VX: Exposure, Decontamination, Treatment

• VX is a human-made chemical warfare agent classified as a nerve agent and is one of the most toxic of nerve agents.
• VX, like all nerve agents, interferes with the operation of an enzyme that stops muscles from contracting. When this enzyme does not work correctly muscles are constantly being stimulated. With continuous contraction of muscles, exposed people may become tired and no longer be able to keep breathing.
• VX is an oily liquid that is amber in color. It is a tasteless liquid with no perceivable odor.
• VX is very slow to evaporate and become a vapor (gas). It evaporates about as slowly as motor oil.
• VX can remain in the environment from days to months depending on the circumstances.

• After a release of VX into the air, people can be exposed through skin contact, eye contact, or inhaling (breathing in) the VX vapor.
• Following release of VX into water, people can be exposed by touching or drinking water that contains VX.
• People can also be exposed to liquid VX by swallowing it, getting it on their skin, or in their eyes.
• Touching or eating food contaminated with VX can expose people to VX.
• Touching or inhaling VX vapor from contaminated clothing can expose anyone who touches the clothes or inhales VX vapor from the clothes.
• Because VX vapor is heavier than air, it will sink to low-lying areas and increase the risk of exposure there.
• Because VX evaporates slowly, VX can be a short-term threat and a long-term threat. Surfaces may remain contaminated with VX and dangerous for days to months.

• Food not contained in glass or metal (such as plastic, paper, or cloth containers) that may have come into contact with vapor or liquid VX should be avoided.
• If the food is in an undamaged sealed glass or metal container, it should not be affected by a VX release. Wash the outside of the container before using.
• If the food smells, tastes, or looks unusual, avoid using the food.
• Follow any directions by local authorities.

Signs and symptoms depend on how much VX a person was exposed to, how the person was exposed, and the length of time they were exposed. VX has no perceivable odor, so until signs and symptoms develop, people may not know that they were exposed.

People exposed to a low or moderate dose of VX may experience some or all the following signs and symptoms within seconds to hours of exposure:

• Abnormally low or high blood pressure
• Blurred vision
• Chest tightness
• Confusion
• Cough
• Diarrhea
• Drooling
• Difficulty breathing
• Drowsiness
• Eye pain
• Eye tearing
• Excessive sweating
• Fast heart rate
• Headache
• Increased urination
• Muscle cramps
• Nausea, vomiting, and/or abdominal pain
• Rapid breathing
• Runny nose
• Shortness of breath
• Slow heart rate
• Small, pinpoint pupils
• Tremors
• Weakness
• Wheezing

Even a small drop of VX on the skin can cause sweating and muscle twitching where VX touched the skin.

Exposure to large doses of VX by any route may result in the following harmful health effects:

• Loss of consciousness
• Cardiac arrest possibly leading to death
• Coma
• Convulsions
• Paralysis
• Respiratory failure possibly leading to death.
• Seizures
• Twitching

1. Get away from the area where the VX was released and breathe fresh air. Make sure you understand your local emergency notification system if you have one. Refer to emergency broadcasts and local authorities for instructions.

• If the VX release was outdoors, go indoors and shelter in place. Make sure windows are closed and ventilation systems are turned off to make sure the contamination does not come inside. If you cannot go indoors, leave the area where the VX was released.
• If you cannot get away from the area where VX was released, go to the highest ground possible because VX is heavier than air and will sink to low-lying areas.
• If the VX release was indoors, get out of the building and seek high ground.

2. Get it off your body right away!

Taking off all layers of clothing (including jewelry and accessories), blotting any liquid, and showering is the best method for removing VX from your body. Ideally, undress and shower immediately or as soon as you can, as described below. If you cannot take off all layers, take off as many clothes as you can.

• Avoid pulling clothing over your head. If you must pull clothing over your head, close your eyes and mouth, and hold your breath so you don’t get VX in your eyes, nose, or mouth. Place items in a designated area, preferably in a plastic bag.
• If you wear contact lenses, take them out and place them with your clothing. Do not put contact lenses back in.
• Use separate, dry, clean cloths or paper towels to blot each part of your body where you feel liquid, beginning with your head and hair, and then your face, hands, body, arms, legs, and feet. Blot your skin for 10 seconds, then rub for 10 seconds any places on your skin or in your hair where you can see or feel liquid.
• Continue blotting and rubbing, with clean, dry cloths or paper towels, dropping used things to the floor. Repeat the process several times if you continue to feel liquid on you. Use a separate clean cloth or paper towels for each part of your body, and for each time you repeat the process.
• First wash your hair, face, and hands, and then wash the rest of your body. Wash from your head to your feet, including armpits and groin, with lukewarm water and mild soap (if available) for about 90 seconds. Use soapy water for a minute, followed by a 30 second plain water rinse. Try not to let the water run into your eyes, nose, or mouth. Do not scrub!
• If your eyes are burning or you can’t see normally, flush your eyes for 10–15 minutes with lukewarm water only. Do not use eye drops.
• Dry your face, then tilt your head back and dry your hair, and then dry down your body. Use anything that will soak up water. Drop used things to the floor. Dress in any available clean clothes to prevent hypothermia. This is especially important if temperatures are cool.
• If emergency response services are available, leave used items on the floor and report their location to emergency personnel. Move as far from the used items as possible. Otherwise, put on waterproof or heavy gloves that won’t let liquid seep through. Gather all used things from the floor, including your clothes, and put them in a plastic bag. Remove gloves and put them in a plastic bag. Close the plastic bag and place it in a second plastic bag. Close up the second bag also.
• Do not put the bags in the regular trash! Place the bags in an area where other people are unlikely to disturb them and come in contact with VX. Inform local authorities of the location of the bags for pick up.

3. Get help. Call 911. Go to a hospital if local officials say it is safe to leave your home. If you need more information, call the Poison Control Center at 1-800-222-1222.

Treatment consists of removing VX from the body as soon as possible and providing supportive medical care in a hospital setting or by trained emergency personnel. Antidotes for VX are available in a healthcare setting. They are most useful if given as soon as possible after exposure.

If someone has ingested VX, do NOT induce vomiting.

Because VX breaks down slowly in the body, repeated exposures to VX or other nerve agents can build up in the body (have a cumulative effect).

People who received low doses usually recover. People who received higher doses of VX may experience chronic or long-lasting symptoms, such as muscle weakness, paralysis, pain, and pins and needles sensations. People who received very high doses are less likely to survive.