Reasonable Rascal
12-04-01, 02:39
Information as supplied by Medical Corps. Our thanks for them making this info publically available.
RR
---------------------------------------------
PLAGUE
Bubonic and Pneumonic Plague
Description
Plague is a gram-negative bacteria (Yersinia Pestis) and may be spread from human to human in sputum droplets (or intentional aerosol) once the disease has gone Pneumonic or by the bite of infected fleas.
As a weapon, consider Plague quite Deadly!
Signs and Symptoms:
Pneumonic-(lungs)--Incubation 2-3 days.
High fever, chills, headache, bloody discharge from the mouth and nose, progressing to labored and harsh breathing, and bluish skin. Death follows onset of severe symptoms (usually 48 hours) from
respiratory failure and circulatory collapse. Untreated, Pneumonic Plague has a 90% mortality rate.
Antibiotic Prophylaxis would be successful.
Bubonic-Black Death-Incubation 2-10 days.
Rapid pulse, rise in temperature, enlarged lymph nodes (buboes) with surrounding swelling. The node may turn black from dead tissue. Within two weeks the buboes generate pus. Untreated, Bubonic Plague has a 60% mortality (usually in 3-5 days).
Antibiotic Prophylaxis would be successful.
Septicemic-Blood infection
Septicemia may occur at any time during the course of either Bubonic or Pneumonic Plague.
Death is swift once the disease is bloodborne.
Antibiotic Prophylaxis would be successful.
War Engine:
Bubonic Plague can be spread by infecting a rodent population (such as in a sewer system). Fleas would then spread the disease to humans. Cats have been known to spread Pneumonic Plague to humans.
Pneumonic Plague can be delivered by aerosol (spray). Thus delivered, Pneumonic Plague is a certainty as well as Bubonic. Food and water will become contaminated.
Prophylaxis: Adults
Oral medications only
DOXYCYCLINE: Adults 100 pounds or over
Doxycycline (Vibramycin) pills or capsules.
1) Minimum adult dosage for Doxycycline = 100mg every 12 hours (BID/q12h) x 30 days or
Duration of exposure-whichever is longer This is a total of 200mg per day.
2) Maximum adult dosage for Doxycycline =
100mg every 8 hours (TID/q8h) x 30 days or Duration of exposure-whichever is longer
This is a total of 300mg per day
TETRACYCLINES: Adults 8 years and over
Adult DOSAGES: Tetracycline or Oxytetracycline.
1) Minimum adult dosage for the Tetracyclines = 500mg every six hours (q6h) x 30 days or
Duration of exposure-whichever is longer This is a daily total of 2,000mg
2) Maximum adult dosage for the Tetracyclines= 500mg every four hours (q4h) x 30 days orDuration of exposure-whichever is longer This is a daily total of 3,000mg
Ciprofloxacin-not for Humans under 19 years
Unknown but suspected "useful" as a prophylaxis.
Adult DOSAGES: Cipro, Ciprofloxacin.
1) Minimum adult dosage for Cipro= 250mg every 8 hours (TID-q8h) X 30 days or
Duration of exposure-whichever is longer This is a daily total of 750mg
2) Maximum adult dosage for Cipro= 500mg every 12 hours (BID) X 30 days or duration of exposure-whichever is longer This is a daily total of 1000mg.
Prophylaxis: CHILDREN:
Oral medication only--Human or Animal Grade Do NOT give Children "Shots"!
When Children are considered Children:
Doxycycline---100 pounds and under
Tetracycline--- 8 years and under
Oxytetracycline---8 years and under
Penicillin--- 60 pounds and under
Cipro--- Do not give to humans under 19 years
Clark's Rule: Weight *best*
Divide the child's weight by 150 lbs. then multiply that number by the ADULT daily dose total. The answer equals the child's total daily dose. For instance, a dosage for a 60 pound child is computed thusly: 60/150 = 0.4 Now multiply that by the minimum daily dose for an adult and you get: 0.4 X 200mg (Doxycycline) = 80mg or: 80mg for a daily dose total of Doxycycline. However, Doxycycline only comes in 50mg and 100mg tabs so, the dosage for the 50 pound child can be adjusted to: 50mg every 12 hours (q12h) x 30 days or Duration of exposure-whichever is longer
Total daily dose = 100mg
Example: 50 pound child taking-- Tetracycline and Oxytetracycline would compute (50/150 times 3000mg) or a 1000mg daily dose total. This dosage would be: 250mg every six hours (q6h) X 30 days or Duration of exposure -whichever comes first.
Young's Rule: AGE
Divide the age of the child by his age + 12. For instance the calculations for a 3 year old child would be 3 divided by 3+12 (15) or 3/15. Thus 1/5th of the daily adult dose total.
Cowling's Rule: AGE
Divide the number of the NEXT birthday by 24.
For example: a 5 year old child's dose would compute: 6 divided by 24 equals 6/24 or 1/4 of the daily adult dose/dosage total.
Control
Isolation:
When handling infected humans wear: Kitchen Gloves, Poncho, Mask, and Eye Protection Strict isolation of patients with Pneumonic Plague. Sanitary procedures for Bubonic Plague.
Decontamination:
Wash or Spray all contaminated objects with: 0.5% Bleach or Iodine solution or Germicidals. Food CANNOT be decontaminated! To decontaminate drinking water using: USP Iodine Crystals --Saturated Solution Add 8 grams of Iodine crystals to a 2 ounce clear glass bottle with a bake-lite cap. NO Plastic! Fill with water and shake vigorously for several minutes, then let settle. Without disturbing the sediment, withdraw 6 teaspoons (30cc) of the saturated solution and add to a quart of tepid water.
Let stand for at least 60 min. To make more of the saturated solution "batch", just add more water to the sediment in the two-ounce bottle and shake. Remember: When there is no more sediment - start another "batch".
Contamination Prevention:
Eat only sealed foods.
Drink only sealed water.
Avoid air conditioning.
Avoid crowds.
Wear a face mask.
Wear kitchen gloves.
Wear a poncho.
Wear boots.
Disposal: Human or Animal
Burn the carcasses OR bury them with quick lime. Clothing and bedding should be burned.
Preventing Outbreaks
Since Pneumonic Plague is quite contagious from human to human, strict isolation must be employed!
Bubonic Plague is contracted from the infected flea/rodent population, therefore, pest control must be implemented. Pesticides for the insects. Poison for the rodent population. Burn the carcasses. Do not use dogs or cats to control rodents.
Treatment
For patients not taking Prophylaxis
Pneumonic and Bubonic Plague:
Adults and Children
Streptomycin-IM--intramuscular q12h (BID)
Treatment should begin within 24 hours of onset of symptoms of Pneumonic Plague. The treatment of choice is Streptomycin I.M. The formula is simple. (30mg per kg of body weight per day for 10 days) Divide into two equal shots 1 kilogram (kg) equals 2.2 pounds, so a 110 pound human would weigh about 50kg. Therefore: 30mg X 50 = 1500mg daily for 10 days. 750mg I.M (Buttocks) every 12 hours for 10 days
Adults Only I.V. Drip
Doxycycline--I.V. Drip-Ringers or D5&W
The formula is as follows: First give 200mg I.V. Drip (loading) then 100mg I.V. Drip every 12 hours for 14 days
Children Only I.V. Drip
Doxycycline-I.V. Drip-Ringers or D5&W
For Children under 100 pounds as follows: 4.4mg per kg of weight, I.V. Drip (loading) then 2.2mg per kg of weight, I.V. Drip every 12 hours
Adults Only--Oral
Doxycycline Oral-pills or capsules
200mg (loading) *then* 100mg every 12 hours for 14 days
Children Only--Doxycycline Oral
See: Clarks Rule
Dose every 12 hours for 14 days (Oral)
Adults Only--Oral
Tetracycline and Oxytetracycline
500mg every four hours for 14 days (Oral)
Children Only-Tetracycline/Oxytetracycline
See: Clarks Rule
Dose every four hours for 14 days (Oral)
_________________
Knowledge shared is learning gained by both teacher and student.
RR
---------------------------------------------
PLAGUE
Bubonic and Pneumonic Plague
Description
Plague is a gram-negative bacteria (Yersinia Pestis) and may be spread from human to human in sputum droplets (or intentional aerosol) once the disease has gone Pneumonic or by the bite of infected fleas.
As a weapon, consider Plague quite Deadly!
Signs and Symptoms:
Pneumonic-(lungs)--Incubation 2-3 days.
High fever, chills, headache, bloody discharge from the mouth and nose, progressing to labored and harsh breathing, and bluish skin. Death follows onset of severe symptoms (usually 48 hours) from
respiratory failure and circulatory collapse. Untreated, Pneumonic Plague has a 90% mortality rate.
Antibiotic Prophylaxis would be successful.
Bubonic-Black Death-Incubation 2-10 days.
Rapid pulse, rise in temperature, enlarged lymph nodes (buboes) with surrounding swelling. The node may turn black from dead tissue. Within two weeks the buboes generate pus. Untreated, Bubonic Plague has a 60% mortality (usually in 3-5 days).
Antibiotic Prophylaxis would be successful.
Septicemic-Blood infection
Septicemia may occur at any time during the course of either Bubonic or Pneumonic Plague.
Death is swift once the disease is bloodborne.
Antibiotic Prophylaxis would be successful.
War Engine:
Bubonic Plague can be spread by infecting a rodent population (such as in a sewer system). Fleas would then spread the disease to humans. Cats have been known to spread Pneumonic Plague to humans.
Pneumonic Plague can be delivered by aerosol (spray). Thus delivered, Pneumonic Plague is a certainty as well as Bubonic. Food and water will become contaminated.
Prophylaxis: Adults
Oral medications only
DOXYCYCLINE: Adults 100 pounds or over
Doxycycline (Vibramycin) pills or capsules.
1) Minimum adult dosage for Doxycycline = 100mg every 12 hours (BID/q12h) x 30 days or
Duration of exposure-whichever is longer This is a total of 200mg per day.
2) Maximum adult dosage for Doxycycline =
100mg every 8 hours (TID/q8h) x 30 days or Duration of exposure-whichever is longer
This is a total of 300mg per day
TETRACYCLINES: Adults 8 years and over
Adult DOSAGES: Tetracycline or Oxytetracycline.
1) Minimum adult dosage for the Tetracyclines = 500mg every six hours (q6h) x 30 days or
Duration of exposure-whichever is longer This is a daily total of 2,000mg
2) Maximum adult dosage for the Tetracyclines= 500mg every four hours (q4h) x 30 days orDuration of exposure-whichever is longer This is a daily total of 3,000mg
Ciprofloxacin-not for Humans under 19 years
Unknown but suspected "useful" as a prophylaxis.
Adult DOSAGES: Cipro, Ciprofloxacin.
1) Minimum adult dosage for Cipro= 250mg every 8 hours (TID-q8h) X 30 days or
Duration of exposure-whichever is longer This is a daily total of 750mg
2) Maximum adult dosage for Cipro= 500mg every 12 hours (BID) X 30 days or duration of exposure-whichever is longer This is a daily total of 1000mg.
Prophylaxis: CHILDREN:
Oral medication only--Human or Animal Grade Do NOT give Children "Shots"!
When Children are considered Children:
Doxycycline---100 pounds and under
Tetracycline--- 8 years and under
Oxytetracycline---8 years and under
Penicillin--- 60 pounds and under
Cipro--- Do not give to humans under 19 years
Clark's Rule: Weight *best*
Divide the child's weight by 150 lbs. then multiply that number by the ADULT daily dose total. The answer equals the child's total daily dose. For instance, a dosage for a 60 pound child is computed thusly: 60/150 = 0.4 Now multiply that by the minimum daily dose for an adult and you get: 0.4 X 200mg (Doxycycline) = 80mg or: 80mg for a daily dose total of Doxycycline. However, Doxycycline only comes in 50mg and 100mg tabs so, the dosage for the 50 pound child can be adjusted to: 50mg every 12 hours (q12h) x 30 days or Duration of exposure-whichever is longer
Total daily dose = 100mg
Example: 50 pound child taking-- Tetracycline and Oxytetracycline would compute (50/150 times 3000mg) or a 1000mg daily dose total. This dosage would be: 250mg every six hours (q6h) X 30 days or Duration of exposure -whichever comes first.
Young's Rule: AGE
Divide the age of the child by his age + 12. For instance the calculations for a 3 year old child would be 3 divided by 3+12 (15) or 3/15. Thus 1/5th of the daily adult dose total.
Cowling's Rule: AGE
Divide the number of the NEXT birthday by 24.
For example: a 5 year old child's dose would compute: 6 divided by 24 equals 6/24 or 1/4 of the daily adult dose/dosage total.
Control
Isolation:
When handling infected humans wear: Kitchen Gloves, Poncho, Mask, and Eye Protection Strict isolation of patients with Pneumonic Plague. Sanitary procedures for Bubonic Plague.
Decontamination:
Wash or Spray all contaminated objects with: 0.5% Bleach or Iodine solution or Germicidals. Food CANNOT be decontaminated! To decontaminate drinking water using: USP Iodine Crystals --Saturated Solution Add 8 grams of Iodine crystals to a 2 ounce clear glass bottle with a bake-lite cap. NO Plastic! Fill with water and shake vigorously for several minutes, then let settle. Without disturbing the sediment, withdraw 6 teaspoons (30cc) of the saturated solution and add to a quart of tepid water.
Let stand for at least 60 min. To make more of the saturated solution "batch", just add more water to the sediment in the two-ounce bottle and shake. Remember: When there is no more sediment - start another "batch".
Contamination Prevention:
Eat only sealed foods.
Drink only sealed water.
Avoid air conditioning.
Avoid crowds.
Wear a face mask.
Wear kitchen gloves.
Wear a poncho.
Wear boots.
Disposal: Human or Animal
Burn the carcasses OR bury them with quick lime. Clothing and bedding should be burned.
Preventing Outbreaks
Since Pneumonic Plague is quite contagious from human to human, strict isolation must be employed!
Bubonic Plague is contracted from the infected flea/rodent population, therefore, pest control must be implemented. Pesticides for the insects. Poison for the rodent population. Burn the carcasses. Do not use dogs or cats to control rodents.
Treatment
For patients not taking Prophylaxis
Pneumonic and Bubonic Plague:
Adults and Children
Streptomycin-IM--intramuscular q12h (BID)
Treatment should begin within 24 hours of onset of symptoms of Pneumonic Plague. The treatment of choice is Streptomycin I.M. The formula is simple. (30mg per kg of body weight per day for 10 days) Divide into two equal shots 1 kilogram (kg) equals 2.2 pounds, so a 110 pound human would weigh about 50kg. Therefore: 30mg X 50 = 1500mg daily for 10 days. 750mg I.M (Buttocks) every 12 hours for 10 days
Adults Only I.V. Drip
Doxycycline--I.V. Drip-Ringers or D5&W
The formula is as follows: First give 200mg I.V. Drip (loading) then 100mg I.V. Drip every 12 hours for 14 days
Children Only I.V. Drip
Doxycycline-I.V. Drip-Ringers or D5&W
For Children under 100 pounds as follows: 4.4mg per kg of weight, I.V. Drip (loading) then 2.2mg per kg of weight, I.V. Drip every 12 hours
Adults Only--Oral
Doxycycline Oral-pills or capsules
200mg (loading) *then* 100mg every 12 hours for 14 days
Children Only--Doxycycline Oral
See: Clarks Rule
Dose every 12 hours for 14 days (Oral)
Adults Only--Oral
Tetracycline and Oxytetracycline
500mg every four hours for 14 days (Oral)
Children Only-Tetracycline/Oxytetracycline
See: Clarks Rule
Dose every four hours for 14 days (Oral)
_________________
Knowledge shared is learning gained by both teacher and student.