Bioterrorism Flashcards
Biosecurity concerns for pathogens that would… (7)
Render a vaccine ineffective
Confer resistance to therapeutically useful antimicrobial
Enhance the virulence of a organism
Increase transmissibility of a pathogen
Alter the host range of a pathogen
Enable the evasion of diagnostic/detection tools
Facilitate delivery of a biological agent
3 biological agents that are transmissible between people
Primary pneumonic plague (droplet)
Smallpox (contact and airborne)
Viral hemorrhagic fevers (contact and airborne)
Bacillus anthracis
morphology, growth conditions, isolated from where, transmission, virulence factors
Gram positive rod Spore forming, facultative anaerobe Catalase and oxidase + NON-HEMOLYTIC ON SBA Isolated from mediastinal lymph node Virulence factors on plasmids No person to person transmission
2 Baciullus anthracis virulence factors
pX01 = genes encoding toxins (responsible for tissue destruction and bleeding) pX02 = genes encoding poly-D-glutamic capsule (protects against phagocytosis)
3 forms of human anthrax
- Cutaneous
- Gastrointestinal
- Inhalation (pulmonary)
Cutaneous Anthrax
symptoms, mortality, specimens
Most common form (95%) Inoculation of spores under skin Painless ulcer, black center Death 20% if untreated Specimen of choice: vesicles fluid, blood or biopsies
Gastrointestinal Anthrax (transmission, symptoms, mortality, specimen)
Ingestion of contaminated meat
Acute GI illness, vomiting, bloody diarrhea, lesion similar to cutaneous
Mortality rate 25-60% despite treatment
Specimen of choice: blood, not stool!
Pulmonary (inhalation) anthrax
symptoms, mortality, specimens
Possible presentation for bioterrorism
Initally just fever, cough, malaise
Rapid progression to high fever, dyspnea, cyanosis, hemorrhagic mediastinitis, pleural effusion
99% mortality despite treatment
Specimens: blood, pleural fluid, biopsies of mediastinal lymph nodes
3 antibiotics to treat anthrax
Penicillin
Doxycycline
Ciprofloxacin
Smallpox
other name, morphology, transmission, reservoir, vaccine, symptoms, mortality
Variola virus
Orthopoxvirus = large dsDNA, enveloped, complex
Transmission: contact, fomites, aerosols
Humans are reservoir, so spreads between us
Intradermal inoculaton (scarification) made from live vaccinia virus
Malaise, muscle aches, fever, rigors
High mortality if not treated (30-50%)
What are 3 viruses transmitted by aerosols
Smallpox (variola virus)
Measles
Varicella
How do you tell the difference between a smallpox rash and a chickenpox rash?
Smallpox: all the stages develop together, mostly on face and extremitites
Chicken: will see all stages at once (lesions, papules, vesicles), mostly on torso
Yersinia pestis
causative agent, disease, vector, reservoir
Plague
Enterobacteriaceae
Fleas are vector, and rodents are reservoir
3 Clinical presentations of the plague
- Bubonic: infected lymph nodes
- Septicemic: blood borne
- Pneumonic: deadliest
Bubonic plague
symptoms, mortality, specimen
Sudden onset of fever, malaise, myalgia Regional lymphadenitis (buboes) Can look for bite marks and lesions 80% become bacteremic 60% mortality if untreated Specimen: lymph node aspirate
If you see a big swelling on lymph nodes, what do you expect?
Francisella
Bubonic plague
Septicemic Plague
acquisition, symptoms, mortality, specimen
Primary or secondary (from bubonic or pneumonic forms)
Systemic disease (endotoxemia, systemic inflammatory response syndrome, shock, DIC, etc)
100% mortality if untreated
Specimen: blood
Pneumonic plague
transmission, symptoms, mortality stat, specimen, antibiotics
Person to person transmission by respiratory droplets
Sudden onset fever, malaise, myalgia, and pneumonia
Rapid progression to cyanosis, hemoptysis, respiratory collapse, sepsis, 100% mortality untreated
Specimen: sputum, BAL
Antibiotics: doxy or septra
Yersinia pestis diagnosis
growth, detection
Clinical suspicion plus labs Grows at 25 degC Grows on MacConkey Bipolar staining PCR or DFA for detection
2 diseases from Francisella tularensis
- Pneumonic: flu like symptoms, mortality 30% if untreated, possible presentation for bioterrorism
- Typhoidal: septicemia, possible presentation for bioterrorism
Francisella tularensis growth conditions
Poorly staining gram negative cocco bacilli
Grows poorly on SBA, CHOC, thayer martin agar
Requires cysteine for growth!
Cysteine heart agar is ideal, also BCYE agar
What can you use to treat tularemia
Doxycycline
