It depends on the dose. At high enough doses, there is no latency period because your cells have been completely destroyed. At lower doses that are still fatal, what’s happening is that the radiation has destroyed the DNA of cells, making them unable to replicate. These cells will continue to live for some time, but once they start dying, there’s nothing to replace them. This becomes apparent as rapidly diving cells begin to die. For example, damaged bone marrow is unable to make new blood cells, which results in profound anemia, low white cell count, and low platelet count as new cells are not made to replace ones that have died. This can lead to rapid onset of major infections and uncontrollable bleeding as there are no white cells to fight infections and no platelets to clot wounds.
Cells of the gastrointestinal system also divide rapidly, so gastrointestinal symptoms are usually early and severe. As the cells that line the digestive tract die, they slough off and are expelled as vomit and diarrhea. The body is then unable to absorb any nutrients as the digestive system is essentially dead. This also allows the bacteria that live in our digestive tracts to enter our bloodstream and cause sepsis.
Essentially, it’s that at certain doses, the radiation exposure isn’t enough to kill cells right away but is enough to make them unable to replicate. Once they die, which can take days or weeks, the latent phase ends and profound illness begins.
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