Anthrax as a biological weapon: Medical and public health management

Ramos, Joseph

doi:10.1016/s0196-0644(99)80076-6

Annals of Emergency Medicine

1999

DOI: 10.1016/s0196-0644(99)80076-6

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Anthrax as a biological weapon: Medical and public health management

Joseph Ramos¹

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Cited by 11 publications

References 13 publications

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Differentiating Inhalational Anthrax From Other Influenzalike Illnesses in the Setting of a National or Regional Anthrax Outbreak

et al. 2004

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The workup of a febrile patient who presents with an influenza-like illness in the setting of a national or regional anthrax outbreak presents a unique challenge to the physicians who initially evaluate this patient, and the diagnostic challenge can be even more profound during the influenza season. Based on information gathered from the recent inhalational anthrax cases, we have developed an algorithm to be used by physicians in the emergency department to evaluate patients with influenza-like illnesses during a national or regional anthrax outbreak. The algorithm necessitates stays no longer than 24 hours in the emergency department or hospital.

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Differentiating Inhalational Anthrax From Other Influenzalike Illnesses in the Setting of a National or Regional Anthrax Outbreak

et al. 2004

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Tularemia as a Biological Weapon

Dennis¹,

Inglesby²,

Henderson

et al. 2001

JAMA

1,238

526

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A weapon using airborne tularemia would likely result 3 to 5 days later in an outbreak of acute, undifferentiated febrile illness with incipient pneumonia, pleuritis, and hilar lymphadenopathy. Specific epidemiological, clinical, and microbiological findings should lead to early suspicion of intentional tularemia in an alert health system; laboratory confirmation of agent could be delayed. Without treatment, the clinical course could progress to respiratory failure, shock, and death. Prompt treatment with streptomycin, gentamicin, doxycycline, or ciprofloxacin is recommended. Prophylactic use of doxycycline or ciprofloxacin may be useful in the early postexposure period.

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Botulinum Toxin as a Biological Weapon

Arnon

Schechter

Inglesby

et al. 2001

JAMA

1,458

597

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An aerosolized or foodborne botulinum toxin weapon would cause acute symmetric, descending flaccid paralysis with prominent bulbar palsies such as diplopia, dysarthria, dysphonia, and dysphagia that would typically present 12 to 72 hours after exposure. Effective response to a deliberate release of botulinum toxin will depend on timely clinical diagnosis, case reporting, and epidemiological investigation. Persons potentially exposed to botulinum toxin should be closely observed, and those with signs of botulism require prompt treatment with antitoxin and supportive care that may include assisted ventilation for weeks or months. Treatment with antitoxin should not be delayed for microbiological testing.

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Anthrax as a biological weapon: Medical and public health management

Cited by 11 publications

References 13 publications

Differentiating Inhalational Anthrax From Other Influenzalike Illnesses in the Setting of a National or Regional Anthrax Outbreak

Differentiating Inhalational Anthrax From Other Influenzalike Illnesses in the Setting of a National or Regional Anthrax Outbreak

Tularemia as a Biological Weapon

Botulinum Toxin as a Biological Weapon

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