Reasonable Rascal
08-28-01, 19:04
Biological weapons or biological warfare (BW) is the use of microorganisms (bacteria, viruses, and fungi) or toxins (poisons produced by living organisms) to produce death or disease in humans, animals, and plants. Few healthcare providers have been trained to recognize or treat victims of a biological agent attack. Nonetheless, the principles of detection, personal protection, infection control, and treatment parallel the standard approach to any natural disease outbreak (such as influenza, Rift Valley Fever, meningitis, and hepatitis).
BW - Current Perspectives
Living organisms - a single bacterium dividing every 20 minutes gives rise to over a billion organisms in 10 hours. Only a small number of organisms required for infection and can be made resistant. Requires minimal equipment and supplies.
BW - General Properties
-Nonvolatile
-Must be dispersed as an aerosol - 1 to 5 microns.
-Route of entry: dermal oral inhalation.
-Respiratory would be primary route of transmission.
-Relatively easy to disseminate.
Impact of a BW Release
-Widespread illness and death.
-110 pounds of anthrax spores sprayed along a 1.5 mile track upwind from a city of 500,000 could kill 24,000 people.
-Profound psychological stress.
BW - Warning Properties
-No readily available monitoring devices.
-Few warning signs beyond suspicious sprayers and aerosol cans.
-Requires a high index of suspicion.
-Patterns of unusual volume of patient complaints or findings.
BW - Epidemiologic Clues
-Large epidemic with high illness and death rate.
-HIV (+) individuals may have first susceptibility.
-Respiratory symptoms predominate.
-Infection non-endemic for region.
-Multiple, simultaneous outbreaks.
-Multi-drug-resistant pathogens.
-Sick or dead animals of multiple types.
-Delivery vehicle or intelligence information.
BW - Epidemiological Information
-Travel history
-Infectious contacts
-Employment history
-Activities over the preceding 3 days.
Bacteria as Biological Agents
Anthrax
Plague
Tularemia
Bacteria - General Characteristics
Single-celled microorganisms
Self-sustaining organisms that do not require a host to reproduce.
May transform into a spore (anthrax).
Bacteria - Disease Producing Properties
Invade tissue producing an inflammatory response
Produce toxins
Comparison of Chemical Warfare and Biological Warfare
Biological weapons
Signs and symptoms would be delayed.
More difficult to detect.
Lower risk of secondary transmission.
Chemical weapons
Immediate effects
Relatively easy to detect.
Possible secondary contamination.
Anthrax
Spore-forming organism that produces infection through absorption, ingestion, or inhalation of spores.
Inhalation most likely route to be used by terrorists.
Anthrax - Signs & Symptoms
1- to 6-day incubation period followed by fever, myalgias, cough, and fatigue.
Initial improvement followed by abrupt onset of respiratory distress, shock, and death in 24 to 36 hours.
Anthrax - Treatment
Usually futile once symptoms develop.
Cipro - Ciprofloxacin 500mg BID
Levacin - Levofloxacin 500mg QD
Supportive care
Vaccine available, but supplies are limited.
Anthrax - Precautions
No case of person-to-person transmission have ever occurred.
Universal precautions required/BSI required.
A HEPA mask of the type used against TB should be worn.
Plague
Normally causes infection in rodents.
Spreads to humans from infected flea bites or by inhalation of the organism.
Symptoms include fever, chills, HA, cough, and sepsis.
Almost 100% of victims with Pneumonic Plague die.
Secondary transmission occurs with the respiratory form of the disease.
Universal precautions required.
Respiratory droplet isolation for pneumonic plague.
Treat with antibiotics.
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Los Angeles County EMS Agency
Samual J. Stratton, M.D.
Medical Director
BW - Current Perspectives
Living organisms - a single bacterium dividing every 20 minutes gives rise to over a billion organisms in 10 hours. Only a small number of organisms required for infection and can be made resistant. Requires minimal equipment and supplies.
BW - General Properties
-Nonvolatile
-Must be dispersed as an aerosol - 1 to 5 microns.
-Route of entry: dermal oral inhalation.
-Respiratory would be primary route of transmission.
-Relatively easy to disseminate.
Impact of a BW Release
-Widespread illness and death.
-110 pounds of anthrax spores sprayed along a 1.5 mile track upwind from a city of 500,000 could kill 24,000 people.
-Profound psychological stress.
BW - Warning Properties
-No readily available monitoring devices.
-Few warning signs beyond suspicious sprayers and aerosol cans.
-Requires a high index of suspicion.
-Patterns of unusual volume of patient complaints or findings.
BW - Epidemiologic Clues
-Large epidemic with high illness and death rate.
-HIV (+) individuals may have first susceptibility.
-Respiratory symptoms predominate.
-Infection non-endemic for region.
-Multiple, simultaneous outbreaks.
-Multi-drug-resistant pathogens.
-Sick or dead animals of multiple types.
-Delivery vehicle or intelligence information.
BW - Epidemiological Information
-Travel history
-Infectious contacts
-Employment history
-Activities over the preceding 3 days.
Bacteria as Biological Agents
Anthrax
Plague
Tularemia
Bacteria - General Characteristics
Single-celled microorganisms
Self-sustaining organisms that do not require a host to reproduce.
May transform into a spore (anthrax).
Bacteria - Disease Producing Properties
Invade tissue producing an inflammatory response
Produce toxins
Comparison of Chemical Warfare and Biological Warfare
Biological weapons
Signs and symptoms would be delayed.
More difficult to detect.
Lower risk of secondary transmission.
Chemical weapons
Immediate effects
Relatively easy to detect.
Possible secondary contamination.
Anthrax
Spore-forming organism that produces infection through absorption, ingestion, or inhalation of spores.
Inhalation most likely route to be used by terrorists.
Anthrax - Signs & Symptoms
1- to 6-day incubation period followed by fever, myalgias, cough, and fatigue.
Initial improvement followed by abrupt onset of respiratory distress, shock, and death in 24 to 36 hours.
Anthrax - Treatment
Usually futile once symptoms develop.
Cipro - Ciprofloxacin 500mg BID
Levacin - Levofloxacin 500mg QD
Supportive care
Vaccine available, but supplies are limited.
Anthrax - Precautions
No case of person-to-person transmission have ever occurred.
Universal precautions required/BSI required.
A HEPA mask of the type used against TB should be worn.
Plague
Normally causes infection in rodents.
Spreads to humans from infected flea bites or by inhalation of the organism.
Symptoms include fever, chills, HA, cough, and sepsis.
Almost 100% of victims with Pneumonic Plague die.
Secondary transmission occurs with the respiratory form of the disease.
Universal precautions required.
Respiratory droplet isolation for pneumonic plague.
Treat with antibiotics.
---------------------------------------------
Los Angeles County EMS Agency
Samual J. Stratton, M.D.
Medical Director