Cascade system for warning doctors of poison threat 'worked well'

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The system for alerting doctors to serious threats worked well in the hours after police revealed the existence of the deadly ricin poison in a north London suburb, health professionals said yesterday.

The system for alerting doctors to serious threats worked well in the hours after police revealed the existence of the deadly ricin poison in a north London suburb, health professionals said yesterday.

GPs and consultants said they had received urgent government warnings about the agent by yesterday morning, hours after public health officials activated the national NHS "cascade" system late on Tuesday.

A detailed warning from the deputy chief medical officer Dr Pat Troop was sent by e-mail at about 4pm on Tuesday as police announced the discovery of the deadly toxin. The e-mail was marked "immediate", the highest priority communication, reserved for "exceptional cases where potentially serious health risks are implicated".

Senior managers were paged to alert them to the urgent e-mails, which were also posted on the internet. Individual hospitals and primary care trustsalerted GPs, doctors and nurses.

The warning gave detailed information on symptoms of ricin poisoning, offered advice on diagnosis and gave contact details for doctors needing further advice. The circular warns: "Ricin is a protein toxin that is derived from castor oil seeds. It inhibits protein synthesis and has widespread toxic effects on the body. These include damage to most organ systems and a combination of pulmonary, liver, renal and immunological failure may lead to death. No antidote is known."

Concerns about the speed with which warnings were passed on were raised yesterday when one unnamed consultant told the Today programme on BBC Radio 4 that he had not received details of the warning. He said: "Clearly, the system isn't yet in place to adequately alert people quickly enough."But a British Medical Association spokes-man said it had received no complaints about the system.

The public appeared to be heeding official advice to be "alert but not alarmed".

The Department of Health said that of the daily 15,000 phone-calls received by the medical helpline, NHS Direct, on Tuesday, 47 were from people who were concerned about ricin poisoning.

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