Signs and Symptoms of Acute Radiation Sickness

Acute radiation sickness can be categorized into three phases: prodrome, latency, and illness. The Table, summarizes the constellation of hematologic, gastrointestinal, and neurologic symptoms, along with the time to onset and dose dependence, associated with each of these phases.

Signs and Symptoms of Acute Radiation Sickness in the Three Phases after Exposure.

Prodrome, According to Exposure Level
Latency†
Illness‡
Mild (1 to 2 Gy)
Vomiting; onset, 2 hr
Duration, 21–35 days; lymphocyte count, 800–1500/mm3 Fatigue, weakness; mortality, 0%
Moderate (2 to 4 Gy)
Vomiting, mild headache; onset, 1–2 hr
Duration, 18–35 days; lymphocyte count,
500–800/mm3
Fever, infections, bleeding, weakness, epilation; mortality, </=50%
Severe (4 to 6 Gy)
Vomiting, mild diarrhea, moderate headache, fever; onset, <1 hr
Duration, 8–18 days; lymphocyte count,
300 to 500/mm3
High fever, infections, bleeding, epilation; mortality, 20–70%
Very severe (6 to 8 Gy)
Vomiting, severe diarrhea, severe headache, high fever, altered consciousness; onset, <30 min
Duration, </=7 days; lymphocyte count, 100 to 300/mm3 High fever, diarrhea, vomiting, dizziness, disorientation, hypotension; mortality, 50–100%
Lethal (>8 Gy)
Vomiting, severe diarrhea, severe headache, high fever, unconsciousness; onset, <10 min
No latency; lymphocyte count, 0 to 100/mm3 High fever, diarrhea, unconsciousness;
mortality, 100%

† Lymphocyte counts in the latency phase represent the range of values that may be seen 3 to 6 days after radiation exposure.
‡ Mortality estimates are for patients who do not receive medical intervention.
 
 
References:

  1. Christodouleas JP, Forrest RD, Ainsley CG, Tochner Z, Hahn SM, Glatstein E. Short-Term and Long-Term Health Risks of Nuclear-Power-Plant Accidents. N Engl J Med. 2011 Apr 20. [Medline]
  2. Champlin RE, Kastenberg WE, Gale RP. Radiation accidents and nuclear energy: medical consequences and therapy. Ann Intern Med. 1988 Nov 1;109(9):730-44. [Medline]
  3. Diagnosis and treatment of radiation injuries. Safety series no. 2. Vienna: International Atomic Energy Agency, 1998. (http://www-pub.iaea.org/MTCD/publications/PDF/P040_scr.pdf)

Created: Apr 25, 2011

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