Re: Gram negative bacteria.

[Guest guest]

"Stachybotrys which was seen at over 8 million colony forming units per square inch. Stachybotrys can produce mycotoxins and is sometimes called the black mold , and is the most toxic of all toxic molds producing some of the most potent and deadly mycotoxins. It is 10 times more toxic that the most pathogenic of the Penicillium or Aspergillus molds which also can produce mycotoxins."

I have NEVER heard of anyone using CFU's and calculating them from volume (cubic meters or liters of air) to an area (square inches). I hope this guy was talking about "spore counts" which are not necessarily "CFU's". As for Stachy being "the most toxic of all toxic molds", that is a big negative. Aflatoxin B is much more potent and more common (than tricothecene) and is produced by many molds, most commonly is the flavus and fumigatus varities of Asper., so his statement is untrue and inflammatory.

As for being "10 times more toxic that the most pathogenc of ...", is downright misleading. "Toxigenic" is not the same as "pathogenic" and to compare them like that is also untrue and inflammatory. Apples and turnips.

Dr. Wei, could you weigh in on this and straighten this out? You explain thing so much better than I do.

[Guest guest]

Thanks for your feedback. I know there are many varied opinions on this subject. I am just trying to do "Mold for Dummies" - who sit in decision making capacity. So would the following be a correct statement?

Sharon

"Symptoms caused by an excessive exposure to molds and mycotoxins; and the toxins produced by some bacteria?" (In another sentence I have already explained that mycotoxins are not always present)

Please understand, I am NOT attempting to write a medical paper. I am just attempting to write a very short "lay paper" that is simple for those who know nothing about this to understand (aka- Mold for Dummies) while being correct from you all's perspective.

[Guest guest]

Sharon, Major biological agents in indoor environemnt that CAN cause illness include fungi (molds), mycotoxins, fungal glucans, bacteria, bacterial endotoxins, and allergens. BTW, bacterial endotoxins is a better term for "toxins produced by some bacteria" Wei Tang QLAB snk1955@... wrote: Okay you all, I am not finding much info that would indicate mVOC's are the cause of serious symptoms. But, I have received this information from a friend. It is in regard to endotoxins produced by gram negative bacteria. Could this, as opposed to the existance of mVOC's, be an explaination

of a "mixture" that is causing illness? Could I, in lay terms, correctly say: "Symptoms caused by an excessive exposure to molds and mycotoxins; and the toxins produced by some bacteria?" (In another sentence I have already explained that mycotoxins are not always present) Please understand, I am NOT attempting to write a medical paper. I am just attempting to write a very short "lay paper" that is simple for those who know nothing about this to understand (aka- Mold for Dummies) while being correct from you all's perspective. Sharon As the literature shows, gram negative bacteria produce endotoxins. In addition, search of the literature demonstrates that endotoxins can do and act synergistically with mycotoxins. Further, when one considers that the fine particulate matter (less than 2 microns) is taken into account the exposure to antigens, mycotoxins, hemolysins, etc. is magnified some 300 fold. I believe that Dr. Brasel, et al (from Dr. Straus’s Lab at TTU), have demonstrated that the mycotoxins are present in the fine particulate matter and that the mycotoxins are also present in the blood of patients from water-damaged buildings. These observations explain why van Emon et al found Stachylysin in the blood of symptomatic building occupants that they could not account for by spore counts alone. We definitely need to go further with this information and these approaches to define the indoor environment and the biological realities of the

contamination. Subject: RE: Dr. Leung and the JACIDate: Mon, 13 Mar 2006 10:06:33 -0600To: , , Margaret: I could not agree with you more. The CDC has shown its callousness with respect to

the mold issue. Other issues that must be addressed are the roles that bacteria and their toxins are playing. For example, I recommended to Lipsey to do bacterial counts in the St. Bernard Parish where FEMA workers have experienced health problems. I have copied Dr. Lipsey’s press release below. As the literature shows, gram negative bacteria produce endotoxins. In addition, search of the literature demonstrates that endotoxins can do and act synergistically with mycotoxins. Further, when one considers that the fine particulate matter (less than 2 microns) is taken into account the exposure to antigens, mycotoxins, hemolysins, etc. is magnified some 300

fold. I believe that Dr. Brasel, et al (from Dr. Straus’s Lab at TTU), have demonstrated that the mycotoxins are present in the fine particulate matter and that the mycotoxins are also present in the blood of patients from water-damaged buildings. These observations explain why van Emon et al found Stachylysin in the blood of symptomatic building occupants that they could not account for by spore counts alone. We definitely need to go further with this information and these approaches to define the indoor environment and the biological realities of the contamination. I you want copies of the culture data I will be most happy to forward the information. March 9, 2006 To: Mr. HudsonFrom: Dr. Lipsey. Toxicologist RE: The Mold and Bacterial Results from the Sampling Dr. Lipsey did in St Bernard Parish The samples I collected on Feb. 11, while on tour of the devastation in St. Bernard Parish, have been analyzed by an independent microbiological lab. Out of 45,000 homes in the parish, only 500 were habitable, and I sampled six (6 ) of them. The mold and bacterial counts and species are listed

below. Most of the homes had extremely high levels of pathogenic mold and bacteria, the highest I have ever seen in my 35 years of testing homes for toxic mold and bacteria. The bacterial counts were as high as 62 million bacteria per square inch of wallpaper and furniture. The most abundant bacteria I found in the homes were Pseudomonas aeruginosa, P. Fluorescens, Enterobacter cloacae, Pantoca, Brevundimonas vesicularis and Stenotrophomonas, all in the tens of millions per square inch of wallpaper and furniture and gram negative bacteria of many kinds. These levels of these pathogenic bacteria can cause many diseases and

death in humans. The gram negative bacteria all produce endotoxins, similar to mycotoxins used in germ warfare at very high levels to kill people within minutes, and include Legionella bacteria, Salmonella, E. coli from human sewage, etc. The mold levels were in the millions of spores per square inch of wallpaper or on furniture and the most common pathogenic mold appeared to be Stachybotrys which was seen at over 8 million colony forming units per square inch. Stachybotrys can produce mycotoxins and is sometimes called the black mold , and is the most toxic of all toxic molds producing some of the most potent

and deadly mycotoxins. It is 10 times more toxic that the most pathogenic of the Penicillium or Aspergillus molds which also can produce mycotoxins. Stachybotrys is uncommon in contaminated homes and I rarely find it in even the most sick of the sick buildings. Stachybotrys produces tricothocenes, ie T-2, and highly purified forms were developed by the U.S. Army and never used and have since, probably been destroyed. There is also the concern that some of the bacteria and molds produce a synergistic effect in combination to make them even more toxic. I was shocked to find out that the Habitat for Humanity volunteers that I toured with, and who were trained by FEMA, had been told that mold cannot hurt you and you do not need any protective equipment. This was totally wrong and I gave them the 800 phone number of the lab that could overnight the proper safety equipment to them c/o the Scotia Prince since none of them had mailing addresses. Highly pathogenic endotoxins from gram negative bacteria were found earlier by NIOSH scientists and personnel from the Louisiana Dept. of Health and the levels were 20 times above normal on average. The levels were not only high inside the flooded homes but also in the ambient air in the neighborhood. Gram negative bacteria and their spores and the endotoxins they produce got into the ambient air in the neighborhoods which created sick

neighborhoods as well as sick buildings totally uninhabitable. I would recommend that anyone even walking thru the neighborhoods in St. Bernard Parish wear HEPA respirators. I developed bronchitis from walking in the neighborhoods, because I always put on my HEPA respirator before entering any of the homes. I inspected almost every area and neighborhood in St. Bernard Parish on Friday and Saturday and took samples and I took pictures. Most of the residents doing remediation of their homes were wearing protective equipment and dragging contaminated debris to the curbside. I inspected many homes and the stench of rotting materials

was in every home and there was significant water damage and high levels of pathogenic molds and bacteria in every home since the homes had been under water for days and have been growing mold for months. There were snakes living in some of the homes and marsh grass in most of the homes and many had marsh grass on top of the roof indicating how deep the water was in those areas of St. Bernard Parish. None of the homes were safe to occupy or even be inside for any length of time without personal protective equipment including a HEPA respirator, rubber gloves, goggles and a Tyvek suit. Many of the homes must be bulldozed and burned since they cannot be

salvaged. None of the Scotia Prince Cruise L:ines residents should return to the neighborhoods without proper protective equipment much less return to their destroyed homes and try to salvage them. Dr. L. Lipsey ( 904 )398-2168550 Water St, #1230, ville, FL 32202Forensic

Toxicologist and former Adjunct Professor,Univ. N. Florida, Div. Continuing Educ., HazMat/OSHA Fla. Comm. College Jax, Institute of Occ. Safety & Health,Clinical Toxicology Advisory Comm., Florida Poison Info Center, Jax.www.richardlipsey.com From: Dr. Jack Thrasher, Immunotoxocologist, March 9, 2006 The endotoxins and the Pseudomonas toxin are the important issues. Endotoxins are very irritating to the mucous membranes of the nose, throat, lungs etc. Can cause sever respiratory distress in asthmatics and may also cause asthma themselves. In addition, it is well accepted that endotoxins open up the blood brain barrier,

making it leaky to toxins. Furthermore, animal and test tube studies show that endotoxins act synergistically with mycotoxins, particularly trichothecenes, to enhance the toxicity of both. A quick PubMed search will bring this out to anyone who wishes to look. The other area of concern is that the bacteria also produce solvents. ( JT ) From: Dr. Straus, Texas

Tech. Univ., March 9, 200 We know that endotoxins get into the air when there are a lot of Gram-negatives present such as E.coli contaminating feedlot soil. We have shown this. It is not known if exotoxin A gets into the air where it can be inhaled. In fact I doubt seriously that this would happen. ( DCS ) Dr. L. Lipsey ( 904 )398-2168550 Water St, #1230, ville, FL 32202Forensic Toxicologist and former Adjunct Professor,Univ. N. Florida, Div. Continuing Educ., HazMat/OSHA Fla. Comm. College Jax, Institute of Occ. Safety & Health,Clinical Toxicology Advisory Comm., Florida Poison Info Center, Jax.www.richardlipsey.com Jack D. Thrasher, Ph.D. Toxicologist/Immunotoxicologist The information contained in this e-mail transmission is privileged and confidential. If you are not the intended recipient, do not read, copy, distribute, or reproduce this transmission. If you have received this e-mail transmission in error you are asked to return it to the sender and/or notify the sender by calling From: Margaret Maizel

Sent: Saturday, March 11, 2006 1:54 PMTo: 'Margaret Maizel'; Jack Thrasher, PhD; SNK1955@...Cc: mch@...; ritchieshoemaker@...; Rllipsey87@...; immunsci@...Subject: RE: Dr. Leung and the JACI Dear Dr.

Thrasher et. Al., Re many-fronted efforts. I might add, if I may, that while little might be expected to be done in the current climate of ‘no funds’ and other priorities, -- working to get a legislative study is ONE way to build the record for what is known, what is not known and what is conflicting. It shouldn’t be a way to decide to do nothing until more is known, (well-known delay tactic to do nothing in the end) but it seems there is such an effective lot of misinformation out there, it would be difficult to move the association/policy community, effectively …………also..CDC, in my estimation is not really THE federal research entity that can properly examine same. Just not

their primary mission. I, myself prefer NIH. (Sorry, any advocates of the CDC and sorry, anyone there who is right-minded). The Kennedy’s, as I have mentioned to Sharon, started one of the Institutes at NIH where I worked for many years. The National Institute of Child Health and Human Development. Ritchie’s work is suggesting a genetic predisposition at least ONE level of susceptibility. If there were a developmental avenue of approach, then so much the better. Studies are not commitments. A well managed study will turn up good science and otherwise. It gives those who would rather NOT do anything no real way to say “no” at the outset. – and it is a public process (to the extent that still may be limited). It takes good staff work to be sure the hearings or studies are well designed. It will likely have to be done in any event in order to effectively free up needed research funding. The current really serious concern for the families and children in NO and the Gulf – as well as everywhere, would make such an initiative (one of many, needed),

always worthwhile. Yes, it’s long-term, but so are the repercussions, and something lasting should come of this. I believe that Sharon’s current interaction with the Senate Committee would gain an expanded level of acceptance with all the heightened concern about the real effects of mold. A study – maybe a fall-back, position should be kept as adefinite possibility. Certainly NOT to let up on frontal approaches, either. – Just to expand the initiatives. I totally agree that this is the time to expend an organized, multi-faceted program for public education on many fronts. Re Conflicts of interest in Sciences. Many good universities are supporting studies in medical ethics. Columbia University is one. See their Center for Bioethics and related centers at: http://www.cumc.columbia.edu/dept/bec/re/academic.html We`all know this is a bigger war than the mold war. Being a player is important. Margaret From: Jack Thrasher, PhD Sent: Friday, March 10, 2006 10:46 AMTo: SNK1955@...; mmaizel@...Cc: mch@...; ritchieshoemaker@...; Rllipsey87@...; immunsci@...Subject: RE: Dr. Leung and the JACI Sharon and all others on list: I strongly believe that this an opportunity to get much needed information out to the public and treating physicians. I commend you and Dr. Leung for you persistence in getting this matter resolved. A position paper as appears in the AAAI and ACOEM should not be written since science and medicine moves so rapidly today. Also, the IOM report had a cut off date of approximately Sept/Oct 2002 and therefore missed years of studies since the initial review. A good example of an oversight, whether deliberate or not, is the fact that IgG antibodies to mold antigens goes back prior to the 1980s in the peer reviewed literature. Ojanen et al were the first, to my knowledge, that associated IgG and IgA antibodies to mold antigens with farmer’s lung disease. In addition, the FDA uses ELISA methods to determine mycotoxins in foods.

Finally, it should be mentioned that the issue of environmental and occupational medicine in the medical school curricula should be brought forth. In 1988 and again in 1995, the National Research Council, in two reports, clearly demonstrated that the subject matter is not adequately presented in the medical school curricula in the U.S. This has not been corrected as of current. In a survey of Primary Care Physicians (PCPs) in the State of Texas (Hamilton, et al, 2005) 86.1% of the respondents reported that they had never received specific training in environmental health history taking and 97.1% of these indicated a desire to learn more about environmental health hazards. The

State of Texas has one the largest Medical Association memberships in the U.S. The data in the Hamilton survey revealed that patients regularly raise questions about environmental topics that PCPs do not routinely discuss. Thus, the danger of position papers is that they do not educate, but only put forth one side of an issue. If medicine is to move forward at the PCP level (this is where ill individuals first go), then we must make certain that the PCPs understand the nature of the problems facing the patient and the PCP. Another problem with such position papers is how the insurance companies and their attorneys use them in deposition and trials. They attempt to allude to the fact that, for example, injury from molds, outside of allergies and asthma, is not generally accepted in the medical and scientific professions. This is the same type of position taken with respect to tobacco, cigarette smoking and side-stream-smoke as well as air pollution

in the cities of throughout the world. Let us move forward on a positive note. Jack D. Thrasher, Ph.D. Toxicologist/Immunotoxicologist The information contained in this e-mail transmission is privileged and confidential. If you are not the intended recipient, do not read,

copy, distribute, or reproduce this transmission. If you have received this e-mail transmission in error you are asked to return it to the sender and/or notify the sender by calling From: SNK1955@... Sent: Friday, March 10, 2006 11:12 AMTo: mmaizel@...Cc: mch@...; ritchieshoemaker@...; Rllipsey87@...;

immunsci@...; Jack Thrasher, PhDSubject: Fwd: Dr. Leung and the JACI Wei Tang, Ph.D.Lab DirectorQLABCherry Hill, NJ

[Guest guest]

See below in red

........................................................................... "Tony" Havics, CHMM, CIH, PEpH2, LLCPO Box 34140Indianapolis, IN 46234 cell90% of Risk Management is knowing where to place the decimal point...any consultant can give you the other 10%â„ This message is from pH2. This message and any attachments may contain legally privileged or confidential information, and are intended only for the individual or entity identified above as the addressee. If you are not the addressee, or if this message has been addressed to you in error, you are not authorized to read, copy, or distribute this message and any attachments, and we ask that you please delete this message and attachments (including all copies) and notify the sender by return e-mail or by phone at . Delivery of this message and any attachments to any person other than the intended recipient(s) is not intended in any way to waive confidentiality or a privilege. All personal messages express views only of the sender, which are not to be attributed to pH2 and may not be copied or distributed without this statement.

-----Original Message-----From: iequality [mailto:iequality ] On Behalf Of DanaSent: Tuesday, March 14, 2006 5:15 PMTo: iequality Subject: Re: Gram negative bacteria.

"Stachybotrys which was seen at over 8 million colony forming units per square inch. Stachybotrys can produce mycotoxins and is sometimes called the black mold , and is the most toxic of all toxic molds producing some of the most potent and deadly mycotoxins. It is 10 times more toxic that the most pathogenic of the Penicillium or Aspergillus molds which also can produce mycotoxins."

I have NEVER heard of anyone using CFU's and calculating them from volume (cubic meters or liters of air) to an area (square inches).

This I presume is a surface number or settled plate data. At 8 x 10E6 spores per sq inch it is similar to one packing them in very neatly with no space left over or space in grape clumps ignoring the 3D aspects. Sounds like a microvac sample here with dilution plates and an estimate. But in general a fear tactic to present it in this way.

I hope this guy was talking about "spore counts" which are not necessarily "CFU's". As for Stachy being "the most toxic of all toxic molds", that is a big negative. Aflatoxin B is much more potent (very true) and more common (than tricothecene) and is produced by many molds, most commonly is the flavus and fumigatus varities of Asper., so his statement is untrue and inflammatory.

As for being "10 times more toxic that the most pathogenc of ...", is downright misleading. "Toxigenic" is not the same as "pathogenic" and to compare them like that is also untrue and inflammatory. Apples and turnips.

Dr. Wei, could you weigh in on this and straighten this out? You explain thing so much better than I do.

[Guest guest]

Dana, Please excuse me for not reading all the posts (yours caught my eyes because it's short). I went back and read it. I believe the unit was CFU per square inch of wall paper. Since you asked, I would write something. Anyone, please feel free to comment. Fungi can be: (1) Pathogenic: causing or capable of causing disease (including the following three and more? Any physician would like to comment on this?) (2) Infectious: capable of causing infection --- Viable infectious fungi can cause infection and multiples in the body of living organisms. (3) Allergenic: having the capacity to induce allergy --- Components of viable or non-viable fungal cells can be allergenic and cause allergic reactions. (4) Toxigenic: producing toxin --- Toxigenic fungi can produce fungal

toxins which poison living organisms. IMO, it would be a difficult thing to compare how many times more toxic one fungi is to another, especially when they have different mechanism. Even on the mycotoxins alone, it would be hard to compare toxic effect to carcinogenic effect, etc. Source of some definitions: http://www.nlm.nih.gov/medlineplus/mplusdictionary.html More on endotoxins: Bacterial endotoxins are lipopolysaccharides (LPS) on the cell wall (outer membrane) of some gram negative bacteria. All gram negative bacteria have LPS, but not all LPS are endotoxins (toxic to human/animal). They are not chemials released into the environment like mycotoxins or bacterial exotoxins. They are very stable and can remain in the environment after bacterial cell death. BTW, gram negative bacteia do not produce spores. Bacterial exotoxins vs. endotoxins: http://www.agen.ufl.edu/~chyn/age2062/lect/lect_25/toxinprops.htm Wei Tang QLAB Dana

wrote: "Stachybotrys which was seen at over 8 million colony forming units per square inch. Stachybotrys can produce mycotoxins and is sometimes called the black mold , and is the most toxic of all toxic molds producing some of the most potent and deadly mycotoxins. It is 10 times more toxic that the most pathogenic of the Penicillium or Aspergillus molds which also can produce mycotoxins." I have NEVER heard of anyone using CFU's and calculating them from volume (cubic meters or liters of air) to an area (square inches). I hope this guy was talking about "spore counts" which are not necessarily "CFU's". As for Stachy being "the most toxic of all toxic molds", that is a big negative. Aflatoxin B is much more potent and more common (than

tricothecene) and is produced by many molds, most commonly is the flavus and fumigatus varities of Asper., so his statement is untrue and inflammatory. As for being "10 times more toxic that the most pathogenc of ...", is downright misleading. "Toxigenic" is not the same as "pathogenic" and to compare them like that is also untrue and inflammatory. Apples and turnips. Dr. Wei, could you weigh in on this and straighten this out? You explain thing so much better than I do.Wei Tang, Ph.D.Lab DirectorQLABCherry Hill, NJ

[Guest guest]

Sharon,

Major biological agents in indoor environemnt that CAN cause illness include fungi (molds), mycotoxins, fungal glucans, bacteria, bacterial endotoxins, and allergens. BTW, bacterial endotoxins is a better term for "toxins produced by some bacteria"

Wei Tang

QLAB

Thanks Dr. Tang, Dana and Tony.

I understand what you all are saying (basically). But what I am trying to do is write in sound bites that can be easily understood by lay people decision makers. This is just a small portion and I am trying to give an overview in no more than two paragraphs - that are also acceptable to you all as correct.

I am attempting to be accurate - not detailed. If I start using words that are part of your everyday venacular, but are foreign to the everyday man, I will lose them before I even get started. So I understand that endotoxins would be more correct, but is "toxins produced by bacteria" correct enough in lay terminology?

Sharon

[Guest guest]

"They are not chemials released into the environment like mycotoxins or bacterial exotoxins." I meant bacterial endotoxins do not get released into the substrate that bacteria are growing (unlike bacterial exotoxins or mycotoxins). However, bacterial endotoxins can be detected in the air as the components in whole or damaged/broken cells (like mycotoxins in airborne fungal cells). Wei Tang QLABWei Tang wrote: Dana, Please excuse me for not reading all the posts (yours caught my eyes because it's short). I went back and read it. I believe the unit was CFU per square inch of wall paper. Since you asked, I would write something. Anyone, please feel

free to comment. Fungi can be: (1) Pathogenic: causing or capable of causing disease (including the following three and more? Any physician would like to comment on this?) (2) Infectious: capable of causing infection --- Viable infectious fungi can cause infection and multiples in the body of living organisms. (3) Allergenic: having the capacity to induce allergy --- Components of viable or non-viable fungal cells can be allergenic and cause allergic reactions. (4) Toxigenic: producing toxin --- Toxigenic fungi can produce fungal toxins which poison living organisms. IMO, it would be a difficult thing to compare how many times more toxic one fungi is to another, especially when they have different mechanism. Even on the mycotoxins alone, it would be hard to compare toxic effect to carcinogenic effect, etc.

Source of some definitions: http://www.nlm.nih.gov/medlineplus/mplusdictionary.html More on endotoxins: Bacterial endotoxins are lipopolysaccharides (LPS) on the cell

wall (outer membrane) of some gram negative bacteria. All gram negative bacteria have LPS, but not all LPS are endotoxins (toxic to human/animal). They are not chemials released into the environment like mycotoxins or bacterial exotoxins. They are very stable and can remain in the environment after bacterial cell death. BTW, gram negative bacteia do not produce spores. Bacterial exotoxins vs. endotoxins: http://www.agen.ufl.edu/~chyn/age2062/lect/lect_25/toxinprops.htm Wei Tang QLAB Dana wrote: "Stachybotrys which was seen at over 8 million colony forming units per square inch. Stachybotrys can produce mycotoxins and is sometimes called the black

mold , and is the most toxic of all toxic molds producing some of the most potent and deadly mycotoxins. It is 10 times more toxic that the most pathogenic of the Penicillium or Aspergillus molds which also can produce mycotoxins." I have NEVER heard of anyone using CFU's and calculating them from volume (cubic meters or liters of air) to an area (square inches). I hope this guy was talking about "spore counts" which are not necessarily "CFU's". As for Stachy being "the most toxic of all toxic molds", that is a big negative. Aflatoxin B is much more potent and more common (than tricothecene) and is produced by many molds, most commonly is the flavus and fumigatus varities of Asper., so his statement is untrue and inflammatory. As for being "10 times more toxic that the most pathogenc of ...", is downright misleading. "Toxigenic" is not the same as

"pathogenic" and to compare them like that is also untrue and inflammatory. Apples and turnips. Dr. Wei, could you weigh in on this and straighten this out? You explain thing so much better than I do.Wei Tang, Ph.D.Lab DirectorQLABCherry Hill, NJ Wei Tang, Ph.D.Lab DirectorQLABCherry Hill, NJ

[Guest guest]

Wei Tang wrote:

> IMO, it would be a difficult thing to compare how many times more

toxic one fungi is to another, especially when they have different

mechanism. Even on the mycotoxins alone, it would be hard to compare

toxic effect to carcinogenic effect, etc.

>

And of course, if a substance is genotoxic, it may induce mRNA

dysregulation that doesn't meet the definition of " cytotoxicity " , but

the lack of proper cellular function caused by the apparently

innocuous exposure is still totally devastating when seemingly

unrelated immunological failure occurs.

And in the end - you are just as dead as if it had been a REAL toxin.

-