SPECIAL CHAPTER: BIOTERRORISM Flashcards
involves the release of toxic biological agents
bioterrorism
intentional release of viruses, bacteria or fungi that can sicken or kill people
biological attack
characteristics of bioterrorism
more insidious
more potential casualties
harder to detect and trace to origin
easier to disperse
characteristic of chemical terrorism
agents are readily available
limited success
treatment options is limited and must be administered in the field
characteristic of nuclear terrorism
easy to detect
key features of biologic agents used as bioweapons
high morbidity and mortality rates potential for person to person spread low infective dose highly infectious by aerosol lack of rapid diagnostic capability lack of universally available effective vaccine potential to cause anxiety availability of pathogen and feasibility of production environmental stability
examples of category A CDC agents
anthrax-bacillus anthracis botulism- clostridium botulinum toxin plague-yersnia pestis small pox- variola major tularemia-francisella tularensis viral hemorrhagic fever arenaviruses bunyaviridae
examples of category B CDC agents
brucellosis epsilon toxin of clostridium perfringes food safety threats such as ecoli salmonella and shigella glanders meliodosis pssitaciosis q fever ricin toxin staph enterotoxin typhus fever viral encephalitis water safety threats such as vibrio cholerae and cryptosporidium parvum
examples of CDC category C agents
emerging infectious diseases threats such as Nipah, hantavirus, SARS or MERS coronavirus and pandemic influenza, COVID 19 virus
anthrax is caused by?
bacillus anthracis
bacillus anthracis is what type of bacteria
gram positive non motile spore forming found in soil causes disease in herbivores
incubation period of B. anthracis
2 to 43 days
death occurred in what day
1-4 days following the onset of symptoms
what are the 4 forms of bacillus anthracis
gastrointestinal
cutaneous
inhalational
injection
what are the 4 forms of bacillus anthracis
gastrointestinal
cutaneous
inhalational
injection
clinical syndrome of bacillus anthracis
cutaneous lesions: papule to eschar
inhalational disease: fever, malaise, chest and abdominal discomfort
pleural effusion: widened mediastinum in xray
how to diagnose bacillus anthracis
culture
gram stain
PCR
wright stain of peripheral smear
treatment for Bacillus anthracis post-exposure
ciprofloxacin 500mg PO bid for 60 days
doxycyline 100 mg PO bid for 60 days
amoxicillin 500 mg po q8H for 60 days (effective if strain is penicillin sensitive)
treatment for active disease of bacillus anthracis
ciprofloxacin 400 mg IV q12h or doxycyline 100 mg IV q12h plus
clindamycin
ntitoxin for treatment of anthracis bacillus
raxibacumab
diphenhydramine to reduce reaction
obiltoxaximab to premedicate
prophylaxis for anthrax bacillus
recombinant protective antigen vaccines
raxibacumab or obiltoxaximab
causative agent of pneumonic plaque
yersinia pestis
clinical syndrome of yersinia pestis
fever cough dyspnea and hemoptysis
infiltrates and consolidation on chest xray
incubation period of yersinia pestis
1- 6 days
diagnosis of yersinia pestis
culture
gram stain
direct fluorescent antibody
PCR
treatment for yersinia pestis
gentamicin
streptomycin
alternatives include: docycyline and chloramphenicol
prophylaxis of yersinia pestis
doxycyline and levofloxacin and formalin fixed vaccine
causative agent of small pox
variola major
clinical syndrome of small pox
fever malaise headache backache emesis maculopapular to vesicular to pustular skin lesions
incubation period of small pox
7-17 days
diagnosis of small pox
culture
PCR
electron microscopy
treatment for small pox
supportive measures consideration for cidofovir, recovirimat, immunoglobulin
prophylaxis for small pox
vaccination and immunization
causative agent for tularemia
francisella tularensis
clinical syndrome of tularemia
fever chills malaise chest discomfort dyspnea headache skin rash pharyngitis conjunctivitis hilar adenopathy on chest xray
incubation period for francisella tularensis
1-14 days
diagnosis for tularemia
gram stain
culture
PCR
immunochemistry
treatment for tularemia
streptomycin gentamicin doxycyline chloramphenicol ciprofloxacin
prophylaxis for tularemia
doxycycline and ciprofloxacin
clinical syndrome for viral hemorrhagic fever
fever myalgia rash encephalitis prostration
incubation period of viral hemorrhagic syndrome
2-21 days
diagnosis for viral hemorrhagic fever
RT-PCR serologic testing for antigen or antibody
viral isolation
treatment for viral hemorrhagic fever
supportive measure for ebola: slow IV infusion
for lassa: ribavarin
prophylaxis for viral hemorrhagic fever
no known chemoprophylaxis
experimental vaccines
causative agent for botulinum toxin
clostridium botulinum
clinical syndrome
dry mouth blurred vision ptosis weakness dysphagua dizziness respiratory failure progressive paralysis dilated pupils
incubation period of botulinum toxin
12-72 hours
diagnosis for clostridium botulinum
mouse bioassay
toxin immunoassay
treatment for clostridium botulinim
supportive measures HPAT
prophylaxis for clostridium botulinum
administration of antitoxin
