug 78
Ban Thin On
Plane - rockets
Green and red
Aug 78
Bouam Long
Plane - rockets
Red, green, yellow
Sep 78
Pha Koug
Plane - rockets
Yellow
Sep 78
Ban Nam Tia
Plane - spray/
rockets
Yellow, green, red
Sep 78
Pha Na Khum
Plane - rockets
Red
Oct 78
Phou Bia
Plane rockets
Oct 78
Ban Done
Plane - spray
Yellow
Oct 78
Phou Bia
Plane - rockets
White, green, red
Nov 78
Phou Chia
Plane - rockets
White, red
Feb 79
Pha Mat
Plane - spray
Yellow
Feb 79
Tong Moei
Plane - rockets
Yellow and red
Mar 79
Pha Mai
Plane - spray
Yellow
Apr-May
Pha Mai
Plane - spray
Gray-white
79 x 4
Mar-May
Pha Mai
Plane - spray
Yellow
79 x 6
May 79
Phou Chia
Plane - spray
Yellow
May 79
Moung Phong
Plane - rockets
Red
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Table C-1 (continued)
Department of State Interviews
DATE
Oct 77
Unk 78
Feb 78
Feb 78
Feb 78
Mar 78
Mar 78
Apr 78
May-Apr
78
Jun 78
Jun 78-
May 79
Mid-78
Oct 78
Oct 78
Oct 78
Nov 78
Nov 78
Nov 78
Apr 79
May 79
May 79
LOCATION
Phu Hay,
S of Phu Bia
Pa Sieng,
S of Phu Bia
Ban Nam Luk,
S of Phu Bia
20 Kms SE of
Phu
Ban
.Pha
Bia
Ko Mai
Houei
Ban Na Pong
Ban Phamsi
Ban Nong Po
Ban Nam Teng
Ban Don area
1-3
Phu
Nam
kms NE of
Bia
Kham
6 kms N of
Phou Khao
3-4 kms N of
Phu Bia
Phou Xang Noi
nr Phu Bia
NE of Pha Khao
Ban Nouia Pong
Nam Po
Pha Mai
METHOD OF ATTACK
Plane (L-19)
rockets
Plane unk bomb
Planes (L-19)
spray (?)
Plane unk spray
(?)
Plane unk bomb
Plane (MIG?)
sacks, burst in
air
Plane (jet?) not
described
Plane not de-
scribed
Plane (MIG?) cloud
Plane unk rocket(?)
Plane (jet?) spray
Plane unk rocket
burst in air
Plane (L-19)
rockets, air
burst
Plane (L-19?)
rockets, air
burst
Plane (L-19?)
rockets, air
burst
Plane (MIG?) spray
Plane unk bomb,
air burst
Plane (L-19)
rocket, air burst
Plane (MIG?) spray
Plane (jet?) spray
Plane (MIG?) spray,
air burst
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MATERIAL USED (SMOKE/GAS)
Yellow-grey gas
Yellow cloud .
Yellow/white gas
Yellow, provided sample
Yellow
Brown gas
Yellow
White, green, blood
colored
Yellow-brown like rain
Yellow gas
Yellow rain
Red gas
Yellow cloud
Red cloud
Yellow gray fog
Yellow and blue cloud
Yellow substance
Yellow gas
Yellow
Yellow
Yellow
clouds
substance
substance
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ANNEX D
ANALYSIS AND REVIEW OF TRICHOTHECENE TOXINS
I. SAMPLE ANALYSES FOR TRICHOimECENES
The Trichothecene Hypothesis
Since 1976, remarkably consistent reports detailing
chemical attacks in Southeast Asia have been received by
the Intelligence Community. Some of these reports were of
particular interest in that they described the use of lethal
agents producing symptoms that could not be correlated with
those produced by traditionally recognized chemical warfare
agents or combinations of them. Table D-1 is a compilation
relating the signs and symptoms reported in Laos, Kampuchea,
and Afghanistan with symptoms associated with certain chemical
agents. The frequency with which a particular symptom was
reported is expressed as a percentage of the total number of
attacks. It is readily apparent that the symptoms most
frequently described in Laos and Kampuchea correspond
most closely with those produced by a group of mycotoxins,
the trichothecenes. A review of the scientific literature
revealed not only that these compounds had physical and
chemical properties indicating potential as chemical agents,
but also that they were the subjects of intensive investiga-
tion by Soviet scientists at institutes previously linked
with chemical and biological warfare research. In the fall
of 1980, the trichothecenes were added to the list of agents
suspected to have been used in Southeast Asia and Afghanistan.
Other candidates under consideration included phosgene oxime,
arsines, cyanogen, nerve agents, riot control agents, and
combinations of these agents.
Numerous samples from chemical attacks in Laos and
Kampuchea were examined at the Chemical Systems Laboratory
(CSL) for the presence of traditional chemical warfare
agents and were reported to be negative. In March 1981 CSL
reported the presence of an unusual compound (C1,H,,A) in the
vapor analyses from several clothing and tissue gales taken
from the victim of a chemical attack. The compound was very
closely related in structure to the simple trichothecenes and
this finding sparked the request for analysis of all future
samples for the presence of trichothecene mycotoxins.
D-1
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Table D-1
Symptoms of Chemical Attacks Reported in Laos, Kampuchea, and Afghanistan
Symptom
Percentage
of Reports
Mentioning
Symptom
Trichothecenes
Nerve
Agents
Arsines
Phosgene
Oxime
Cyanogens
Riot
Incapitant Control
(BZ) Agents
Laos
Multiple deaths
84.6
X
Vomiting
71.4
Diarrhea
53.1
Hemorrhage
52.0
Xa
Breathing difficulty
47.95
X
X
X
X
Itching and skin
irritation
43.9
X
������
Nausea
42.8
X
Animal death
41.8
X
Blurred vision
39.7
X
X
Headache
36.7
-
X
Fatigue
35.7
Nasal excretion
34.7
X
Rash or blisters
32.6
X
-
Tearing
30.6
X
X
X
Coughing
28.6
X
X
X
Effect on Vegetation
26.5
X
X
Dizziness and vertigo
25.5
X
X
X
Facial edema
20.4
X
X
X
Thirst and dry mouth
20.4
X
X
Skin color change
16.3
X
X
-
Tachycardia
12.3
X
X
X
Temporary blindness
9.18
X
X
X
-
Rapid loss of
consciousness
9.18
Xb
��� ���
X
X
Salivation
6.12
Xc
Hearing loss
5.1
X
Tremors or convulsions
4
X
X
X
Sweating
3
Paralysis
3
X
X
Loss of appetite
3
X
X
Frequent urination
2
X
-
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Percentage
of Reports
Mentioning
Symptom
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Table D-1 (continued)
Nerve Phosgene
Trichothecenes Agents Arsines Oxime
Cyanogens
Incapitant
(BZ)
Riot
Control
Agents
Kampuchea
Multiple deaths
72.4
X
X
X
X
Hemorrhage
62.06
X
Xd
Dizziness and vertigo
51.7
X
X
X
X
X
Vomiting
41.3
X
X
X
X
Nausea
34.5
X
X
X
X
X
Skin irritation
27.6
X
X
X
X
Rapid loss of
consciousness
24.1
b
X
X
--
X
X
Fever
20.68
X
Headache
17.2
X
X
X
X
X
Tearing
el
13.8
X
X
X
X
X
X
X
1 Breathing difficulty
13.8
X
X
X
X
X
X
X
H
tr Fatigue
13.8
X
X
X
Paralysis
10.3
X
X
X
Numbness
6.9
X
X
X
X
?
Blurred vision
6.9
X
X
X
X
X
X
X
Dry throat and thirst
6.9
X
X
Edema
6.9
Xe
X
X
���
Salivation
3.4
X
X
--
Vegetation affected
3.4
X
?
?
Diarrhea
3.4
X
X
X
Cough
3.4
X
X
X
X
X
X
Nasal discharge
3.4
X
X
X
X
X
Rash or blister
3.4
X
X
X
X
Chills
3.4
X
?
Hearing loss
3.4
X
--
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Percentage
of Reports
Mentioning
Symptom Symptom
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Table D-1 (continued)
Nerve Phosgene
Trichothecenes Agents Arsines Oxime
Cyanogens
Incapitant
(BZ)
Riot
Control
Agents
Afghanistan
Rapid loss of
consciousness
47.9
Xb
X
X
X
Skin irritation and itching
31.5
X
X
X
--
X
Multiple deaths
30.1
X
X
X
X
--
Nausea
20.5
X
X
X
--
X
X
Vomiting
19.1
X
X
X
--
--
X
Tearing
17.8
X
X
X
X
X
X
Dizziness and vertigo
16.4
X
X
X
X
X
Blisters or rash
15
X
--
X
X
X
Difficulty breathing
13.7
X
X
X
X
X
X
X
Paralysis
13.7
X
X
X
--
Headache
12.3
X
X
X
X
X
Temporary blindness
8.2
X
--
X
X
X
X
Salivation
6.8
Xc
X
Loss of appetite
6.8
X
X
X
Effects on vegetation
5.5
X
--
Fatigue
5
X
X
X
Confusion
4.1
X
X
Hemorrhage
4.1
X
Xa
Change in skin color
2.8
X
--
X
Diarrhea
2.8
X
X
X
--
Coughing
1.3
X
X
X
X
X
X
X
a
Bloody frothing.
Only at very high doses.
Depending on which trichothecenes.
Blood flecked frothing.
e Depending on compound.
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The Kampuchean Leaf and Stem Sample--The First Analysis
for Trichothecenes
On 24 March 1981 a number of samples from the US Embassy
in Bangkok was received. Two of the samples were reported to
have been collected from the site of a chemical attack that
occurred in the vicinity of TV 3391, an area just south of
Phnum Mak Hoeun. A vegetation sample and a water sample
were collected within 24 hours of the attack. Examination
of bodies of victims of this attack by medical personnel
revealed highly unusual degeneration of the mucosal lining
of the gastrointestinal tract. The effects described
paralleled those known to be produced by the trichothecenes.
The samples were submitted to Chemical Systems Laboratory
for analysis for the presence of chemical warfare agents.
No evidence of known chemical warfare agents was found. An
initial test for the trichothecenes by thin layer chromato-
graphy (TLC) was inconclusive because of severe problems with
interfering substances and the lack of appropriate standards.
The trichothecenes are difficult to detect even under ideal
circumstances and the presence of interfering substances in
the sample may make identification and quantitation by TLC
inconclusive. A review of the limitations and potentials
of analytic methods for trichothecenes led those authors
to conclude that the computerized gas chromatography/mass
spectroscopy method in the selected ion monitoring mode
would enable precise identification and quantitation of
these compounds in complex mixtures. An additional recent
publication includes a summary of the currently available
methods suitable for trichothecene analysis and an assessment
of their utility and limitations.
A portion of the leaf and stem sample was furnished to
the US Army for further analysis. This sample (see table D-2,
group I/A), a positive control sample to which T-2 toxin
was added (group I/B), and a negative control sample of
similar vegetation (group I/C) were forwarded to Dr.
Chester J. Mirocha, Department of Plant Pathology, Univer-
sity of Minnesota. Dr. Mirocha was given no information
concerning the history or content of the samples, and was
requested to analyze the three unknowns for the presence of
trichothecene toxins using the best methods at his disposal
Briefly, the analysis involves a series of extractions
followed by ferric gel separation, selected ion monitoring
on a computerized gas chromatograph/mass spectrometer, and
a full mass spectral scan for comparison with known stand-
D-2
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Table D-2
Trichothecene Sample Analyses
Reference Number/
CASE Number
Sample Group I/
M-22-81
Sample Group II/
M-23-81
Code Date Received Description
A
Ea
29 Apr 81
26 Aug 81
Leaf and stem + negative
control
Sample from attack area
(spiked) pos. control
External neg. control
Environmental samples
Water
Yellow powder
Speck (unknown substance)
Current Status
Analysis complete.
Code A sample: T-2 - 3.15 ppn4111
Nivalenol - 109 ppm
Deoxynivalenol - 59.1 ppm
Code B sample:
T-2 - 35.7 ppm
Nivalenol - 21.7 ppm
Code C sample:
Negative results
Analysis complete.
Code D sample:
Deoxynivalenol - 66 ppm
Diacetoxyscirpenol - Trace,
Code E sample:
T-2 - 150 ppm
Diacetoxyscirpenol - approx.
25 ppm
Code F sample:
Diacetoxyscirpenol - 10 ng
a
Additional 25 mg of this sample was provided to laboratory for analysis for nivalenol and
deoxynivalenol (see Sample Group X/M-11-82)
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Table D-2 (continued)
Trichothecene Sample Analyses
Reference Number/
CASE Number
Sample Group III/
M-26-81
1) Sample Group IV/
NJ M-1-82
Sample Group V/
M-2-82
Sample Group VI/
M-3-82
Code Date Received Description
A
A14
Al5
A16
Al7
20 Sep 81
5 Oct 81
11 Oct 81
22 Oct 81
Environmental samples
(Negative controls)
Water sample
Soil sample
Soil sample
Dried corn
Rice
Leaves and stem
Leaves and stem
Leaves and stem
Leaves and stem
Environmental samples
(Negative controls)
Blood samples
Blood samples
Current Status
Analysis complete.
Negative results on all
samples tested to date.
Retained at USAMIIA pending
results of higher priority
analyses.
Analysis complete.
Negative results on all
samples tested to date.
Analysis complete.
Analytical findings to date
have tentatively identified
HT-2, a deacetylated
metabolite of T-2 toxin, in
the blood of patients 3 and
4 (see Table D-3).
UNCLASSIFIED
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Reference Number/
CASE Number
'J Sample Group VII/
w M-7-82
Sample Group VIII/
M-8-82
Sample Group IX/
M-9-82
Sample Group X/
M-11-82
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Table D-2 (continued)
Trichothecene Sample Analyses
Code Date Received Description
Al
Al3
Bl
B-13
E-2
17 Nov 81
17 Nov 81
6 Nov 81
19 Nov 81
Blood samples
Environmental samples
Environmental samples
(Sock, pants, mask,
water)
Environmental sample
Yellow powder
V.
Current Status
Medical laboratory evalua-
tion of blood samples con-
ducted by US Army Medical
Research Institute of Infec-
tious Diseases (USAMRIID)All
No significant statistical.'
differences between control
samples from alleged victims
of "yellow rain, but a trend
toward low blood cell counts
in victims was noted. See
Table D-3
Retained at USAMIIA pending
completion of higher priority
analyses.
A metabolite of T2 toxin
(HT ,0 was tentatively identi-
fied in the blood of two
victims of a CW attack.
Analysis in progress.
Analysis in progress.
Analysis complete.
143 ppm 11,)
27 ppm DAS
0 Nivalenol
0 Deoxynivalenol
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ards. The methods used are among the most sensitive and
specific for detection of these compounds; also false positives
are rare. Toxins can be identified by their mass spectra
and quantified with a high degree of accuracy. Group I/A--
the vegetation sample allegedly exposed to a CW agent--was
found to contain 109 parts per million (ppm) of nivalenol,
59.1 ppm of deoxynivalenol, and 3.15 ppm of T-2 toxin;
each is a potent toxin of the trichothecene group. No
trichothecenes were detected in the negative control sample
(group I/C), and 35 ppm of T-2 toxin were detected in
group I/B--the sample to which T-2 toxin had been added.
It was Dr. Mirocha's assessment that a mixture of these
particular toxins in the high levels detected could not
have occurred as a result of natural contamination.
The possibility that the identified toxins were pro-
duced by natural fungal contamination is addressed in
section III. In summary, the possibility was discounted
on the basis of the climatic conditions required for pro-
duction of T-2 toxin, the high levels of toxins detected,
the unusual mixture of toxins found, and the results of
surveys of Southeast Asia for the presence of these toxins.
This conclusion was supported by the analysis of normal
flora samples from Kampuchea described below.
Analyses of Control Samples From Kampuchea for the
Presence of Trichothecenes
On 20 September 1981, nine control samples were received
from US Army personnel in Bangkok, Thailand, for the purpose
of conducting laboratory analyses for background levels of
trichothecene toxins. The samples were collected from an
area near TV 3391 that had not been subjected to any re-
ported chemical attacks. The samples were collected by US
personnel under instructions to reproduce the sampling con-
ditions, handling, packaging, and transfer conditions of
the original sample as closely as possible. The same species
of plant was sampled, and three other vegetation samples were
also collected. A water sample as well as two soil samples
were recovered. Samples of corn and rice from the area were
also taken. These grains provide an ideal substrate for
growth of toxin-producing fungi and would therefore be a
sensitive indicator of any natural occurrence. The
nine samples were forwarded under code to Dr. Mirocha for
trichothecene analysis. A portion of each sample was also
submitted to CSL for background determinations of CN-, Cl-,
and Fl- levels. No trichothecenes were detected in any of
these samples (group III/A-I), indicating that nivalenol,
D-3
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deoxynivalenol, T-2, and diacetoxyscirpenol are not prevalent
in the geographical area from which the alleged CW exposed
sample was collected. The appearance of these trichothecenes
in high levels and unique combinations in a sample associated
with a chemical attack producing symptoms typical of trichoth-
ecenes exposure indicates that these toxins may have been
used as chemical weapons. This conclusion is further sup-
posed by the confirmatory evidence provided by the analysis
of additional alleged CW samples from Laos and Kampuchea
which are described below.
Analysis of Additional CW Samples From Laos and
Kampuchea for the Presence of Trichothecenes
Chemical Systems Laboratory provided three additional
suspected chemical warfare samples for analysis for tricho-
thecenes. The first sample (group II/D) consisted of 10 ml
of water taken from the same chemical attack site in
Kampuchea as the leaf and stem sample previously examined
(group I/A). The second sample (group II/E) came from the
site of a "yellow rain" attack occurring on 13 March 1981
in the village of Muong Cha (TF 9797) in the Phou Bia region
of Laos. The agent was sprayed from a twin-engine propeller
aircraft at approximately 1200 hours. The falling substance
was described as "like insect spray" and sounded like driz-
zling rain. It was quite sticky at first, but soon dried to a
powder. Symptoms described by victims included nausea, vomiting,
and diarrhea. A sample of the agent scraped from the surface
of a rock by a victim and carried into Thailand was turned
over to US Embassy personnel. The third sample (group II/F)
was taken from the site of a "yellow rain" attack that
occurred at 1400 hours on 2 April 1981 at Ban Thong Hak
(TF 9177). Twenty-four people reportedly died in this attack
and there were 47 survivors. Symptoms included severe skin
irritation and rash, nausea, vomiting, and bloody diarrhea.
This sample was scraped from the surface of a rock with a
bamboo knife by a survivor of the attack. Although the
individual took precautions (that is, cloth mask) a severe
skin rash and blisters developed.
These three samples were submitted to Dr. Mirocha for
analysis. Group IUD (the water sample from Kampuchea) con-
tained 66 ppm of deoxynivalenol and a trace amount of
diacetoxyscirpenol (DAS). A trace quantity of group II/E was
screened as strong positive for trichothecenes. Further
analysis of that sample confirmed the presence of high levels
of T-2 toxin (150 ppm) and diacetoxyscirpenol (25 ppm).
D-4
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Interference from phtalate compounds (leached from the plastic
packaging) made detection of nivalenol and deoxynivalenol diffi-
cult. In a second analysis, the extraction process was modified
so that nivalenol and deoxynivalenol could be measured accurately.
The analysis showed the presence of 143 ppm T2 and 27 ppm DAS.
No nivalenol or deoxynivalenol was detected. Interestingly,
examination of the petroleum ether fraction from sample group
II/E revealed the presence of a yellow pigment almost identical
to that previously identified by Dr. Mirocha in cultures of
Fusarium roseum, indicating that the yellow powder probably
consisted of the crude extract of a Fusarium culture.
There was very little of group II/F contained in the
vial received for testing. The quantity was too small to
be accurately weighed and inspection of the vial revealed
only a very small speck estimated to weigh much less than
0.1 mg. That speck contained 10 ng of diacteoxyscirpenol,
a level equivalent to 100 ppm at the very least and probably
much higher. The sample size was too small to allow adequate
analysis for the other three trichothecenes of interest.
These results, in general, support the hypothesis that
trichothecenes have been used as chemical warfare agents in
Laos and Kampuchea. The presence of these high levels of
trichothecene toxins in water and in yellow powder scraped
from rocks argue against natural occurrence, since neither
water nor rock is a suitable environment for growth of the
fungi required to produce the toxins.
Differences between the analyses of the Kampuchean leaf
and stem sample and the water sample collected from the same
attack site raise additional questions. The failure to find
T-2 toxin in the water sample is probably due to the relative
insolubility of T-2 toxin in water. The presence of DAS in
the water might be the result of biotransformation or breakdown
of T-2, as they are so structurally similar, differing only
in the substitution on carbon 8. While this hypothesis cannot
be entirely ruled out it is unlikely on the basis of known
biotransformation of T-2 in the laboratory. The initial
vegetation sample was not screened for DAS, though the mass
spectra from the initial analysis will be reexamined for
trace amounts of DAS.
The absence of nivalenol in the water sample is more
difficult to explain because nivalenol is water soluble. The
effect of environmental conditions and microorganisms on the
stability of these compounds may vary widely for each of the
specific compounds and may explain the analytical results.
Further scientific investigation of these factors is needed.
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II. ANALYSIS OF BLOOD SAMPLES FROM CHEMICAL ATTACK VICTIMS
Blood samples drawn from victims of recent chemical
attacks have been received for analysis for indications of
trichothecene exposure. Little is known concerning the rate
of metabolism of trichothecenes in humans; it is difficult,
therefore, to estimate the probability of detection of
trichothecenes or their metabolites in blood samples. T-2
is rapidly cleared from the blood in animals, and 25 percent
of the total dose is excreted within 24 hours after exposure;
therefore, it is unlikely that trichothecenes could be detected
unless samples were obtained within 24 to 48 hours after an
attack. Other blood parameters are affected by the trichothe-
cenes, however, and may prove to be useful markers. The
trichothecenes induce a severe leukopenia (decrease in white
cell count) which can persist for several weeks following
exposure. In addition, the trichothecenes affect some liver
and kidney function marker enzymes which can be monitored in
the blood.
On 11 October 1981, four whole blood samples and four
blood smears were received from the US Embassy, Bangkok. The
blood was drawn from four Khmer Rouge soldiers on 7 October
inside Kampuchea. Detailed medical histories as well as
descriptions of the attack were recorded on each individual
from whom a blood sample was taken. All four men were victims
of a gas attack occurring in the fall of 1981 near Takong.
Symptoms experienced included vomiting, blurred vision, bloody
diarrhea, difficulty breathing, dry throat, loss of conscious-
ness, frontal headache, tachycardia, and facial edema. Un-
fortunately, the samples could not be refrigerated until 48
hours after collection. It was therefore not possible to
obtain data concerning white cell counts and blood chemistry.
The four whole blood samples were submitted to Dr. Mirocha
for analysis for trichothecene metabolites because of the
possibility (admittedly remote) that some of the metabolites
may bind to blood proteins and may still be detectable even
three weeks after an attack. These analyses are reported as
group V A14-A17 in table D-2.
On 22 October 1981 additional blood samples were received.
These had been drawn from nine victims from the 19 September
attack and from four control individuals of similar age and
background who had not been exposed to a chemical attack. The
samples had been properly refrigerated and were accompanied by
very complete and detailed medical histories taken by trained
medical personnel who examined the individuals. Included in
the package were blood smears and heparinized and nonheparin-
ized samples from each individual. The samples were
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submitted to US Army Medical Research Institute of Infectious
Diseases (USAMRIID) for blood assays. These results are
reported in table D-3.
The above results show no statistically significant
differences between exposed and control groups (students
T-test). A trend toward depressed white cell counts in
eight individuals exposed to chemical agent was observed.
Such an observation would be compatible with the clinical
picture of toxin exposure; however, it is also compatible
with a number of other medical problems and a larger control
sample would be required before such results could be ade-
quately interpreted. Abnormal liver and kidney functions
were not indicated by this data.
Portions of these blood samples were analyzed by
Dr. Mirocha for presence of trichothecenes and/or trichothecene
metabolites. The results of those analyses are consistent
with trichothecene exposure in at least two of the gassing
victims and tend to support the hypothesis that a trichothecene-
based agent was used in this attack.
Using the selected ion-monitoring gas chromatography/mass
spectroscopy analysis technique, Dr. Mirocha was able to
identify tentatively a metabolite of T� toxin (that is, HT2)
in the blood of two alleged victims. The compound was
identified on the basis of its selected ion masses and gas
chromatographic retention times.
The tentative identification of HT2 in the blood of two
victims, and the trend toward depressed white cell counts in
these same victims, cannot be taken as conclusive scientific
proof of toxin exposure because the trace amount of the
compound present precluded unequivocal identification and
quantitation, and also because many other medical problems
in addition to toxin exposure can cause a decrease in white
cell counts. It is interesting to note that the individual
who showed the greatest amount of the compound tentatively
identified as HT, in his blood, was reported to have received
the greatest exp8sure to the agent and also had the lowest WBC.
He was exposed to contaminated water for more than 30 minutes
and was the only victim who fell down in the water and actually
swallowed some of it. However, the description by victims of
symptoms correlating exactly with those associated with tricho-
thecene poisoning, provide strong circumstantial evidence that tri-
chothecenes were used as chemical agents in yet another chemical
attack in Southeast Asia.
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Table D-3
Peripheral Blood Hemograms of
Kampuchean Victims of Chemical Attack
Patient
No. RBCa Hgbb Hctc
1 specimen clotted
WBC
Retice
MCV
MCHg
MCHCh
2
4.46 12.6 37
4,700
1.0
84
28.5
34
3
4.90
11.8
40
5,700
0.4
81
26
32
4
4.90
10.3
34
1,700
2.1
70
21
30
5
4.92
15.0
46
5,300
1.2
93
32
34
6
4.04
12.6
37
4,300
0.8
93
31
34
7
4.88
15.6
46
3,000
0.5
94
32
34
8
5.56
17.0
50
8,700
1.5
91
31
34
9
4.88
11.2
35
5,000
1.0
73
23
32
Controls:
10
6.23
12.5
41
7,200
0.8
66
20
30
11
4.47
11.9
38
8,000
0.9
85
26.5
31
12
4.88
12.9
41
5,100
2.0
85
26.5
32
13
5.16
15.6
46
6,500
1.0
90
30.5
34
Normal range:
male
female
4.5-6.0
14-18
40-54
7,400
80-94
27-32
33-38
3.5-5.0
12-16
37-47
�2,000
BUNi
Creatinine
SGPTi
Alkaline
Phosphatase
Normal Range M
7-20
0.4-1.7
6-37
24-69
23-71
1.
9.0
3.5
48
132
2.
8.5
0.8
36
47
3.
8.0
1.4
12
75
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Table D-3 (continued)
Peripheral Blood Hemograms of
Kampuchean Victims of Chemical Attack
BUNi Creatinine SGPTi Alkaline
Phosphatase
4A.
11
1.3
6
94
4B.
10.5
1.2
6
68
5.
6.0
1.6
12
84
6.
7
1.2
18
115
7.
8.5
1.7
6
69
8.
10
1.5
36
79
9.
12.5
1.4
12
70
10.
10.5
1.8
12
86
11.
12
0.8
24
74
12.
12
1.4
6
76
13.
9.0
1.2
30
102
a
Red blood cells
x10-6
(#/cc)
Hemoglobin (gm/100cc)
Hematocrit (%)
White blood cells (#/cc)
Reticulocytes (#/cc)
Mean corpuscular volume (u3)
Mean corpuscular hemoglobin (uug)
Mean corpuscular hemoglobin concentration (%)
Blood urea nitrogen (mg%)
Serum glutamic pyruoic transaminase
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Trichothecenes have been identified previously in environ-
mental samples taken from several other chemical attacks in
Laos and Kampuchea. Analysis of control vegetation, water,
soil, corn, and rice samples from these areas, as well as
reviews of published scientific literature, indicate that
the particular toxins that have previously been identified
are not known to occur naturally in the combinations found
and at the levels detected in Southeast Asia. The latest
analysis results contribute another piece of evidence to the
growing body of data supporting the charge that trichothecenes
have been used as chemical/biological agents in Southeast Asia.
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111 UNCLASSIFIED
III. OVERVIEW OF NATURAL OCCURRENCE AND SIGNIFICANT PROPERTIES
OF TRICHOTHECENES
Historical Trichothecene Mycotoxicoses
The trichothecenes are members of a large group of
naturally occurring toxins known as mycotoxins. The word
"mycotoxin" is derived from the Greek "mykes" meaning
fungus and the Latin "toxicum" meaning poison. It refers
to a metabolite produced by a mold that is toxic to man or
animals. Mycotoxicoses have been described as the "neglected
diseases" and, before 1960, little English-language litera-
ture concerning the diseases caused by mycotoxins was avail-
able. Interestingly, the first comprehensive studies of
mycotoxin diseases were conducted in the Soviet Union in the
late 1930s. Thus, Soviet scientists have been involved in
research with some of these compounds for almost 30 years
longer than their Western counterparts (see section V of this
annex). The Soviet Union has had serious problems with myco-
toxin contamination of food and has suffered several severe
outbreaks of disease in humans.
The group of mycotoxins that has figured most prominently
in Soviet scientific literature since the 1940s are the tricho-
thecenes. They are a group of chemically related, biologically
active fungal metabolites produced primarily by various species
of Fusarium. Table D-4 lists some of the toxins in this group
and producing fungi. The fungi are well-known plant pathogens
that frequently invade numerous agricultural products.
Trichothecene toxins, perhaps more than any other myco-
toxins, have been associated with acute disease in humans.
Most of the human intoxications occurred in the Soviet Union
(table D-5). The earliest recognized outbreak occurred in
1891 in the Ussuri district of eastern Siberia. Humans who
consumed contaminated grain exhibited headache, chills, nausea,
vomiting, vertigo, and visual disturbances. Dogs, horses,
pigs, and domestic fowls were reported to be affected.
The most extensive mycotoxicosis outbreak reported to
have caused multiple fatalities in man also occurred in the
Soviet Union. In 1944 30 percent of the population of Oren-
burg near Siberia was affected by alimentary toxic aleukia
or ATA, a disease later shown to be due to ingestion of tricho-
thecene toxins. Over 10 percent of the entire population
of the Orenburg district died of the disease. Numerous other
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TABLE D-4
Trichothecene-Producing Fungi
Type
Trichothecenes
(A) T-2 Type
T2 Toxin
HT2 Toxin
Diacetoxy-
Scirpenol
Neosolaniol
(B) Nivalenol-Type
Nivalenol
Monoavetyl-
Nivalenol
Diacetgl-
Nivalenol
Deoxynivalenol
(C) Macrocylic
Roridins
Veirucarins
Satratoxins
Vertisporin
Fungus
F. tricinctum
F. roseum
F. equiseti
F. sporotrichioides
F. lateritium
F. poae
F. solani
F. rigidiusculum
F. semitectum
F. nivale
F. opisphaeria
F. roseum
UNCLASSIFIED
Myrotheclum
verrucaria
M. roridum
Stachybotrys atra
Verticimonosporium
diffractum
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TABLE D-5
Historical Trichothecene Mycotoxicosis
Toxicosis
Districts and
Affected Species Symptoms
"Taumelgetreide" Toxicosis USSR Headache, nausea, vomiting,
Man, farm animals vertigo, chills, visual
disturbances
Alimentary toxic aleukia USSR Vomiting, diarrhea, multiple
Man, horse, pig hemorrhage, skin inflamation,
leukopenia, angina
Stachibotryotoxicosis
Bean-hull toxicosis
Dendrodochiotoxicosis
Moldy corn toxicosis
Red mold toxicosis
USSR, Europe
.Horse
Japan
Horse
Shock, somatitis, hemorrhage,
dermal necrosis, nervous
disorders
Convulsion, cyclic move-
ment
USSR, Europe Skin inflamation, hemorrhage
Horse
United States Emesis, hemorrhage
Pig, cow
Japan, USSR
Man, horse, pig, cow
UNCLASSIFIED
Vomiting, diarrhea con-
gestion and hemorrhage
of lung and intestine
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outbreaks of ATA occurred in the Soviet Union, primarily be-
tween the years 1942-1947. The contamination was traced to
overwintered millet, wheat, and barley infected with Fusarium.
Symptoms of the disease included vomiting, skin inflammation,
multiple hemorrhaging (especially of the lung and gastro-
intestinal tissue), diarrhea, leukopenia, and suppression
of bone marrow activity.
In 1939, Nikita Khrushchev was dispatched to the Ukraine
region of Russia by Premier Joseph Stalin to organize and
improve agricultural operations and to identify the disease
that was causing the deaths of many horses and cattle. The
problem was traced to hay and straw contaminated with Stachy-
botrys atra. The disease, later referred to as stachybotryo-
toxicosis, occurred after ingestion or contact with the con-
taminated grain. Symptoms included ulcerative dermatitis,
perioral dermatitis, blood dyscrasias, hemorrhagic syndromes,
abortion, and death. The greatest economic impact was due
to loss of horses, but cattle, sheep, poultry, and humans
were also affected.
Other disease outbreaks in which similar symptoms were
exhibited occurred in 1958 and 1959 among horses and cattle
in the Soviet Union and Eastern Europe. Thousands of ani-
mals were lost in these outbreaks. Other intoxications were
reported subsequently in Japan, Europe, the Soviet Union,
and the United States, affecting various domestic animals
and--in the case of red mold toxicosis--affecting man. All
of these diseases have now been shown to be due to ingestion
of trichothecenes rather than to an infectious agent. In
earlier disease outbreaks, the levels of toxin present in
the contaminated grain was not measured; however, the levels
of nivalenol and/or deoxynivalenol measured in toxic grains
implicated in more recent outbreaks (that is, "moldy corn
toxicosis" and "red mold toxicosis") were typically between
2 and 8 ppm.
Natural Occurrence of Trichothecene Mycotoxins
Publications concerning the occurrence of trichothecenes
have been relatively scarce because of the lack of convenient
detection methods and the complexity of the trichothecene
family of compounds. Only recently have scientists developed
methods capable of distinguishing between close structural
derivatives and accurately quantitating the levels of toxin
present (see table D-6 for comparison of analytical methods).
Extreme care must be taken when reviewing the scientific
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TABLE D-6
Physiochemical Methods for Detection of Trichothecenes
in Feedstuffs
Method
Trichothescenes
Detected
Detection
Limits
Required
Standards
Use and
Limitation
Thin-layer
chromatography
1-dimension
Thin-layer
chromatography
2-dimension
a
iGas-liquid
Ictchromatography
Gas chromato-
graphy/mass
spectrometry-
normal scanning
mode
Gas chromato-
graphy/mass
spectrometry-
selection ion
monitoring
All
All
Nonhydroxy-
lated or TMS
derivatives
TMS
derivatives
TMS
derivatives
Nuclear-magnetic- All
resonance
0.1 micogram/spot
(H2SO4)
0.1-1.0 microgram/
spot (H2SO4)
0.03-0.05
microgram/
microliter
injection
0.02-0.05
microgram/
microliter
injection
0.007-0.02
microgram/
microliter
injection
Reference
Standard
Reference
Standard
Reference
Standard
Reference
Standard or
Spectrogram
Reference
Standard or
Spectrogram
Reference
Standard or
Spectrogram
UNCLASSIFIED
Qualitative
Interference
Not confirmatory
Qualitative
Less interference
Confirmatory
Quantitative
Monoglyceride
interference
Equivocable
identification
Semiquantitative
Less interference
Unequivocable
identification
Quantitative
Best for complex
mixtures
Unequivocable
identification
Confirmatory
Purified toxin
structure
elucidation
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TABLE D-6 (continued)
Method
Trichothescenes
Detected
Detection
Limits
Required
Standards
Use and
Limitation
Radioimmunoassay
(developmental
stage)
T-2 toxin
1-20 nanogram
Rabbit anti-
T-2 toxin
anti-body
3H-T-2 toxin
UNCLASSIFIED
Sensitive
Low inter-
ference
Relative
structural
specificity
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�
literature on natural occurrence of these compounds, because
erroneous conclusions can be drawn on the basis of results
obtained with inadequate analytical techniques. Misidenti-
fication of compounds and gross overestimation of concen-
trations have occurred using techniques such as thin layer
chromatography as the basis of analysis. Table D-7 lists
the reports of natural occurrence of T-2 toxin, diace-
toxyscirpenol, and nivalenol that were obtained from a liter-
ature search of over 3,000 citations concerned with tricho-
thecene toxins. Levels that are questionable on the basis
of techniques used are indicates. It is immediately apparent
that the levels of toxins found in the various samples from
Laos and Kampuchea are highly unusual, even if one accepts
the questionable reports in table D-7 as valid. The levels
of these toxins (150 ppm T-2 toxin, 109 ppm of nivalenol,
more than 100 ppm of diacetoxyscirpenol, and 66 ppm of de-
oxynivalenol) are markedly higher than those reported to
occur in nature. It should also be noted that the inci-
dences recorded in table D-7 concern levels of toxin pro-
duced when Fusarium is growing on its ideal substrate, while
the Laos and Kampuchea samples were taken from surfaces that
would be extremely unlikely to support Fusaria growth and
toxin production, that is, the surface of rocks and water.
Higher levels of toxin production can, of course, be induced
when the mold species is grown in pure culture under ideal
conditions in the laboratory; for instance, the Soviets have
succeeded in producing 4 grams of T-2 per kilogram of sub-
strate. In a natural environment, however, the Fusaria
species cannot compete well with other molds such as species
of Aspergillus and Penicillium, and, as in table D-7, levels
of toxin produced are orders of magnitude lower.
The conclusion that the levels of toxins found in the
Southeast Asia samples could have occurred only by means of
an unnatural mechanism is also strengthened by surveys of the
area conducted by various researchers. Surveys of the toxi-
genic fungi and mycotoxins of Southeast Asia conducted by the
Mahidol University in Bangkok and the Massachusetts Institute
of Technology, have not revealed the presence of T-2, niva-
lenol, deoxynivalenol, or diacetoxyscirpenol, although other
mycotoxins such as aflatoxin, were identified. These results
were confirmed by our analysis using our own methodology of
normal flora samples of vegetation, soil, water, corn, and
rice from Kampuchea that revealed the presence of no tricho-
thecenes.
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Table D-7
1. Spontaneous Occurrence of Trichothecene Mycotoxins
Toxin Country
Source
Concentration
(parts per million)
Referencea
T-2 Toxin
Mixed feed
0.08b
15
USA
UK
India
Brewer's grains
Sweet corn
Ned
4 '
19
5
Canada
India
Corn
Sorghum
'NDd
NDd
4
22
Canada
Barley
25
20
India
Safflower seed
d
3-5
6
US
Corn stalks
0.11b
16
US
Feed supplement
ND
7
US
Corn
2
8
US
Mixed feed
0.3
14
France
Corn
b
0.02
10
US
Corn
ND
2
Diacetoxyscirpenol
US
Mixed feed
0.5
15
US
Mixed feed
0.1
15
India
Safflower seed
3-a
6
India
Germany
Sweet corn
Corn
14
d
31.5
5
23
US
Corn
0.88
21
Deoxynivalenol
Corn stalks
b
1.5b
16
US
US
Corn
1.8b
15
US
Corn
1.0b
15
US
Corn
0.1
15
US
Mixed feed
b
o.og
15
US
Mixed feed
1.0b
15
US
Mixed feed
1.0
15
US
US
Corn
Corn
7.4
d
0.1-25
9
21
US
Corn
trace-25d
2, 21
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Table D-7 (continued)
Toxin Country
Source
Concentration Referencea
(parts per million)
Deoxynivalenol (Continued)
US
Corn
1.1-10.7
26
US
Corn
41 b
25
US
Corn
1.0
17
US
Oats
5a
17
Japan
Barley
ND b
18
US
Corn
1.0 b
13
US
Corn
��6b
6b
13
US
Mixed feed
0.0,
13
France
Corn
0.6
10
South Africa
Corn
2.5
11
Zambia
Corn
7.4
11
US
Corn
ND
2
Japan
Barley
7.3
18
Austria
Corn
1.3
24
Austria
Corn
7.9
24
Canada
Corn
7.9
24
Nivalenol
Japan
Barley
ND
18
France
Corn
4.3b
10
Partially characterized trichothecenes
US
Corn
NDd
25
India
Safflower seed
ND
6
Skin irritant factors-not analyzed chemically
US
Corn
. . b
93 positive of 173
3
US
Corn
Multiple positive samples
21
Yugoslavia
Corn
16 positive of 191
1
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a
References:
1.
Balzer et al. (1977)
14.
Mirocha (1979b)
2.
Ciegler (1978)
15.
Mirocha et al. (1976b)
3.
4.
Eppley et al. (1974)
Funnel (1979)
16.
17.
Mirocha et al. (197911)
Mirocha et al. (1979 )
5.
Ghosal et al. (1978)
18.
Morooka et al. (1972)
6.
Ghosal et al. (1977)
19.
Petrie et al. (1977)
7.
Hibbs et al. (1974)
20.
Puls and Greenway (1976)
8.
Hsu et al. (1972)
21.
Romer, T., Ralston Purina, St. Louis, MO
(personal communication)
9.
Isshi et al. (1975)
22.
Rukmini and Bhat (1978)
10.
Jemmail et al. (1978)
23.
Siegfried (1979)
11.
Marasas et al. (1977)
24.
Vesonder and Ciegler (1979)
12.
Miller (1976)
25.
Vesonder et al. (1976)
13.
Mirocha (1979a)
26.
Vesonder et al, (1978)
Zearalenone (F-2 Toxin) also
ND = toxin concentration was
Levels that are questionable
detected in the sample.
not determined.
on the basis of techniques used.
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Skeptics have formulated theoretical explanations for
the analytical results to support a hypothesis of natural
occurrence of these toxins. It was postulated that the trich-
othecenes found were absorbed through the roots of a plant,
translocated to the leaves, and exuded and washed onto the
surface of a rock and into water where they were found. A
1981 publication by Jarvis et al. reported a Brazilian shrub
that appeared to absorb, translocate, and chemically alter
a macrocyclic trichothecene produced by a soil fungi. While
this citation is used to support a hypothetical mode for
natural deposition in Southeast Asia it should be noted
that the plant reported by Jarvis et al. did not exude the
toxin, that the toxin was extremely phytotoxic to all other
plants assessed, and that the plant was not capable of denovo
trichothecene synthesis. No other trichothecenes have been
found to be absorbed and translocated in any other plant in
this manner. Control samples of soil and vegetation from
Southeast Asia do not support endemic presence of these
toxins. The appearance of these particular trichothecene
toxins in these high levels in environments generally inhos-
pitable to their formation cannot reasonably be attributed
to a natural contamination.
Chemical and Physical Properties of the Trichothecenes
When considering the suitability of trichothecenes as
agents, factors such as stability, solubility, and ease of
production must be considered. The general structure for
the trichothecene group is shown in figure D-1. There are
over 40 currently known, naturally occurring, 12 to 13 epoxy-
trichothecenes. The R groups may be hydroxyls, acylated
hydroxyl groups, or esters. The R group for the toxins
detected in Sample Group IJA are shown below the general
structure. All of the compounds have in common an olefinic
double bond at carbon atoms 9 and 10 and an epoxy group at
carbon atoms 12 and 13. These compounds are stable, espe-
cially in the solid form. They may be stored for years at
room temperature with no loss of activity. They are heat
stable with no loss of activity noted after heating for 1 hour
at 100 degrees centigrade. The solubility depends on the R
groups; highly hydroxylated derivatives are more water soluble.
The compounds are also quite stable in solution. Detoxification
can be accomplished by treatment with strong mineral acid, which
will open the 12 to 13 epoxide bond and abolish all biological
activity. Most of the toxins are well absorbed through mucous
membranes and some through skin; this property is also a func-
tion of the R group.
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Figure D4
General Strodare of Trichothecenes
fel= o-- c�cisrof
c:1411
/12'M
iltsmOac
Re0Ac
Its=0H
Unclassified!
R1
=
0
R1
R2
=
OH
R2
R3
=
OH
R3
R4
=
OH
R4
R5
=
H
R5
Nivalenol Deoxynivalenol
= 0
= OH
= OH
= H
= H
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Some of these compounds have been synthesized chemically;
however, biosynthesis employing Fusarium species is the most
effective way to produce large quantities. In a preliminary
search of recent Soviet open source literature, 50 articles
dealing with the trichothecenes were reviewed. Of these, 22
dealt with defining optimum conditions for biosynthesis of
the compounds. N. A. Kostyunina has reported production of
T-2 toxin at levels of 4 grams per kilograms of substrate
(normally wheat grain, or rice). Numerous industrial micro-
biology plants have been identified in the Soviet Union.
Some of these are involved in production of single-cell pro-
tein for fodder additives, others produce antibiotics, and.
the function of still others is unknown. The only difference
between an antibiotic and mycotoxin is their target speci-
ficity. Both are produced by fungi, but the mycotoxins are
relatively more toxic to man than to microorganisms. Myco-
toxins can be produced in good yield employing the same
techniques that are used to produce some antibiotics. Thus,
it may be concluded that the Soviets could produce tricho-
thecenes in large amounts. They produce an antibiotic that
is a trichothecene derivative, which would provide an ideal
cover for agent production facilities.
Medical Effects of the Trichothecenes in Humans
The most prominent symptoms associated with trichothe-
cene poisoning are listed in table D-5. Striking among these
is the rapid onset of vomiting with severe itching and tingl-
ing of the skin. Hemorrhage of the mucous membranes and
bloody diarrhea follow. That table also presents symptoms
reported to have been caused by the trichothecenes in gas
attack victims in Laos, Kampuchea, and Afghanistan. The
correlation is striking.
The talm,'s (dose required to produce death in 50 percent
of a test p6ulation) of the trichothecenes in laboratory
animals range from 0.1 mg/kg to greater than 1,000 mg/kg
depending on the particular toxin, species, and route of
exposure. The LD5n of T-2 toxin in cat is -0.5 mg/kg.
However, the EDmn ?dose required to produce a desired phy-
siological effe6t in 50 percent of a test population) is
much lower. The Elkil to produce a vomiting reaction is
0.1 mg/kg, and for ain irritation it is in the tenths of
microgram range.
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110
Most of the data concerning the toxicological effects
of the trichothecenes are derived from animal data in which
pure compounds were administered by oral, subcutaneous,
intraperitoneal or intravenous routes. Unfortunately, there
are no reports concerning the effects of inhalation of mix-
tures of the compounds. Therefore, it is difficult to specu-
late concerning the effects that would be expected in humans
who were exposed to an aerosol of mixtures of these very potent
toxins. The most useful data concerning exposure in humans
was obtained in a Phase I clinical evaluation of anguidine
(diacetoxyscirpenol) as an anticancer drug. Diacetoxyscir-
pen(); was administered by intravenous infusion. Doses of 3
mg/e/day caused immediate onset of nausea, vomiting, diarrhea,
somnolence (and/or mental confusion), fever, chills, a general-
ized erythema with a burning sensation, hypotension, dyspnea,
stomatitis, hives, and ataxia. Because of the side effects
the treatment was discontinued. The properties which make
the use of diacetoxyscirpenol potentially useful as an anti-
cancer drug are the same as those responsible (in part) for
its extreme toxicity. It and the other trichothecenes cause
extensive damage to rapidly dividing cells such as tumor cells.
Unfortunately, the cells of the lining of the gastrointestinal
tract and bone marrow are also rapidly dividing and the effects
of the trichothecenes on these cells result in severe rapid
degeneration of these tissues. The compounds also have direct
effects on the clotting factors in the blood (that iP,
a primary effect on Factor VII activity and a secondary
effect on prothrombin) which result in excessive hemorrhage
following trauma.
The other useful body of clinical data concerning the
effects of trichothecenes in humans is drawn from descriptions
of the course of the disease in the natural outbreaks that
occurred in the Soviet Union. The clinical picture may be
divided into four stages. The effects produced are very simi-
lar to radiation poisoning and there is a latent phase in
which the overt symptoms disappear similar to that seen in
radiation poisoning.
The first stage occurs within minutes to hours after
ingestion of toxic grains. The symptomatology described
was produced by oral exposure to low doses. In exposure
by inhalation, the symptoms may be more pronounced or the
time course accelerated. The characteristics of the first
stage include primary changes, with local symptoms, in the
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buccal cavity and gastrointestinal tract. Shortly after
ingestion of toxic grain, the patient experiences a burning
sensation in the mouth, tongue, throat, palate, esophagus,
and stomach as a result of the toxin's effect on the mucous
membranes. The tongue may feel swollen and stiff and the
mucosa of the oral cavity may be hyperemic. Inflammation
of the gastric and intestinal mucosa occurs, along with vomit-
ing, diarrhea, and abdominal pain. In most cases excessive
salivation, headache, dizziness, weakness, fatigue, and
tachycardia accompany the initial stage. There may be fever
and sweating, but the body temperature normally does not
rise. The leukocyte count may begin to decrease in this
stage and there may be an increased erythrocyte sedimentation
rate. This first stage may last from three to nine days.
The second stage is often called the latent stage or
incubation period because the patient feels well and is
capable of normal activity. It is also called the leuko-
penic stage because its main features are disturbances in
the bone marrow and the hematopoietic system, characterized
by a progressive leukopenia, a granulopenia, and a relative
lymphocytosis. In addition, anemia and a decrease in erythro-
cytes, in the platelet count, and hemoglobin occurs. Dis-
turbances in the CNS and autonomic nervous systems may occur.
Weakness, vertigo, fatigue, headache, palpitations, and mild
asthmatic conditions may occur. Visable hemorrhagic spots
(petechiae) begin to appear on the skin and this marks the
transition to the third phase. The second stage may last
three to four weeks. The transition to the third stage is
sudden and symptoms progress rapidly.
In the third stage petechial hemorrhages occur on the
skin of the trunk, arms, thighs, and face and head. They
can vary from a millimeter to a few centimeters in size.
Capillaries are very fragile and any slight trauma results
in hemorrhage. Hemorrhages of the mucous membranes of the
mouth, tongue, soft palate, and tonsils occur. Nasal, gas-
tric, and intestinal hemorrhages can be very severe. Areas
of necrosis begin to appear on the lips, fingers, nose,
jaws, eyes, and in the mouth. Lymph nodes are frequently
enlarged and the adjoining connective tissue can become so
edematous that the patient has difficulty opening his mouth.
Blood abnormalities previously described are intensified.
Death may occur from hemorrhage, strangulation (due to
swelling) or secondary infection.
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The fourth stage is convalescence. Three to four weeks
of treatment are required for disappearance of necrotic
lesions and hemorrhagic effects. Two months or more may
elapse before the blood forming capability of the bone mar-
row returns to normal.
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IV. Bibliography of Literature Non-Soviet
Angsubhakorn, S., Sahaphong, S., Phiernpichit, L., Romruen,
K., Thamavit, W., and Bhamarapravati, N., "Toxigenic Fungi
in Food and Foodstuffs of Thailand," J. Med. Ass. Thailand,
Vol. 60, No. 4, (1977), pp. 162-168.
Balzer, I., Bodanic, C., and Muzic, S., "Natural Contamina-
tion of Corn (Zea mays) with Mycotoxins in Yugoslavia,"
Annals Nutrition Alimentals, Vol. 31, 1977, pp. 425-430.
Bamburg, J. R. and Strong, F. M. "Mycotoxims of the
trichothecene family produced by Fusarium tricinctum and
trichoderma lignorum, "Phytochemistry, Vol. 8, 1969, pp.
2405-2410.
Ciegler, A., "Trichothecenes: Occurrence and Toxicoses,"
Journal of Food Protecion, Vol. 41, 1978, pp. 399-403.
Dekker, "Mycotoxic Fungi, Mycotoxins, Mycotoxicoses," An
Encylopedic Handbook, 1977.
Eppley, R. M., Stoloff, L., Trucksess, M. W., and Chung, C. W.,
"Survey of Corn for Fusarium Toxins," Journal of the Associa-
tion of Official Analytical Chemists, Vol. 57, 1974, pp. 632-635.
Funnel, H. S., "Mycotoxins in Animal Feedstuffs in Ontario 1972
to 1977, "Canadian Journal of Comparative Medicine, Vol. 43,
1979, pp. 243-246.
Ghosal, S., Chakrabarti, D. K., and Choudhary, K. C. B.,
"The Occurrence of 12, 13 Epoxytrichothecenes in Seeds of
Safflower Infected with Fusarium oxysporium f. sp. carthami,"
Experientia, Vol. 33, 1977, pp. 574-575.
Ghosal, S., Biswas, K., Srivastava, �R. S., Chakrabarti, D. K.,
and Choudhary, K. C. B., "Toxic Substances Produced by
Fusarium V: Occurrence of Zearalenone, DiEzetoxyscirpenol
and T-2 ToXin in Moldy Corn Infected with Fusarium monili-
forme Sheld," Journal of Pharmaceutical Science, Vol. 67,
1978, pp. 1,768-1,769.
Hibbs, C. M., Osweiler, G. D., Buck, W. B., and Macfee, G. P.,
"Bovine Hemorrhagic Syndrome Related to T-2 Mycotoxin,"
Predeedings of the American Association of Veterinary Labora-
tory Diagnosticians, Vol. 17, 1974, pp. 305-310.
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Hsu, I. C., Smalley, E. B., Strong, F. M., and Ribelin, W. E.,
"Identification of T-2 Toxin in Moldy Corn Associated with
a Lethal Toxicosis in Dairy Cattle," Applied Microbiology,
Vol. 24, 1972, pp. 684-690.
Ishii, K., Ando, Y., and Ueno, Y., "Toxicological Approaches
to the Metabolites of Fusaria. Isolation of the Vomiting
Factor from Moldy Corn Infected with Fusarium Species," Chem-
ical Pharmacology Bulletin, Vol. 23, 1975, pp. 2,162-2,164.
Jarvis, B. B., Midiwo, T. O., and Tuthill, D., "Interaction
Between the Antibiotic Trichothecenes and the Higher Plant
Baccharis megapotamica," Science, Vol. 214, 1981, pp. 460-461.
Jemmali, M., Ueno, Y., Ishii, K., Frayssinet, C., and Etienne, M.,
"Natural Occurrence of Trichothecenes (nivalenol, deoxynivalenol,
T-2) and Zearalenone in Corn," Experientia, Vol. 34, 1978, pp.
1,333-1,334.
Joffe, A. Z. "Alimentary Toxic Aleukia," in Microbial Toxins,
Vol. 7, 1971, pp. 139-189. Edited by S. Kadis, A. Ciegler,
S. J. Ajl, Academic Press, N. Y.
Marasas, W. F. 0., Kreik, W. P. J., Van Rensburg, S. T.,
Steyn, M., and Van Schalkwyk, G. C., "Occurrence of Zeara-
lenone and Deoxynivalenol, Mycotoxins Produced by Fusarium
graminearum Schwabe in South Africa," South African Journal
of Science, Vol. 73, 1977, pp. 346-349.
Miller, J. K., "Suspected Mycotoxic Diseases of Pigs in
Scotland. Second Meeting on Mycotoxins in Animal Disease,''
Eds. Patterson, D. S. P., Pepin, G. A., and Shreeve, B. J.,
1976, pp. 14-16. Pinner: Middlesex.
Mirocha, C. J., "Fusarium Species and their Effects on Farm
Animals," Proceedings of the 15th Annual Nutrition Conference
for Feed Manufacturers, 1979a, pp. 49-58, Guelph.
Mirocha, C. J., "Trichothecenes Produced by Fusarium. In
Conference on Mycotoxins in Animal Feeds and Grains Related
to Animal Health," Ed. Himoda, W., 1979b, pp. 289-260.
Report FDA/BVM-79/139. National Technical Information Service:
Springfield.
Miocha, C. J., Pathre, S. V., Schauerhamer, B., and Christen-
sen, C. M., "Natural Occurrence of Fusarium Toxins in Feed-
stuff," Applied and Environmental Microbiology, Vol. 32,
1976b, pp. 553-556.
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Morooka, N., Uratsuji, N., Yoshizawa, T., and Yamamoto, H.,
"Studies on the Toxic Substances in Barley Infected with
Fusarium," Japanese Journal of Food Hygiene, Vol. 13, 1972,
pp. 368-375.
Murphy, W. K.
Bodey, G. P.,
of Anguidine,
1,497-1,502.
, Burgess, M. A., Valdivieso, M., Livingston, R. B.,
and Freireich, E., "Phase I Clinical Evaluation
" Cancer Treatment Reports, Vol. 62, 1978, pp.
Petrie, L., Robb, J., and Stewart, A. F., "The Identification
of T Toxin and its Association with a Hemorrhagic Syndrome
in Cattle," Veterinary Record, Vol. 101, 1977, p. 326.
Puls, R., Greenway, J. A., "Fusariotoxicosis from Barley
in British Columbia II. Analysis and Toxicity in Suspected
Barley," Canadian Journal of Comparative Medicine, Vol. 40
1976, pp. 16-19.
Rukmini, C., Bhat, R. V., "Occurrence of T-2 Toxin in Fusar-
ium-infested Sorgham from India," Journal of Agriculture and
Food Chemistry, Vol. 26, 1978, pp. 647-649.
Shank, R. C., Wogan, G. W., and Gibson, J. B., "Toxigenic
Molds in Foods and Foodstuffs in Tropical South-east Asia,"
Fd. Cosmet. Toxicol., Vol.10, 1972, pp. 51-60.
Siegfried, R., "Fusarium-toxine," Naturwissenschaften,
Vol. 64, 1977, p. 274.
Vesonder, R. F., Ciegler, A., "Natural Occurrence of Vomitoxin
in Austraian and Canadian Corn," European Journal of Applied
Microbiology and Biotechnology, Vol. 8, 1979, pp. 237-240.
Vesonder, R. F., Ciegler, A., Jensen, A. H., Rohwedder, W. K.,
and Wiesleder, D., "Co-identity of the Refusal and Emetic
Principle from Fusarium-infected Corn," Applied and Environ-
mental Microbiology, Vol. 31, 1976, pp. 280-285.
Vesonder, R. F., Ciegler, A., Rodgers, R. F., Burbridge, K. A.,
Bothast, R. J., and Jensen, A. H., "Survey of 1977 Crop year
Preharvest Corn for Vomitoxin," Applied and Environmental
Microbiology, Vol. 36, 1978, pp. 885-888.
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�
Soviet Scientists Involved in Mycotoxin Research
A. Kh. Sarkisov
V. I. Bilay
(also spelled Bilai)
V. A. Tutel'yan
M. A. Akhmeteli
L. Ye. Olifson
M. F. Nesterin
K. Z. Salomatina
Ye. P. Kozhevnikova
N. D. Osadchaya
L. F. Mikhaylova
Sh. M. Kenina
V. L. Kartashova
L. R. Filonova
T. Ye. Tolcheyeva
Kn. A. Dzhilavyan
I. S. Yelistratov
N. S. Tishkova
V. I. Kaplun
Ye. P1 Kozhevalkova
S. M. Gubkin
L. I. Il'ina
P. A. Il'in
All Union Scientific Research
Institute of Experimental
Veterinary Science, Moscow
Ukrainian SSR Institute of
Microbiology and Virology,, Kiev
USSR Academy of Medical Sciences
Nutrition Institute, Moscow
USSR Academy of Medical Sceinces
Institute of Epidemiology and
Microbiology
D-28
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A. M.
D. T.
N. A.
V. V.
I. A.
V. V.
Z. K.
Z. Z.
L. S.
L. I.
T. A.
I. Yu
N. S.
A. V.
M. N.
L. I.
M. S.
Kogan
Martynenko
Kostyunina
Yerinakov
Kurmanov
Semenov
Bystryakova
Orlova
L'vova
Lozbina
Shevtsova
Makedon
Proskuryakova
Borovkov
Nazypov
Lozbin
Marova
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V. SELECTED BIBLIOGRAPHY OF SOVIET LITERATURE
Maksimova, R. A., Palmova, N. P., Khuratova, B. G., "The
Effect of Polyploidogenous Factors on the Mycelium of Tri-
chothecin and Fibrinolytic Enzymes," Mikrobiologiya, 1979,
Vol. 48, No. 2, pp. 324-328.
Zhakhanov, A., "Growth and Development of Weakly and Strongly
Toxic Strains of Fusarium Sporotrichioides With Different
Sources of Nitrogen Nutrition," Vestnik Seliskokhozyaistvennoi
Nauki Kazakhstana, 1977, Vol. 20, No. 9, pp. 35-36.
Kirpichenko, L., "Effect of Different Sources of Nitrogen
on the Growth and Pathogenicity of Fusarium Oxysporum,"
Referativnyi Zhurnal, 1976, 3.14.434.
Berestetskii, O. A., Nadkernichnii, S. P., Patyka, V. F.,
"Isolation and Characteristics of a Phytotoxic Substance
Produced by Fusarium Lateritium Nees," Mikologiya i Fito-
pathologiya, Vol. 9, No. 4, 1975, pp. 325-327.
Paletskaya, L. N., Kiseleva, N. T., Zhuravleva, V. P., Gonna,
E. I., Saryeva, A. N., "Effects of Nitrogenous Fertilizers on
Fusarium Oxysporum f. Vasinfectum and Its Toxicity," Mikologiya
i Fitopatologiya, Vol. 7, No. 6, 1973, pp. 515-520.
Kvashnina, E. S., "Physilogical and Ecological Character-
istics of Fusarium Species of the Section Sporotorichiella,"
Mikologiya i Fitopatologiya, Vol. 10, No. 4, 1976, pp. 275-282.
Kalinina, R. T., "The Determination of Pathogenicity of and
the Presence of Phytotoxins in Fusarium Fungi-the Pathogens
of Root Rot of Wheat," Mikologiya i Fitopatologiya, Vol. 14,
No. 1, 1980, pp. 51-56.
Kostyunina, N. A., Ermakov, V. V., "Isolation and Identifi-
cation of Zearalenone," Veterinariya, Moscow, USSR, No. 11,
1976, pp. 101-103.
Palyusik, M., Matrai, T., "Effect of Carbon Dioxide and
Mositure on Toxin Production by Fusarium Strains During
Storage of Maize," Magyar Allatorvosok Lapja, Vol. 32, No. 9,
1977, pp. 572-573.
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Seelyey, G., Vanyi, A., Petri, A., "Effect of Irradiation
on the Viability and Toxin Porduction of Different Fungus
Species," Magyar Allatorvosok Lafja, Vol. 34, No. 6, 1979,
pp. 412-416.
Polovinki, G. P., "Accumulation of Fusaric Acid by Different
Fusarium Species and Their Phytotoxic Properties," Mikrobio-
logicheskii Zhurnal, Vol. 41, No. 5, 1979, pp. 504-508.
Bilai, V. I., Ellanskaya, I. A., "Morphological Features of
the Fusarium Species Under Submerged Cultivation,"Mikrobiol.
Zh., Vol. 42, No. 2, 1980, pp. 172-179.
Maksimova, R. A., Rapoport, I. A., "Investigation of the
Mutagenic Effects of Nitrosomethylurea on Trichothecium
Roseum, A Producer of the Antibiotic Trichothecin,"
Genetika. Publ. 67, Issue 3, pp. 107-113.
Zaichenko, A. M., Proskuryakova, N. S., Dakhnovsky, V. I.,
''Physiological and Biochemical Characteristics of Dendrodochium
Toxicum in Connection with Biosynthesis of Dendrodochins in the
Process of Dendrodochium Toxicum 5800 Cultivation. II. Dynamics
of Dendrodochins Component Composition," Mikrobiol. Zh., Vol.
42, No. 3, 1980, pp. 315-318.
Bilai, V. I., Nikol'skaya, E. A., Bogomolova, L. A., Zakordonts,
L. A., Strizhevskaya, A. Ya., Silvers, V. S., Zaichenko, A. M.,
Proskuryakova, N. S., "Regulation of Growth and Biosynthetic
Activity of Microscopic Fungi," Mikrobiol. Zh., Vol. 33, No. 2,
1971, pp. 134-140.
Bilai, V. I., Shcherbina, S. N., Bogomolova, L. A., Proskuryokova,
N. S., "Effect of Different Ratios of Carbon and Nitrogen on
Biosynthesis of Fusaric and Nicotinic Acids and on Respiration
in Fusarium (Ukrainian)," Mikrobiol. Zh., Vol. 36, No. 3, 1974,
pp. 293-299.
Bilai, V. I., Koval, E. Z., "Features of Growth of Fusaria
With Assimilation of Hydrocarbons (Ukrainian)," Mikrobiol.
Zh., Vol. 36, No.5, 1974, pp. 587-594.
Bilai, V. I., Losjakova, L. S., Serebrennikov, V. M., Shkolnyj,
A. T., "Growth of Microbiol. Zh., Vol. 40, No. 3, 1978, pp.
327-332.
Bilai, V. I., Strizhevskaja, A. IA., "Growth of Mycelium
and Rate of Xylan, Xylose and Glucose Uptake By Strains of
Different Fungi Species," Mikrobiol. Zh., Vol. 39, No. 3,
1977, pp. 307-310.
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Panozishvili, K., Zoltnikova, N. V., Borovkov, A. V., "Verrucarin
A From Dendrodochium Toxicum," Khim. Prir. Soedin., No. 2, 1972,
p. 245.
Kurbatskaya, Z. A., Ibragimov, R. G., "Growth and Toxin Forma-
tion in Some Species of Aspergillus Genus Under Different Tem-
perature Conditions of Cultivation," Mikrobiol. Zh., Vol. 41,
No. 4, 1979, pp. 358-362.
Bilai, V. I., Shcherbina, S. M., Ellanska, I. A., "Formation
of Group B Vitamins by Different Species of Fusarium LK,"
Mikrobiol. Zhur., Vol. 33, No. 3, May/June 1971, pp. 310-314.
V. I., "Determination of Growth and Biosynthetic
Activity of Fungi," Metody Eksp. Mikol., 1973, pp. 5-16.
Bilai, V. I. Misyurenko, I. P., "Formation of Toxins During
the Submerged Cultivation of Fusarium Sporotrichiella," Dopov.
Akad. Nauk Ukr. RSR, Vol. 36, No. 9, 1974, pp. 846-849.
Bilai, V. I., Nikol'skaya, E. A., Bilai, T. I., "Regulation
of Enzymic Activity of Fungi by the Relation and Level of
Nutrient Components," Fiziol. Puti Povysh. Ferment. Akt.
Mikroorg., 1973, pp. 134-148.
Erofeev, N. S., Bezborodov, A. M. Bilai, V. I., Bogomolova,
L. A., Zolotareva, E. A., Medvedeva, T. N., Surovtseva, V. M.,
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of Dendrochium Toxicum and Formation of Dendrochin," Eksp.
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Lignin of Pinus Silvestris," Reference MZUKA 77, Vol. 39,
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"Effect of Colchicine and Other Polyploidogenous Factors
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pp. 80-85.
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tion and Identification of Mycotoxin T-2 Produced by Fusarium
Sporotrichiella," Soviet Agricultural Sciences, 1978, No. 3,
pp. 47-49.
Bilai, V. I., "Principles of Taxonomy and Structure of Phyto-
pathogenic Species of the Genus Fusarium Lk. Ex Fr," Mikrobiol.
Zh., Vol. 40, No. 2, 1978, pp. 148-156.
Bilai, V. I., Cherkes, A. I., Bogomolova, L. A., Frantsuzova,
S. B., Toxicobiologic Properties of Fusaric Acid, A Metabolite
of Fusarium Oxysporum (Ukrainian)," Mikrobiol. Zh., Vol. 37,
No. 3, 1975, pp. 325-328.
Palmova, N. P., Maximova, R. A., "Effect of Inhibitors of
Protein Synthesis on the Growth and Biosyntetic Activity of
Trichothecium Roseum," Mikrobiologiya, Vol. 48, No. 5,
1979, pp. 858-862.
Maximov, V. N., Maximova, R. A., Minayeva, T. A., "Charac-
teristics of the Directed Biosynthesis of Trichothecin and
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logiya, Vol. 49, No. 2, 1980, pp. 258-264.
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istry, Biosynthesis, Determination, Effect on the Body),"
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150-155.
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Composition of the Lipid Complex of Grain Infected by the Micro-
scopic Fungus Fusarium Sporotrichiella Bilai," Prikl Biokhim
Mickrobiol., Vol. 14, No. 4, July/August 1978, pp. 630-634.
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Bilai, V. I., "Principles of the Systematics and the Struc-
ture of Phytopathogenic Secies of the Genus Fusarium Lk. Ex
Fr," Mikrobiol Zh., Vol. 40, No. 2, March/April 1978, pp.
148-156.
Olifson, L. E., "On the Question of Biosynthesis of Toxic
Steroles by the Microscopic Fungi Fusarium Sporotrichiella,
Paper Presented," Mikrobiologichnyy Zhurnal, Vol. 35, No.
2, 1973, p. 266.
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Fusarium Oxysporum F. Inli (Bolley) Synder Et Hansen and the
Formation of Toxins," Izvestiya Timiryazevskoy Selskokhozya-
ystvennoy Akademii, No. 3, 1972, pp. 143-147.
Alisova, Z. I., "Immunization of Rabbits by the Toxic and
Atoxic Condensation of Liquid Cultures of the Fungus Fusarium,"
Voprosy Meditsiny, Vol. No. 1 1964, p. 190.
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Fusarium Genus Molds (4th All Union Conference on Aerosols,
1958)" Letopis Zhurnalnykh Statey, No. 38, 1959, p. 127.
Titova, L. M., "Amino Acids as a Single Source of Nitrogen
for Toxin Forming Fungi," Mikrobiologichnyy Zhurnal, Vol.
33, No.2, 1971, pp. 159-164.
Bekker, Z. E., Poletayeva, V. F., "The Role of Zinc in the
Pathogensis of Fusarium Wilt and the Biosynthetic Activ-
ity of Strains of Its Etiologic Agent," Izvestiya Akademii
nauk Turkmenskoy SSR, No. 2, 1968, pp. 3-9.
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Some Toxic Fungi of the Genus Fusarium," SB Nauchn Rab
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Sporotrichiella Bilai Var Sporotrichidides, Sherb, Bilai Under
Different Conditions of Cultivation," SB Nauch TR Ryazan
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nykh Statey, No. 32, 1969, p. 140.
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Bekker, E. E., Doviet, M., Ovletmuradov, K. D., Pushkareva,
I. D., Poletayeva, V. F., Shilina, S. G., Yaskova, E. I.,
"Nature and Biosynthesis of the Causative Agent Toxin of
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Fusarium Agents of Root Rot in Winter," Mikrobiologi-
chnyy Zhurnal, Vol. 32, No. 6, 1970, pp. 700-704.
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ANNEXE
MEDICAL EVIDENCE
Southeast Asia
Since 1976, multiple kinds of sources--refugees, relief
medical and civilian workers, and many specially qualified
physicians--consistently have detailed unusual signs and
symptoms of victims of "yellow rain." Specifically, vic-
tims in Southeast Asia subjected to a direct attack of the
yellow powder, mist, smoke, or dust would be seen to begin
retching and vomiting in a matter of minutes. This and the
effects described below were not pronounced in individuals
even 100 meters from the attack zone, indicating a rela-
tively dense chemical/carrier combination that was effective
in low wind conditions.
Unlike that caused by a traditional riot-control nausea
agent, the initial induced vomiting following exposure to
"yellow rain" was protracted over hours to days often accom-
panied by dizziness with rapid heartbeat and apparently low
blood pressure, chest pain, loss of far-field vision, and
a feeling of intense heat and burning on the skin, but not
described as being most acute in the groin and axillae. Thus,
the acute signs and symptoms match some of the effects of
traditional vomiting and blister agents, but clearly not all.
A significant number of victims also reported intense
"red eyes," "bleeding gums," convulsions or more often
trembling, and vomiting of blood with or without production
of copious amounts of saliva within the first hours after
the attack again lasting many hours to days apparently de-
pending on the exposure level. Thick mucus, pinpoint pupils,
respiratory collapse, prolonged spasticity, and involuntary
urination or defecation were never reported after a yellow
rain attack, and this absence helped to rule out organophos-
phate nerve agents in the minds of CW experts. Man medical
and environmental samples also ruled out these and other
traditional agents such as DM, DS, and others.
Many observers of the "yellow rain" effects reported
formation within several hours of small (1 centimeter)
homogeneous, hard, fluid-filled blisters over only exposed
areas of skin, frequently including the victim's hands, arms,
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�
entire throat, and face, whenever skin was uncovered. In
most cases, the vomit, after two to eight hours, contained
blood, and in many cases a good deal of it. About half of
those receiving the most concentrated doses of yellow mate-
rial who had been directly under the spray were in several
hours after the attack observed to cease vomiting tempo-
rarily. This interval was often followed in five to 15
minutes by a period of great pain when the victim would
hold his abdomen and emit a "gush" of blood from his
mouth and nose. These individuals were usually dead within
minutes after that. Close questioning by physicians of
those who witnessed these final moments leave no doubt that
these observed effects were the results of severe gastro-
intestinal bleeding, significant pulmonary bleeding, tempo-
rary compression of accumulated blood in the stomach, and
finally projectile vomiting of as much as several hundred
milliliters of blood. These findings were consistent with
animal and human autopsies.
Many victims of the yellow material received less than
the full brunt of a spray, or entered the attack zone sev-
eral hours to two days later, or consumed food or water con-
taminated by the material. These individuals often within
the next 24 hours developed signs and symptoms similar to
those of the more directly affected (but often without pro-
nounced skin effects if they did not contact the powder
residue directly). In addition to attacks of intense
vomiting (five or six times a day), they also had diarrhea,
with bloody stools passed up to eight times a day. Bleed-
ing under the fingernails and around the skin of the eyes
and severe bruising of the skin are also commonly reported.
Opiates helped the fluid loss in adults; but, in children
or young persons not able to tolerate the treatments of raw
opium and water, death occurred in about half the cases
after 10 days to two weeks. On the basis of reported signs
and symptoms, the cause of delayed death was almost cer-
tainly dehydration.
In many cases chemical attacks are reported to produce
symptoms other than the ones described here. There has
always been, however, a direct association of the symptoms
above with reports of "yellow rain" attacks--that is, when
yellow material is used these symptoms appear; other agents
may give rise to other symptoms. Although it is possible to
have one or even several of these symptoms associated with
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111
traditional CW agents, no expert has been able to "fit"
the sequence, severity, and consistency with any of them.
In many cases victims and observers were examined, histories
taken, and interviews conducted by several health profess-
ionals weeks apart. Remarkable consistency has been observed.
From the beginning of the "yellow rain" episodes
in 1976, autopsies have occasionally been reported anecdot-
ally. Some have been done by less than expert technique,
some by nonphysicians, and some were on animals rather than
human victims. However, the consistency of the early
reported "putrefaction" or "rotteness" of the digestive
tract within 12 to 48 hours after death led many forensic
experts to suspect that one effect of the poison,- whatever
it was, was to cause necrosis (cell death) of rapidly divid-
ing mucosa (mucous membranes), especially in the stomach
and upper small intestine. Other autopsy findings included
hyperemia (engorgement with blood) of digestive mucosal
linings, and remarkably intense congestion and swelling
in the lungs, liver, spleen, and sometimes the kidneys.
These and other findings often led experts in toxicology
and pathology to suggest mycotoxin or even trichothecene
intoxication based on clinical and pathological data alone.
Although not a common cause of death, trichothecene
effects have been reported in the forensic, oncological,
and toxicological literature for several years. Unpub-
lished findings often were discussed in symposiums. In sev-
eral dozens of cases toxic effects in humans and animals
have been carefully recorded, and they match those of the
"yellow rain" story with good precision. (See table.)
There are no additional signs or effects of known tricho-
thecene intoxication not frequently reported by victims,
nor are there any reported "yellow rain" symptoms that
cannot be explained by the effect of the four specific
trichothecene toxins found in the samples, and the doses
inferred from the operational situation and description.
From a medical viewpoint, there are no significant
differences in the reporting from Laos and Kampuchea. The
timing and delivery systems have sometimes varied, but the
effects of the chemical agent, both clinically and patholog-
ically, are identical. In one case, a series of blood
samples from Kampuchean victims also showed a trend toward
leukopenia (reduction in number of white blood cells) and
the presence of a trichothecene metabolite (HT-2) consistent
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Comparison of Reported "Yellow Rain" Effects
With Known Trichothecene Effects
Yellow Rain Reports
1.
2.
3.
Nausea, vomiting--severe, immediate
"Falling down, world turning"
"Burning of skin" . . . small blisters
1.
2.
3.
4.
"Shaking all over, flopping like fish
out of water"
4.
5.
"Bleeding eyes"
5.
6.
"Pounding" chest, rapid heartbeat,
weakness
6.
7.
Severe pain in center of chest
7.
8.
Sleepiness, "not able to talk"
8.
9.
Bleeding gums
9.
10.
"Can't breathe"
10.
11.
"Skin and body hot with cold"
11.
12.
Diarrhea with blood
12.
13.
Loss of appetite, inability to eat
13.
14.
Bleeding into skin and fingernails
14.
15.
Drop in white blood cell count
15.
16.
"Rotten esophagus, stomach, intestines;
soft spleen and liver"
16.
17.
Swelling of all organs
17.
Effects of Trichothecenes (*)
Nausea, vomiting--severe, immediate
Dizziness
Generalized erythema with a burning
sensation of skin
Ataxia (failure of muscular coordination),
occasional tremors and convulsions
Congestion of the sclera (white outer coat
of eyeball) and blood in tears
Hypotension (abnormally low blood pressure)
with secondary rise in heart rate
Angina (substernal chest pain)
Somnolence, central nervous system symptoms
Stomatitis (inflammation of oral mucous
membranes) and ptyalism (excessive
salivation)
Shortness of breath
Fever and chills
Diarrhea with blood
Anorexia
Thrombocytopenia (decrease in number
of platelets, white blood cells
involved in clotting of blood) and
purpura (skin discoloration caused
by hemorrhage into tissues)
Leukopenia and anemia
Rapid necrosis of linings of gastro-
intestinal tract; lymphoid necrosis in
spleen and liver
Congestion of all organs
* Effects are immediate at levels near to or above 500 to 1,000 mg total body burden for an adult.
Athough inhalation data are pending, the levels are consistent with reported lethal and sublethal
doses. Trichothecenes in combination when directly ingested or inhaled are more toxic in some
cases, and the order of signs and symptoms and timing varies.
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with trichothecene intoxication (see annex D for blood analysis
results). To a first order, dose-response effects are also
seen, and routes of administration are consistent with effects.
Public Health Issues. An early hypothesis (1978-79) was
that a significant number of the deaths, especially in Laos,
could be explained by the heavy use of riot-control agents such
as CS, CN, DM, and agents which cause itching and/or blistering.
The hypothesis was rejected quickly on two grounds. First,
trace contaminant analysis did not show the presence of any of
these compounds in samples (several samples did, however,
contain a trichothecene precursor). Secondly, contrary to
commonly held views, the epidemiology of diseases endemic to
the Central Highlands and the public health of the H'Mong do
not support the view of malnourished, disease-ridden, and weak
persons who would succomb easily to riot-control agents. Also,
a number of studies have shown the opposite: a relatively low
incidence of pulmonary disease (lower than what could otherwise
account for certain effects); better nutritional states than
could otherwise account for death in 10 days to two weeks from
water loss (dehydration) and calorie depletion; and a death
rate of near zero from causes other than infection, geronto-
logical causes, and trauma.
Afghanistan
Some deaths with bleeding have been described in the
accounts from Afghanistan. In one series of cases a physician
examined a number of persons who had been exposed to sublethal
doses of a yellow smoke/black smoke combination attack and one
man near death after a series of attacks. Hemoptysis (nasal
bleeding)--but not hematemesis (bleeding from the gastro-
intestinal tract)--was reported in about half of these and
other cases.
Several features of at least one of the chemical agents--
an incapacitant--used in Afghanistan defy explanation at this
time. One posture is that it is highly selective for the
central nervous system rather than the autonomic nervous
system. No good candidate has yet been identified which
will selectively inhibit the central nervous system to cause
unconciousness for several hours as reported. A second
finding has been the presence of a dermal anaesthesia,
affecting only exposed areas of skin.
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Postattack Medical Survey. There is evidence
that after some of the attacks in Laos and Afghanistan,
Soviet or Communist (Pathet Lao) forces entered the
attack zones to conduct surveys. Several reports indicate
that a group of survivors from a toxin attack on a
Laotian village were taken several kilometers from
the village and injected with a small volume of a clear
solution said by their captors to be a "new" medicine
to "assess the gas." The injections were given intra-
muscularly in the upper arm and reportedly did nothing
to alleviate the weakness, nausea, vomiting, or diarrhea
suffered by the survivors. One source reported the
effect of the drug was to cause an immediate sensation
of warmth throughout his body. Only the use of opium
later eased the discomfort, after the survivors had lied
to their captors about how much better the new medicine
made them feel. It is probable that the procedure was a
test, either of a new antidote or of a drug developed
to reduce incapacitation from the nausea and vomiting.
Similarly, in a few cases in Afghanistan, Soviet troops
were reported to disembark from helicopters or armored
personnel carriers at the edge of an attack site. Three or
four, dressed in full anticontamination gear, walked among
the dead; examined the corpses; and, opening them with a
crude autopsy incision, examined the organs in the abdominal
and thoracic cavities. In one report a solution was toured
into the incision. When the corpses were later recovered
by Mujahedin guerrillas, the body cavity contents were
destroyed beyond recognition. These bizarre stories would
be discounted were it not for the past reliablility and
quality of reporting from the sources, which is be-
lieved excellent.
These and a small number of additional reports support
the hypothesis that the perpetrators of some of the attacks
are interested in studying aftereffects, lethality, or some
other quasi-experimental aspect of use of a new chemical
weapon. Details are not sufficiently clear to explain the
purpose of the above events, and "destruction of evidence"
is by itself not an entirely credible explanation. Recent
indications from Afghanistan indicate that one purpose of
these reviews of bodies and the field surveys is to determine
levels of toxic materials still present in the attack zone
before Soviet troops occupy it.
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