Syrian activists, rescuers and medics said Sunday that a poison gas attack on a rebel-held town near the capital has killed at least 40 people, allegations denied by the Syrian government.
The alleged attack in the town of Douma occurred late Saturday amid a resumed offensive by forces loyal to the Syrian government.
The U.K.-based Syrian Observatory for Human Rights said at least 80 people were killed in Douma on Saturday, including around 40 who died from suffocation. But it said the suffocations were the result of shelters collapsing on people inside.
Opposition-linked first responders, known as the White Helmets, reported the attack, saying entire families were found suffocated in their homes and shelters. It reported a death toll from the suffocation of more than 40, saying the victims showed signs of gas poisoning including pupil dilation and foaming at the mouth.
In a statement, however, it reported a smell resembling chlorine, which would not explain the described symptoms, usually associated with sarin gas.
One video circulated by activists showed lifeless bodies of around a dozen children, women and men, some of them with foam at the mouth.
"Douma city, April 7 … there is a strong smell here," a voice can be heard saying.
It said around 500 people were treated for suffocation and other symptoms, adding that most medical facilities and ambulances were put out of service because of the shelling.
The Syrian American Medical Society (SAMS) a relief organization, issued similar reports of 41 people killed and hundreds wounded. SAMS reported that a chlorine bomb hit Douma hospital, killing six people, and a second attack with "mixed agents" including nerve agents had hit a nearby building.
Basel Termanini, the U.S.-based vice president of SAMS, told Reuters another 35 people had been killed at the nearby apartment building, most of them women and children.
SAMS operates 139 medical facilities in Syria where it supports 1,880 medical personnel, according to its website.
"We are contacting the U.N. and the U.S. government and the European governments," he said by telephone.
The U.S. State Department said reports of mass casualties from an alleged chemical weapons attack in Douma were "horrifying" and would, if confirmed, "demand an immediate response by the international community."
Syrian state news agency SANA said Army of Islam, the rebel group in Douma, was making "chemical attack fabrications in an exposed and failed attempt to obstruct advances by the Syrian Arab army," citing an official source.
"The army, which is advancing rapidly and with determination, does not need to use any kind of chemical agents," the government statement said.
U.S. State Department spokeswoman Heather Nauert recalled a 2017 sarin gas attack in northwestern Syria that the West and the United Nations blamed on Assad's government.
"The Assad regime and its backers must be held accountable and any further attacks prevented immediately," she said.
"The United States calls on Russia to end this unmitigated support immediately and work with the international community to prevent further barbaric chemical weapons attacks," Nauert said in a statement.
Syrian President Bashar Assad has won back control of nearly all of eastern Ghouta in a Russian-backed military campaign that began in February, leaving just Douma in rebel hands. After a lull of 10 days, government forces began bombarding Douma again on Friday after a 10-day truce collapsed over disagreement regarding evacuation of opposition fighters. Violence resumed days after hundreds of opposition fighters and their relatives left Douma toward rebel-held areas in northern Syria.
A reporter for Lebanon's Al-Manar TV embedded with Syrian troops near Douma said government forces advanced toward Douma from the towns of Misraba and Madiara that were recently captured by troops. Al-Manar TV is run by Lebanon's Hezbollah group that has sent thousands of fighters to Syria to back government forces.
The government-controlled Syrian Central Military Media said government forces captured several farms Saturday on the southern and western edges of the city that is home to tens of thousands of people. SCMM said the area controlled by the Army of Islam in and around Douma is 19 square kilometers (7.3 square miles).
The group said its fighters repelled all government attacks that began Friday, adding that 17 Syrian soldiers were killed.
By Saturday evening, state media reported that troops were approaching Army of Islam fortifications on the edge of the town, adding that street battles could soon begin. It said warplanes bombarded the group's headquarters and command and control center.
State TV said Army of Islam fighters pelted several neighborhoods in Damascus with mortar shells, killing six civilians and wounding more than 30.
The Observatory said the bombardment of Douma killed eight people and wounded 48, including 15 children.
