The formerly healthful 44-year-old man, about 10 min after departure, suddenly felt disoriented and began to sweat profusely, vomited, collapsed and then lost consciousness. The third case of poisoning, due to which the application of an OP-NA from the Novichoks group was identified, which occurred on 20 August 2020 during a domestic flight in Russia.

A similar case occurred on 30 June 2018 in Amesbury (United Kingdom), where two British citizens were poisoned with the same compound as in Salisbury. The compound of series A revealed a case of acute poisoning (of Sergei Skripal and his daughter Yulia), probably with the nerve agent A-234. An example illustrating the threat of Novichok was the chemical attack on 4 March 2018 in Salisbury (United Kingdom). Novichoks pose a constant and enormous danger due to their extreme toxicity. Furthermore, introducing solutions to protect medical personnel in contact with a hazardous substance increases the chances of saving casualties of HAZMAT/CBRNE incidents.

Filling in the missing data gaps will accelerate progress in improving protection against Novichoks and developing optimal therapy for treating poisoning casualties.

Novichoks pose a severe threat due to their toxicity however, there is insufficient information about the identity of A-series nerve agents. The review includes data on treating poisoning caused by OPs which could be used as guidelines for the therapy in case of Novichok exposure and HAZMAT/CBRNE approaches. Novichok’s toxic action mechanism consists of the inhibition of acetylcholinesterase activity. They were surreptitiously created during the Cold War by the Soviet Union. The tremendous toxicity of Novichoks is assumed to be several times greater than that of VX, whereas no published experimental research supports this. Novichoks-organophosphorus compounds belong to the nerve agents group, constituting the fourth generation of chemical warfare agents.

Antidote for organophosphate poisoning