On February 13,2017, the estranged half-brother of the North Korean dictator Kim Jong Il, Kim Jong Nam, was assassinated by two female operatives- one Vietnamese and the other Indonesian using the highly toxic synthetic neurotoxin (nerve agent) VX in a public and international venue –the Kuala Lumpur International Airport.

Apparently, the DPRK had never used chemical weapons (CW) for assassinations until the U.S. abandoned the Red Line on CW use in Syria.

Why would North Korea choose to use VX for a political –type of assassination?

One can only  surmise that it may have been due to the fact that VX is highly lethal in very small quantities and that perhaps, in the broader context, North Korea wanted to demonstrate that it has the capability of producing , storing and deploying  a much feared chemical warfare agent that had the capacity to decimate combatants and non-combatants alike .

VX is by far the most potent of the organophosphate nerve agents; a single micro droplet of VX on the skin can be fatal. VX is a liquid with a low vapor pressure   and volatility, and spontaneous evaporation is minimal.  VX is environmentally persistent and can also be either thickened for greater adherence to bodily or environmental surfaces, although it is relatively viscous, or made into a “dusty agent” via micronization techniques.   The advantages of VX (or any other chemical agent or toxin) are increased volatility, increased pulmonary deposition and retention in the alveoli of the lungs, and increased penetration of clothing and chemical protective equipment.

VX, and other nerve agents and organophosphate pesticides express their toxicity by inhibiting the enzyme acetylcholinesterase (AChE) at the neuromuscular junction. AchE is the primary negative regulator of the cholinergic system, a division of the autonomic nervous system (ANS). The function of AChE is to degrade the neurotransmitter acetylcholine (ACh) which serves to facilitate nerve transmission and effects skeletal and smooth muscle, glandular structures (nicotinic and muscarinic receptors), as well as some components of the central nervous system (CNS).  The receptor binding stimulates skeletal muscle, smooth muscle, exocrine glands neurons in the CNS and sympathetic ganglia. The G-series nerve agents such as sarin (military nomenclature GB), V-series nerve agents (VX) and organophosphate pesticides, for instance Malathion, parathion or dichlorvos, essentially disrupt both autonomic and central nerve transmission causing overstimulation of skeletal muscle, smooth muscle and exocrine glands and CNS components leading to adverse physiological effects including bronchoconstriction (an asthma –like tightening of the bronchial airways ), bronchorrhea (profuse mucous secretions in the bronchial airways) , bradycardia (a slowing heart rate) as well as skeletal muscle tetany and convulsions. These sequelae of nerve agent toxicity adversely affect the nervous system with subsequent muscle fatigue and failure (including respiratory muscles), fatigue and failure of neurons in the respiratory center of the medulla oblongata, which leads to central apnea (cessation of breathing) and fluid –filled airways which impair both ventilation and oxygenation.

These agents also undergo an “aging” process where they will bind irreversibly with AChe unless treatment is rendered in a timely fashion utilizing the antidote 2-PAM Chloride or similar oxime to chemically reverse the chemical bond between the nerve agent and Ache and atropine to reverse the cholinergic crisis. The oximes, such as 2-PAM Chloride, serve to re-activate AChE so that it is enabled to break down or catalyze acetylcholine (AC h) to acetate and choline. Diazepam and midazolam are anticonvulsive agents and muscle relaxants that are administered to control seizure activity (benzodiazepines).

These agents can cause toxicity through inhalation, injection, transmucosal and transdermal/percutaneous exposures. Inhalation occurs through direct absorption of nerve –agent vapor (sarin having the highest volatility of all the nerve agents) or aerosolized droplets into the pulmonary tree. In particular, the classically described G-agent nerve “gases“ sarin (GB), GD (soman – with an “aging” time of ~ 2 minutes and requiring rapid treatment ),and tabun (GA) possess sufficiently high vapor pressures and volatilities to produce lethal vapor concentrations at room temperature ,and even more so in confined spaces (eg. 1995 Tokyo sarin subway attack).

The use of a nerve agent for a politically or socially motivated assassination is unusual as these weapons have been designed to serve as militarized mass casualty weapons /weapons of mass effect.

Global intelligence assets are aware of the nature and extent of North Korea’s chemical weapons program. The country is not a signatory of the Chemical Weapons Convention (CWC), one of only four holdouts to the almost universal treaty.

The country is presumed to have approximately between 2,500-5,000 tons of chemical agents, including VX. However, assessments indicate that North Korea ‘s three chemical weapons facilities could produce up to 12,000 tons of chemical weapon agents per year.

Chemical weapons (as well as biologicals) are extremely intimidating to enemy forces, as well as civilian populations.  The Assad regime deliberately chose to conduct chemical warfare against his own populace knowing that such an attack would not only result in high case fatality rates/mass casualties, but would have a profound psychological effect, leaving a huge psychological “footprint“ among the survivors of his chemical atrocities and extreme demoralization among the opposition.

The same reasoning follows for the victims of the chemical attacks on the Kurdish population in Halbaja during the reign of Saddham Hussein or the victims of the vesicant agent, sulfur mustard during the 1988 Iraq-Iran war.

The assassination of Kim Jong Nam may be a precursor to escalation on the Korean peninsula, and even threaten unprotected and untrained civilian populations with chemical warfare. North Korea may also seek to deploy chemical weapons and strike US and South Korean forces.

The constant sabre rattling demonstrated by Kim Jong Il and his oppressive regime may lead some to believe that North Korea should not be taken seriously. In the context of the country’s possession of chemical weapons, the global community needs to heed the signs of this unstable leader and its potential to strike hard utilizing some of the world’s most unthinkable and inhumane ways of conducting warfare.

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Frank G. Rando possesses over 30 years of real world experience as a public safety professional,clinician, educator ,emergency and crisis manager ,author and consultant in the areas of tactical ,disaster and operational medicine, weapons and tactics, law enforcement /criminal investigations ,counterterrorism, hazardous materials management and emergency response ,toxicology, environmental safety and health,and health care and public health emergency management .