Biological Diseases
|
Agent & Incubation
Period
|
Signs,
Symptoms, Sequelae and
Mode of Acquisition |
Source
|
Vaccine
available
|
Contagious
between
humans |
Treatment
|
Comments
|
|
Anthrax 7 days post exposure |
*Resembles
a common cold (fever, cough, malaise) which progresses to severe
dyspnea, diaphoresis, stridor, cyanosis and shock * Chest xray shows a mediastinal widening. * Gram positive bacilli seen on blood smear and culture. * Hemorrhagic mediastinitis, thoracic lymphadenitis, and/or meningitis. * Inhalation of spores from contaminated animal products |
*
Infected animal tissue * Spores can live in the soil for years * Biological warfare agent |
*
Yes … approved for ages 18-65 * 3 injections given 2 weeks apart, followed by 3 more injections at 6, 12, & 18 months |
extremely unlikely Standard precautions |
*
Early treatment essential * Ciprofloxacin * Doxycycline * Penicillin * Special considerations for treatment of children, elderly, & pregnant women |
90-100% of cases are fatal |
|
Anthrax 7 days post exposure |
Spores
enter the skin * Infection more likely with a cut or abrasion on the skin * Infection begins with a raised, itchy bump that resembles a bug bite * Within 1-2 days, a vesicle develops, followed by a painless ulcer 1-3 cm in diameter with a black necrotic center * Lymph glands in the adjacent area may swell |
Infected |
Yes … approved
for ages 18-65 * 3 injections given 2 weeks apart, followed by 3 more injections at 6, 12, & 18 months |
rare Standard precautions |
Early
treatment is essential * Ciprofloxacin * Doxycycline * Penicillin * Special considerations for treatment of children, elderly, & pregnant women |
Death
rare if treated * 20% of untreated cases are fatal |
|
Anthrax 7 days post exposure |
Early
symptoms : nausea, vomiting, malaise, anorexia, fever, acute inflammation
of the GI tract * Advanced symptoms: abdominal pain, vomiting blood, severe diarrhea * Illness progresses rapidly * Eating undercooked contaminated food |
Infected
animal tissue * Spores can live in the soil for years * Biological warfare agent |
Yes … approved
for ages 18-65 * 3 injections given 2 weeks apart, followed by 3 more injections at 6, 12, & 18 months |
rare Standard precautions |
Early
treatment is essential * Ciprofloxacin * Doxycycline * Penicillin * Special considerations for treatment of children, elderly, and pregnant women |
25-75% of cases are fatal |
|
Botulism
(foodborne) Incubation depends
on amount bacteria and toxin ingested |
Early
symptoms: abdominal cramps, nausea, vomiting, diarrhea, difficulty
seeing, speaking, swallowing. * Double or blurred vision, drooping eyelids, slurred speech, dry mouth, * Progresses to an acute, afebrile, symmetric, descending flaccid paralysis with multiple cranial nerve palsies, coma * The most poisonous substance known, a major bioweapon threat due to its extreme potency, lethality, ease of production, transport, and misuse. |
Contaminated food from restaurants or home canned sources Bacteria commonly
found in the soil |
Botulinum toxoid vaccine is available but supplies are scarce and mass outbreaks of disease are rare | No Standard precautions |
*
Antitoxin available from CDC; must be administered early in course
of disease * Supportive care |
*
Presents public health emergency * Mortality rate = 8% |
|
Botulism Incubation depends
on amount and rate of toxin absorption |
*
Ptosis, diplopia, blurred vision, dysarthria, dysphonia, dysphagia * Progresses to an acute, afebrile, symmetric, descending flaccid paralysis with multiple cranial nerve palsies, coma * The most poisonous substance known, a major bioweapon threat due to its extreme potency, lethality, ease of production, transport, and misuse. |
Industrially
produced botulinum toxin, diluted for treatment of spastic disorders
and cosmetic treatment of wrinkles could be diverted to bioterrorism |
Botulinum toxoid vaccine is available but supplies are scarce and mass outbreaks of disease are rare | No Standard precautions |
* Supportive care | As above |
|
Botulism Incubation depends on amount bacteria inoculated and rate of toxin production |
*
Double or blurred vision, drooping eyelids, slurred speech, dry mouth, * Progresses to an acute, afebrile, symmetric, descending flaccid paralysis with multiple cranial nerve palsies, coma * Will NOT penetrate intact skin |
Bacteria
found in soil … in recent years black tar heroin from California
is a prime source |
as above | Standard precautions | *
Antitoxin available from CDC; must be administered early in course
of disease * Supportive care |
Infectious disease that would NOT result from bioterrorism |
| Botulism (intestinal) Clostridium botulinum |
Lethargy,
feeds poorly, constipation, weak cry, and poor muscle tone * Occasionally susceptible patients may harbor C. botulinum in their intestinal tract (most often occurs in infants) |
Bacteria commonly found in the soil | as above | Standard precautions |
*Supportive care *Antitoxin is not routinely given for infant botulism |
Infectious disease that would NOT result from bioterrorism |
| Brucellosis (foodborne) Brucella species Incubation is variable |
*
Flu-like symptoms such as fever, sweats, headache, back pain, and
physical weakness. * In severe cases, the patient may develop hepatitis, arthritis, spondylitis, anemia, leukopenia, thrombocytopenia, meningitis, uveitis, optic neuritis, papilledema, and endocarditis * Chronic symptoms may include recurrent fevers, joint pain, and fatigue. |
Ingesting
contaminated milk, dairy, or animal products * High risk in unpasteurized milk, ice cream and cheeses |
None available for humans | Extremely rare … although may possibly be transmitted through breast milk, sexual contact, or tissue transplantation Standard precautions |
Doxycycline
and rifampin used in combination for 6 weeks * Recovery takes a few weeks to several months |
Mortality <2% |
| Brucellosis (inhaled) Brucella species |
As above | Inhaling aerosolized Brucella | None available for humans | As
above |
As above | As above |
| Brucellosis (wound) Brucella species |
As above | Transmitted via skin abrasions while handling infected animals. | None available for humans | As
above Standard precautions |
As above | As above |
|
Pneumonic
Plague Incubation is |
Early
signs are fever, headache, weakness, dyspnea and productive cough
(bloody or watery sputum) * May see nausea, vomiting, abdominal pain, or diarrhea * Acutely swollen and painful lymph nodes appear on the 2nd day of the infection, and the overlying skin is erythematous * Pneumonia progresses over 2-4 days followed by septic shock and death |
Bacteria carried by rodents and their fleas Bioweapon usage would occur after aerosolization of the bacteria |
None at this time, however research is underway | Occurs
through respiratory droplets during face-to-face contact Respiratory Droplet Precautions / Strict Isolation |
Early
treatment is important * Ciprofloxacin * Streptomycin * Tetracycline * Chloramphenicol * Doxycycline * Special considerations for treatment of children, elderly, and pregnant women * Resp. isolation precautions, prophylactic antibiotic for close contacts of patient |
Death can occur in as little as 2-4 days |
| Smallpox Variola virus
|
Initial
symptoms are high fever, fatigue, head and back aches. * 2-3 days later, a rash appears in the mouth, on the face, arms, and legs. The rash begin as flat red lesions that evolve at the same rate … after a day or two the lesions become pus-filled and begin to crust early in the second week. Scabs fall off after 3-4 weeks * Patients with smallpox are most infectious during the first week of illness, although are contagious until all skin scabs are healed * In people exposed to smallpox, the vaccine can be given w/I 4 days to lessen or prevent the illness |
*Infected saliva droplets | The
U.S. has an emergency supply available (has not been routinely used since 1972) |
Occurs
through respiratory droplets during face-to-face contact * Can also be transmitted by contaminated clothing or bedding Respiratory Droplet & Airborne Precautions |
No
proven treatment although research for antivirals continue * Supportive care should include intravenous fluids, antipyretics, and antibiotics for secondary infections * Patients admitted to the hospital should be placed in negative pressure rooms, staff should use standard precautions to protect against spread of the disease. |
* Mortality rate = 30% |
|
Tularemia Incubation is |
Initial
symptoms are fever, pharyngitis, headache, body aches, and upper
respiratory illness, rapidly progressing to bronchitis, pneumonia,
pleuropneumonitis, bacteremia. May see nausea, weight loss, malaise with continued illness. * Inhalation would have the greatest adverse public health consequences … release in a densely populated area would result in an abrupt onset of a sick population (yet, slower progression than anthrax or plague). * This is a dangerous bioweapon due to its extreme infectivity, ease of dissemination, and substantial capacity to cause illness and death. |
Contaminated
arthropods, soil, animals, water, and vegetation * Humans become infected by direct contact, ingestion, or inhaled infective aerosols |
Vaccine available, not fully approved for general use | No Standard precautions |
Individual
treatment drugs of choice: Streptomycin Gentamycin * Mass Casualty treatment drugs of choice: Doxycycline Ciprofloxin * Special considerations for children, pregnant woman, and those w/ immuno-suppression |
<2% mortality rate |
| Viral
Hemorrhagic Fevers (VHF) |
VHF
is a term used to describe a severe multisystem syndrome in which
the overall vascular system is damaged. * Initially, fever, fatigue, dizziness, muscle aches, weakness, and extreme fatigue are seen in the patient. * Severe infections will produce bleeding under the skin (petechiae), internal bleeding, or bleeding from body orifices. These patients will progress to shock, nervous system malfunction, coma, delirium, seizures, and/or renal failure. * VHF refers to a group of illnesses caused by several families of viruses: Arenaviruses (Argentine, Bolivian, Lassa) Bunyaviruses (Rift Valley, Hantavirus) Filoviruses (Ebola, Marburg) Flaviviruses (Tick-borne, Kyasanur Forest) |
Most
VHFs are insect or animal borne * The vector for Ebola and Marburg viruses are unknown * Humans become infected through contact with rodent’s bodily fluids or when bitten by an arthropod. |
Available
only for yellow fever and Argentine hemorrhagic fever at this time. * No vaccines exist for the other VHFs. |
Humans
may transmit some VHFs |
*There are no treatments for most• of the VHFs. * Supportive care is given. * Ribavirin may be of use with Lassa fever, HFRS, Congo-Crimean HF, and Rift Valley fever |
Mortality
rate varies with each VHF … most are between 50-90% mortality
rate |
| Q
Fever Coxiella burnetii Incubation
is |
Sudden
onset of high fevers (104-105), severe headache, malaise, myalgia,
confusion, sore throat, chills, sweats, nonproductive cough, nausea, vomiting, diarrhea, abdominal pain, chest pain. * Fever lasts for 1-2 weeks. * 30-50% of patients develop pneumonia * This agent is highly infectious and resistant to heat, drying, and most disinfectants. It easily becomes airborne & is inhaled by humans, and therefore is at risk of abuse by bioterrorists. * Chronic Q fever occurs when infection persists for > 6 months … these patients are prone to endocarditis. |
Infected
milk, urine, feces, amniotic fluid of animals * Humans are infected by inhaling dried, contaminated particles * Ingestion of contaminated milk may produce illness |
yes … although not commercially available in the United States | rare Standard precautions |
Q fever: Chronic Q fever: |
Q fever< 2% mortality rate Chronic |
©RnCeus.com