CH 69 Bioterrorism 107

NAME CAUSE SIGNS & SYMPTOMS DIAGNOSIS TREATMENT

Anthrax
(Acute infectious
disease caused by
spore forming gram+
bacteria)
*Animals can become
infected. 3 Forms:
Pulmonary, Cutaneous,
& GI. Infection depends
on route of exposure.
Can enter the body
threw contaminated
food, inhalation, or
open wound. Person-
Person transmission.
** Vaccine available in
US for more than 30
years. Only people
recommended getting
vaccine is those in the
military or those who
leave the country a lot.
Incubation period
Pulmonary is 1-5 days,
but can last up to 60.
Flu like symptoms:
cough, fever, sore
throat, fatigue, malaise,
sweating, and chest
discomfort, muscle
aches. Shock & Death
can occur 24-36 hours
after symptoms.
Incubation for Skin is
1-7 days. Itching, skin
reaction, brawny
edema, and dark scab.
Chest X-Ray (shows
widened mediastinal)
this could indicate
hemorrhaging with a
90% mortality rate,
Blood culture, ELISA,
PCR.
**If treatment is not
immediate &
aggressive the infected
person will die.
Antibiotics therapy for
8 weeks with Doxylin
or Cipro.
After exposure remove
clothing, shower with
soap and water.
Exposed person can
receive vaccine of 3
doses. Once after
exposure, then 2
weeks, 4 weeks.
Clorox (1:9) ratio.
Smallpox
(Highly contagious
viral disease in humans
are the ONLY
reservoir)
Potential biohazard.
Last known case 1949.
Immunizations
stopped in 1972.
Smallpox is
transmitted person-
person as an aerosol,
droplet, or contact.
Headache, high fever,
myalgia 10-17 days
after airborne
inhalation. Pustular
rash appears on face 2-
3 days. Client is
contagious from onset
until scabs separate 3-
week period. 30%
infected will die. **US
has a stockpile of
vaccine.
No Effective
Treatment. Vaccination
2-3 days after exposure
& immediate isolation
procedures. **
Standard precautions
& airborne
precautions.
Supportive care. Wear
protective clothing,
gown, gloves, special
mask.
CH 69 Bioterrorism 107

Plague
(Disease caused by
bacterium Yersinia
pestis)
Zoonotic disease
Two types Bubonic
(acquired from bite of
flea feeding on rat or
other rodents infected)
& pneumonic (Person-
person). *Pneumonic is
less common but
highly contagious &
frequently fatal.
Researchers working
on oral vaccine,
military will be first to
receive.
Client becomes ill
within 2 days of
exposure. Bubonic:
painful swollen tender
lymph gland in groin,
neck, armpit. Fever,
chills, headache,
exhaustion, can lead to
septicemia, shock or
death.
Pneumonic: fever,
chills, weakness, chest
pain, cough, blood-
tinged sputum,
shortness of breath.
Can progress to
respiratory failure,
shock and death.
Blood cultures, lymph
gland samples. Sputum.
Antibiotics, supportive
care, isolation, surgical
drainage of lesions.
Antibiotic of choice for
bubonic plague is
streptomycin.
Antibiotics for
pneumonic plague:
Cipro, Garamycin,
Streptomycin. Droplet
precautions for 72
hours after antibiotic
therapy. Use standard
precautions.
Botulism
(Toxin Clostridium
botulinum, paralyzes
muscles)
The toxin is one of the
most posioness
substances known,
usually food borne
allergen.
Paralysis may appear
comatose but still has
complete cognitive
functioning.
Standard Precautions.
Passive Immunization.
Supportive care.
Viral Hemorrhagic
Fever
(Ebola, Yellow fever,
Dengue fever)
All infections are
aerosol except for
dengue fever.
Can products.
Circulatory
compromise.
Isolation in negative
pressure room.
Caregivers wear head
covers, gown gloves,
and face shield,
personal respirator.
Care is supportive. No
CH 69 Bioterrorism 107

treatment or proven
cure.
Tularemia
(Caused by Francisella
tularensis)
Inhalation. Standard precautions.
Streptomycin or
gentamycin.
Ricin
(Waste products of
castor beans from
castor oil)
Exposure is unlikely; it
would have to be done
by a terrist. Can be in
powder, mist, pellet, or
weak acid form. Not
contagious, cannot be
spread. Prevents cells
from making protein-
causing cells to die.
Death may occur.
Begin in 8 hours after
inhalation. Respiratory
distress, fever, cough,
nausea, tightness in
chest, diaphoresis,
pulmonary edema,
hypotension,
respiratory failure.
Death may occur 36-72
hours after exposure. If
person is still alive
after 3-5 days,
recovery is likely.
**** According to the
CDC ricin has potential
medical uses such as
bone marrow
transplants and as
treatment to kill
cancer.
NOT CONTAGIOUS
No Antidote.
Supportive care. Get
Ricin out of or off of
body as quickly as
possible. Remove
clothing, wash body
with warm soapy
water & seek medical
treatment.
Sarin
(Nerve agent available
since WWII)
Clear, colorless,
odorless & tasteless
gas. Fastest, most toxic
chemical agent. Small
amounts can kill a
person.
Loss of consciousness,
seizures, paralysis,
respiratory failure,
death within seconds
to minutes of exposure.
Avoid Sarin, supportive
care.
Nuclear Radiation
(Dirty Bomb)
Sickness occurs hours-
days after exposure.
Nausea, vomiting,
diarrhea. If they live
then they usually
develop cancer or bone
marrow suppression
later in life.
Body waste is checked
for radiation levels.
Little to no effective
treatment. Treat
symptoms.
CH 69 Bioterrorism 107

-Terrorism- using or threatening to use any product, weapon, harmful act or substance to kill or injure a large number of
people.
-Bioterrorism- use of biological agent for purpose of harming, killing, and or instilling fear in large number of people.
-CDC- Federal government Goal to promote health & quality of life by preventing & controlling disease, injury, or disability.
-Biological agents include: Bacteria, viruses, fungi, toxins that are cultivated to cause harm to humans.
-Easy to obtain, do not need large are for production, and no special equipment.
- Category of Bio agents:
A-Agents easily disseminated person-person, HIGH mortality rate. Ex: Anthrax, Smallpox, Plague, and Botulism
B- Moderately easy to spread, Low Morbidity. Ex: Brucella, Chlamydia, Ricin, Typhus fever, viral encephalitis
C- Engineered for mass dissemination, HIGH morbidity rate. EX: Hantavirus, yellow fever, TB.

Department of Health & Human Services: US GOV Agency, protecting health of all Americans & providing essential services to
those who are least able to provide for themselves. Works with state & local governments.

Federal Emergency Management Agency: protect US from all hazards, natural disasters, acts of terrorism, and other human
made disasters.

CDC Informs all Americans of threats against health & life.

National Guard Medical Services: Everything necessary to screen and treat clients who need outpatient care.

Joint Commission: Emergency preparedness