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4-Bioterrorism Agents Flashcards

1
Q

This is a deliberate release of viruses, bacteria, or agents used to cause illness or death in people, animals, or plants.

A

Bioterrorism

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2
Q

Why are bioterrorism agents typically found in nature?

A

Cuz they could be mutated to increase their ability to cause disease

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3
Q

These are spore-forming, G+ rods that appear as long serpentine chains and clumps (medusa head) on microscopy.

A

Bacillus anthracis

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4
Q

How long can the anthrax spores survive in the soil?

A

Years

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5
Q

This is the virulence factor for anthax that is made of poly-D glutamic acid, is antiphagocytic, and only produced during infection.

A

Capsule

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6
Q

What are the 3 protein components of the anthrax toxin?

A 
Protective antigen (PA)
Edema factor (EF)
Lethal factor (LF)
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7
Q

What is the role of PA?

A

Carries EF and LF and penetrates the cells

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8
Q

What happesn when PA combines with EF?

A

since EF is a cAMP-inducing toxin –> edema

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9
Q

What happens when PA+LF?

A

DEATH

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10
Q

Where is anthrax disease serious?

A

In coutnries where herd vaccination is not practiced

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11
Q

What are the 3 routes of human disease infection?

A

Inoculation, inhalation, and ingestion

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12
Q

What accounts for the 95% of transmission for anthrax?

A

inoculation of spores through exposed skin

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13
Q

Who is at risk for inhalation of anthrax?

A

Woolsorters

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14
Q

Who is at risk for ingestion of anthrax?

A

Herbivores

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15
Q

After inhalation of the spores or droplets of anthrax, which cells carry it from the lungs to the lympatic system?

A

Macrophages

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16
Q

During the first 5 days of anthrax infection, what are the Sx?

A

malaise, fever, non-productive cough

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17
Q

After traveling into the lymphatic system, where do the spores germinate and multiply to make more toxin?

A

Lymph nodes

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18
Q

Within what time do you see pulmonary necrosis, septicemia, progressive respiratory distress and cyanosis, massive edema of the neck and chest?

A

withing 24 hours

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19
Q

What % of mortality occurs with anthrax infection in within 48 hours?

A

95%

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20
Q

What is the appearance of anthrax on non-selective media?

A

non-hemolytic, grow rapidly, “gray ground glass” appearance

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21
Q

What do you see on CXR for anthrax infections?

A

Mediastinal widening

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22
Q

What are the 2 DOC for anthrax infection?

A

Ciprofloxacin and doxycycline

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23
Q

What is the form of the vaccine for anthrax?

A

Formalin-killed B. anthracis

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24
Q

Who gets the vaccine (6 doses over 18mo)?

A

Only military personnel

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25
This is a G+ anaerobic rods, that infects adults that do home canning and infants that eat honey.
C. botulinum
26
What is the effect of the heat-labile neurotoxin to cause flaccid paralysis form C. botulinum?
inhibits the release of Ach
27
How many cases/year do we see classic or foodborne botulism?
< 30 cases/yr
28
So what form of botulism is bioterrorism related?
Inhalation botulism | potential for high mortality
29
After what time frame from ingestion botulism do you see blurred vision, dry mouth, dilated pupils, CONSTIPATION, abd pain, and no fever?
1-2 days
30
What do people die from in ingestion botulism?
respiratory paralysis
31
What % mortality is ingestion botulism?
10%
32
What si the treatment for ingestion botulism?
antitoxin | + supportive, stomach lavage
33
Should you give antibiotics for botulism infections?
nah
34
This is the disease caused by an oxidase-neg, G- rod that causes hemorrhagic pneumonia
Pneumonic plague | yersinia pestis
35
When do you die form pneumonic plague?
2 days
36
What do you see on gram stain of LN aspirate for Y. pestis?
safety pins
37
Is the inactivated vaccine still available?
Nah
38
Is pneumonic plague, anthrax, or both spread person-person?
Pneumonic plague
39
How do you get smallpox (variola)?
via respiratory droplets
40
How does person-person transmission occur for smallpox?
Fomites
41
What is the % mortality occur in outbreaks for smallpox?
30%
42
What do you see on the skin for smallpox?
Small pox. lol. jk. but not really. they're papules that become pustules that crust and scab
43
There was a vaccine for smallpox but in what year did they stop making it?
1980
44
When i say "bunny" you think of what bug?
Fanciesella tularensis
45
Story time!
my parents got a rabbit when i was like 5 and at the time i was really into teenage mutant ninja turtles (obviously). so we were deciding to name this rabbit and i came up with the awesome suggestion of "Shredder ball", as Shredder is the villian in TMNT and "ball" cuz it was fluffy. my parents disagreed with my choice and in turn named it "Lilly" which makes no fuckin sense cuz it was brown and white and didnt look like a lilly pad at all. i cried about that one for a little while. if i ever get a rabbit again i will name it Shredderball.
46
What is the gram stain/shape of F. tularensis?
Aerobic G- bacillus
47
Though there are sever hundred cases of Shredderball infections/yr, what is the mortality rate?
~8%
48
How many F. tularensis do you need for infection?
10-50
49
What are the clinical manifestations for F. tularensis?
dry cough, dyspnea, chest pain, lobar PNA may develop, ARDS in some, may lead to Typhoidal (septicemic) tularemia
50
Though the gram stain is usually negative, what agar does F. tularensis grow on?
BCYE (remember all the "-ellas" grow on BCYE??"
51
What are the 4 brucella spp to cause brucellosis?
B. abortis, suis, melentensis, and canis
52
Aborted fetuses can transmit brucellosis by what method into humans?
Inhalation of aerosols (10-100 organisms)
53
What are the Sx of acute disease?
fever, weakness, fatigue, malaise, depression, anorexia, profuse sweats, chills
54
What is the 2 antibiotics you give for 6 weeks for the brucellosis?
Doxycycline + rifampin | or doxycycline for 6 wks + streptomycin for 2-3 wks
55
This is the bug that causes Q fever from the placenta of infected livestock.
Coxiella burnetti
56
What are the 2 manifestatons of coxiella burnetii?
PNA and hepatitis
57
Serology of what 2 antigens are used for the Dx of C. burnetii?
Phase I and II antigens
58
What is the DOC for C. burnetii?
Doxycycline
59
What is the bug that causes glanders and meliodosis?
Bulkhoderia spp
60
What are the lab characteristics of Bulkhoderia spp?
nonmotile, nonsporulating, obligate aerobic, G- rods, nonfermenters
61
Which Bulkhoderia spp causes glanders?
B. mallei
62
Which Bulkhoderia spp causes melioidosis?
B. pseudomallei | whitmore disease
63
B. mallei (glanders) is a primary disease of what?
Horses, mules, and DONKEYS
64
So how do people get B. mallei?
direct contact with secretions from infected animal
65
B. pseudomallei is endemic in which areas?
SE asia and australia
66
How do humans get B. pseudomallei?
direct contact from contaminated source
67
What is the typical clinical manifestion of glanders and meliodosis?
local manifestations with ulceration
68
What happens in the pulmonary form of glanders and meliodosis?
PNA, pulmonary abscesses, and pleural effusions
69
The septicemia form of glanders is usually fatal withing what time frame?
7-10 days
70
Which pts are susceptible to the septicemia form of melioidosis?
chronically ill pts (HIV, DM)
71
What are the Sx tothe septicemic form of melioidosis?
resp distress, headache, fever, diarrhea, pus-filled lesions on skin, and systemic abscesses
72
What is the fatality rate of septicemic melioidosis within 24-48 hrs?
90%
73
What shows up on gram stain of sputum, urine, and skin lesions for glanders and meliodosis?
small, G- bacilli may have safety pin bipolar appearance like Y. pestis
74
What are the 3 drugs of choice for glanders and meliodosis?
Amoxicillin and clavulanate Doxy TMP-SMZ

Public Health (14 decks)

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