At the Scene of reported Sarin Gas Attack
A Brief Clinical and Epidemiologic Comparison with the Japan Attacks
The June 27, 1994 sarin terrorist attacks in Matsumoto, Japan, and on March 20, 1995, in the Tokyo subway, provide the most through epidemiologic and pathologic case reports currently available for the evaluation of mass poisonings with this extremely toxic gas. The facts regarding the Japanese attacks are as follows.
- In Matsumoto members of the Aum Shinrikyo group released sarin in a residential area. It was a) an attempt to murder magistrates deliberating a real estate dispute; and b) an assessment of the poison’s efficiency for mass murder. The logistics of the crime included a refurbished refrigerator truck containing a heater for vaporization of twelve liters of liquid sarin, and powerful fans to diffuse a thick cloud of gas near the residencies of the involved judges. The sarin was 70 percent pure.
- Over six hundred residents and rescuers were poisoned, fifty-eight were hospitalized, and seven were killed. The calculated mortality-morbidity ratio was approximately 1.16 percent (7/600). (“Sarin Poisoning in Matsumoto, Japan, The Lancet 7/29/1995)
- On March 20, 1995, during the peak of morning rush hour a second sarin attack disrupted several Tokyo subway lines. This attack was focused on the stations close to the Tokyo National Police Agency and other central government centers. Aum Shinrikyo members punctured plastic bags of liquid sarin in subway cars jammed with workers headed to government offices. The liquid sarin was 30 percent pure.
- More than six thousand passengers and rescue workers were injured—eight hundred required hospital treatment or evaluation and twelve died. The mortality/morbidity ratio was 0.18 percent. (Yanagisawa, N. “Sarin Experiences in Japan,” Journal of Neurologic Science.
Sarin Victims in Tokyo Subway
II – On April 4th, helicopters or airplanes of the Syrian Arab Army dropped airborne ordnance over the village of Khan Sheikhun, Idlib Provence, Syria. The village was under the supervision of several groups currently in armed opposition to the government of President Bashar Al-Assad. Mr. Assad’s government has secured the support of the Russian armed forces, the Lebanese Hezbullah, and Iranian forces under the command of the Iranian revolutionary guard.
- Casualty reports were extremely variable. Injury numbers ranged from three hundred to more than five hundred, and reported deaths ranged from early accounts of fifty-eight to eighty-seven. Later sources reported fatalities in excess of one hundred, with children’s deaths ranging from ten to twenty-seven. Many of the major world journals, such as the New York Times have reported mortalities in the ranges above.
- Thus the reported mortality-morbidity would range from approx 72/500 to 100/300. This gives a range of 14.4 percent and 33 percent. Expressed in percentages, this represents an increase between 1,241 percent and 16,666 percent. The purity was not reported. However, earlier studies of weaponized sarin, in this region, particularly in the Iran-Iraqi War, had a purity in the 30-60 percent range.
The reported Iblid mortality-morbidity ratios are incompatible with sarin use as the etiological agent in the attacks of April 4, 2017 Khan Sheikhoun, Iblid Provence, Syria.
This could be due to several reasons:
- Another unidentified chemical agent was used.
2- Differing mortality-morbidity due to the differing mechanisms of gas dissemination. However, the two Japanese poisonings had, markedly, more intensive, prolonged exposures, which should have produced higher mortality-morbidity rates.
3-The differing availability of treatment and evacuation? While the Japanese civil defense was better equipped overall, the organizations involved in Syrian rescue operations had basic response preparations for the gas attacks and were able to evacuate injured patients to better-equipped Turkish medical facilities.
4- The casualty count was exaggerated.
5- The 1994-95 Japanese studies were unreliable.
Currently no credible evidence exists confirming sarin as the etiologic agent responsible. Hence the claim that sarin was the etiologic agent is highly unlikely.
“At Least 58 Killed in Alleged Chemical Weapons Attack in Syria.” April 4, 2017.www.independent.co.uk, accessed April 4, 2017
Khaddar, Kareem, Schams Elwazer, et al. “Suspected Gas Attack in Syria Reportedly Kills Dozens.” CNN. April 7, 2017.
“Worst Chemical Attack in Years in Syria; U. S. Blames Assad.” April 4, 2017. New York Times.
Seto, Yasuo. “The Sarin Gas Attack in Japan and the Related Forensic Investigation.”www.opcw.org, accessed April 11, 2017.
“Scores Reported Killed in Gas Attack on Syrian Rebel Area.” April 4, 2017. Reuters.
Yanagisawa, N. “Sarin Experiences in Japan: Acute Toxicity and Long-term Effects.” Journal of Neurologic Science. November 1, 2006.
——. “Sarin Poisoning in Matsumoto, Japan” The Lancet, July 29, 1995.
By: Dr. Joseph Harris, MD
Harlem, New York
Note: Dr. Harris has worked as a physician in Rawanda and other war zones. he was participant at Doctor’s Without Borders when the were awarded the Nobel Peace Prize.