The Use of Anthrax and Orthopox Therapeutic Antibodies from Human Origin in Biodefense

Abstract

s95 accidents with overexposure of both workers and the population. The threat of nuclear terrorism with possible negative consequences for the population is real. Medical triage of exposed individuals by the extent of required medical aid is critical in large-scale radiation emergencies. Medical triage is based on the prediction of acute radiation consequences by estimated exposure dose. Whereas physical dosimetry, which provides more accurate dose estimates, often is not feasible in the event of large-scale radiation accidents, especially within the first hours and even days after exposure, biological dosimetry is of special value. Thus, a scale of Radiation Injury Severity Classification (RISC) has been developed based on the recently available medical data on 59 workers in Russia and two in the US, who were exposed due to the short-term acute irradiation. The RISC scale includes clinical and hematological parameters for triage of acute radiation injuries into three prognostic categories: (1) survival probable; (2) survival possible; and (3) survival improbable. For in-situ testing of the RISC scale, 24 workers with the full clinical information for the first days after acute exposure have been selected. Eight physicians with limited training in assessment of radiation injuries have been recruited to test the scale. They have used the RISC scale to assign a numerical score to each of the 24 cases. Physicians have been able to classify appropriately 84% of cases. More importantly, they have correctly classified 96.8% of cases into a category of possible survival, i.e., those who would benefit of medical care. A more extensive in-situ testing is planned to validate these findings.