A coworker (we’ll call her Tina) approached me yesterday for what she called “pseudo medical advice.” Apparently she had gone to a local sandwich shop with a friend, and purchased some bottled water to compliment her deli item. As the two sat down at a table and prepared to have a leisurely lunch, Tina twisted off the water top and took a big swig.
To her horror, she had taken a large gulp of what tasted like lemon soda instead. She checked the plastic bottle – it was marked as pure water. She instantly recalled that the bottle top had come off rather easily and she heard no characteristic suction noise as air first entered. She was gripped with fear – could this be a poisoning? Did someone tamper with the bottle to inflict harm on unsuspecting victims?
Tina’s friend advised her to call the Poison Control Center. The woman who answered asked if Tina was having any symptoms – nausea/vomiting, headache, dizziness, abdominal pain… She denied each of these, complaining only of some tingling around her mouth (probably because Tina was so worried that she was hyperventilating). The Poison Control Center recommended that she keep the bottle, call the water manufacturer, and go to the ER immediately if she experienced any symptoms.
Tina asked me if she had done the right thing and if I thought she might have been poisoned. I told her that calling the Poison Control Center was a good idea, and although the thought of drinking out of a stranger’s water bottle is fairly disgusting, here’s what I thought about her actual risk:
1. The most likely scenario is that someone was using the water bottle for their daily drink – refilling it with soda from home and taking it to work each day. They probably left it on a counter by accident and a clerk reshelved it in the cooler. I give this an 80% chance of being the cause of the SNAFU.
2. The second most likely scenario is that some kids wanted to pull a prank and intentionally filled the water bottle with soda to see what would happen when someone drank it. I give this a 19.99% likelihood.
3. The third potential explanation for what happened, which is very unlikely, is that a nefarious random killer is masking poison with Sprite or 7-Up in water bottles around the city. I give that a 0.0001% chance on the high side.
The reason why I don’t think Tina’s drama is consistent with a poisoning is three-fold:
1. Most poisonings are directed towards specific individuals - renegade spies, abusive spouses, unwanted kids, that sort of thing. It’s quite rare for people to bother to try to poison random individuals. In the rare cases where this has happened (take the Tylenol debacle of 1982 for example – where cyanide was carefully planted in non-tamper resistant bottles) the idea was to make the person think that the product they were taking was totally NORMAL. Otherwise, why would the person take the full dose? A water bottle filled with soda is a real red flag.
2. The most common deadly poisons are flavorless and odorless (cyanide and arsenic) so there would be no need to use lemon soda to cover the taste. Styrchnine is incredibly bitter and can’t be covered up easily – anthrax, ricin, and sarin have to be inhaled so they wouldn’t be as successful in a bottle form.
3. Tina had no immediate symptoms. Arsenic poisoning causes symptoms within 2-24 hours of exposure, with abdominal pain, headache, weakness, dizziness being the most common initial symptoms. They are followed by bloody urine, jaundice, and severe abdominal pain. For cyanide, the effects are very rapid – causing confusion, fainting, collapse and potential coma. Again, after 24 hours Tina was completely asymptomatic.
After discussing this with Tina she said she felt much better and she perked up nicely. Then tilted her head thoughtfully and asked, “could I catch an infectious disease from drinking out of someone else’s bottle? Like, could I get herpes?”
“Oh yes, that’s possible. Cold, flu, and herpes viruses can be transmitted from glasses and bottles.”
A look of horror crossed her face.
“Um… well (I tried to save all the reassuring I’d done about the poisoning) it’s probably unlikely… I uh, don’t know how long the bottle was sitting in the fridge, maybe the viruses dried up and died?”
“Well, thanks, Val. I guess we’ll just have to wait and see what happens.”
“Yep. You’ll probably be just fine. Did you have your flu shot this year?”
“Oh, never mind.” I said.
And Tina turned around and left with about the same level of anxiety that she had arrived. We’d just switched poisoning for herpes or the flu. Oh well?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.