Biological
Attack
General Guidance
Diagnosis:
Be alert to the following -
1. Groups
of individuals becoming ill around the same time.
2. Sudden increase of illness in previously healthy individuals.
3. Sudden increase in the following non-specific illnesses:
- Pneumonia,
flu-like illness, or fever with atypical features
- Bleeding disorders
- Unexplained rashes, and mucosal or skin irritation, particularly
in adults
- Neuromuscular illness, like muscle weakness and paralysis
- Diarrhea
4. Simultaneous disease outbreaks in human and animal or bird populations.
5. Unusual temporal or geographic clustering of illness (for example,
patients who attended the same public event, live in the same part of
town, etc.)
Decontamination
Considerations
1. Decontamination
of patients usually not required for biological agents.
2. Clothing removal and biosafety bagging is recommended.
3. Handle equipment used according to standard infection control practices.
Agent - Anthrax
Incubation - 2 to 6 days
Range - 2 days to 8 weeks
Symptoms - Flu-like symptoms, nausea, vomiting, abdominal pain, fever, respiratory distress
Transmission & Precautions - Aerosol inhalation, No person-to-person transmission, Standard precautions
Agent - Botulism
Incubation - 12 to 72 hours
Range - 2 hours to 8 days
Symptoms - Difficulty swallowing or speaking, Symmetric descending weakness, Respiratory dysfunction, No sensory dysfunction, No fever
Transmission & Precautions - Aerosol inhalation, Food ingestion, No person-to-person transmission, Standard precautions
Agent - Plague
Incubation - 1 to 3 days by inhalation
Symptoms - Sudden onset of fever, chills, headache, myalgia, Pneumonic: cough, chest pain, dyspnea, fever, Bubonic: painful lymph nodes
Transmission & Precautions - Person to person transmission in pneumonic forms, Droplet precautions until patient treated for at least 3 days
Agent - Tularemia "pneumonic"
Incubation - 2 to 5 days
Range - 1 to
21 days
Symptoms - Fever, cough, chest tightness, pleuritic pain, Hemoptysis rare
Transmission & Precautions - Inhalation of agents, No person to person transmission
but laboratory personnel at risk, Standard precuations
Agent - Smallpox
Incubation - 12 to 14 days
Range - 7 to 17 days
Symptoms - High fever and myalgia, itching, abdominal pain, delirium, Rash on face, extremities, hands, feet, confused with chickenpox which has less uniform rash
Transmission & Precautions - Person to person transmission, Airborne precautions, Negative pressure, Clothing and surface decontamination.