It is a worst-case scenario that worries politicians and public health officials: Terrorists detonate a nuclear weapon or a "dirty bomb" in a major city, exposing tens of thousands of victims to the harmful effects of radiation.
A new device is under development by scientists at Duke University to help first responders tackle the pandemonium that could result. The technology helps quickly identify who needs to be treated for radiation poisoning.
The device uses genomic technology to capture molecular snapshots of genes or patterns of genes that are "turned on" or "turned off" in the body's response to radiation.
These patterns - called genomic signatures - reflect the dose of radiation a person has been exposed to, said one of the test's developers, Dr. John Chute, a member of the Duke Institute for Genome Sciences & Policy.
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"Currently there is no rapid test that could be used to diagnose radiation exposure in the event of a mass casualty, and that is a priority for the government," Chute said. He and colleagues have recently received a $3.7 million federal contract to develop the device. The contract could grow to as much as $43.6 million over the next five years.
Current tests take a number of days to complete - far too long for patients who must be treated within hours of exposure with medications to bolster their blood and immune systems.
So the researchers are partnering with the California-based companies DxTerity Diagnostics andInvetech, as well as the University of Arizona, to convert their genomic test into a portable device that can assess thousands of blood samples in just under 30 minutes.
James Porto, executive director of the Community Preparedness and Disaster Management Program in the School of Public Health at UNC Chapel Hill, said such a test has been the "holy grail" of disaster response.
"I think this research could yield an extremely useful tool, one that is far ahead of where we are now," said Porto, who has not been involved in the device's development. "But it is unlikely that this single test will hold the answer; rather it will probably be one in a battery of tests that point to which persons are truly exposed."