title: What lessons can we learn from the Japanese sarin attacks?
abstract: On 27 June 1994 a Japanese terrorist group, Aum Shinrikyo, released sarin in Matsumoto. Some 600 people were exposed: 58 were admitted to six hospitals and all recovered: seven casualties living close to the sarin release died outside hospital. This release followed an earlier attempt by Aum Shinrikyo to use sarin to kill the head of a religious sect perceived as a threat. In December 1994, a former supporter of the group was murdered by Aum Shinrikyo using VX. On 20 March 1995, Aum Shinrikyo launched a coordinated attack using sarin on the Tokyo subway system. Over 5000 "casualties" sought medical attention of whom 984 were moderately poisoned and 54 were severely poisoned; 12 died. Despite some initial difficulties, Japanese emergency units and local hospitals were able to respond reasonably rapidly. Analysis of the events reveals a number of important lessons for authorities as well as physicians to consider when preparing for such incidents.
authors.affiliation: National Poisons Information Service (Birmingham Centre) and West Midlands Poisons Unit, City Hospital Birmingham B18 7QH, UK.
authors.forename: Allister
authors.initials: A
authors.lastname: Vale
mesh_terms: D051337:Chemical Terrorism / Q000517:prevention & control*; D002619:Chemical Warfare Agents / Q000506:poisoning*; D004189:Disaster Planning / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration; D006801:Humans; D007564:Japan; D009422:Nervous System Diseases / Q000139:chemically induced; D011041:Poisoning / Q000453:epidemiology; D018635:Rescue Work / Q000458:organization & administration; D012524:Sarin / Q000506:poisoning*
chemical_list: D002619:Chemical Warfare Agents; D012524:Sarin