 CDC Home  Case Definition: Nerve Agents or Organophosphates
Clinical description  Nerve agent or organophosphate toxicity
might result from multiple routes of exposure. It consists of a
cholinergic syndrome of excess respiratory and oral secretions,
diarrhea and vomiting, diaphoresis, convulsions, altered mental
status, miosis, bradycardia, and generalized weakness that can
progress to paralysis, respiratory arrest and death (1-3).  In
certain cases, excessive autonomic activity from stimulation of
nicotinic receptors will predominate in the syndrome and will
manifest as fasciculations, hypertension, mydriasis, and
tachycardia.  Laboratory criteria for diagnosis    • Biologic: A
case in which nerve agents in urine are detected, as determined
by CDC or a LRN laboratory that has this capacity. Decreased
plasma or red blood cell cholinesterase activity based on a
specific commercial laboratory reference interval might indicate
a nerve agent or organophosphate exposure; however, the
reference intervals for chol