Term
| What are the 3 elements for bioterrorism? |
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Definition
- Perpetrators
- Agent
- A way to disseminate |
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Term
| What are the properties of a biologic agent? |
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Definition
- Highly infective - small dose spreads person to person
- Fatal or incapacitating
- Stable to environment upon release
- No effective prophylaxis/tx |
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Term
| What are CDC category A diseases? |
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Definition
- High priority
- Easy dissemination
- High mortality
- Anthrax, botulism, plague, smallpox, tularemia, viral hemorrhagic fevers |
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Term
| What are CDC category B diseases? |
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Definition
- Easy to disseminate
- Low mortality, moderate morbidity
- Brucellosis, Food contamination (shigella, salmonella, E. coli O157), Q fever, C. perfringens, Viral encephalitis |
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Term
| What are CDC category C diseases? |
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Definition
- Have the potential for a higher morbidity/mortality
- Nipah virus, hantavirus, tickborne, yellow fever, MDR-TB |
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Term
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Definition
A gram(+) SPORE forming bacilli that is infectious but not contagious.
Found in soil, animals. Clinical presentation depends on route of infection!
**PA - lethal factor causes apoptosis. |
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Term
| What are the 3 routes of anthrax transmission? |
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Definition
- Cutaneous – Most common, results in a lesion then systemic sx. 20% mortality
- Intestinal – Nausea, fever, leads to ulcers. up to 60% mortality
- Pulmonary – inhaled spores, can incubate for 43 days. Biphasic - prodrome (sore throat, myalgia, cough) then fever, shock, coma. CXR = infiltratates, effusion. 90% mortality |
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Term
| What is the tx regimen for inhalation and GI anthrax? |
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Definition
- Cipro/Levo + Doxy + 1 or 2 of: RIF, Vanc, PCN, ampi, chloramphenicol, imipenem, clinda, clarith
- Use cipro, not levo in kids. Benefits outweigh risk in pregnancy |
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Term
| What is the tx regimen for cutaneous anthrax? |
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Definition
- Cipro OR Doxy
** 60 days for all anthrax tx. Prophylaxis for all those considered exposed to AIR, not hospital staff caring for patients |
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Term
| For which bioterrorism agent is there a vaccine? |
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Definition
| Anthrax - the Biothrax vaccine. 3 injections. Used for military |
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Term
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Definition
Caused by orthopoxvirus (Variola major) - has no animal/environmental reservoir.
HIGHLY contagious through air and blister, until rash appears. 30% mortality if unvaccinated |
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Term
| What is the presentation of smallpox? |
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Definition
Fever, back pain, HA, rash progresses to pustules --> death from SIRS
**TX is SUPPORTIVE CARE ONLY. The US is currently immune, no more vaccination. CDC stockpiles vaccine |
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Term
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Definition
Yersinia pestis - transmitted by fleas. COULD be aerosolized
- Bubonic - most cases. Swollen lymph nodes. 60% mortality if untreated
- Pneumonic - bioterrorism, presents like pneumonia. High mortality
- Septicemic - 100% mortality |
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Term
| What is tx and prophylaxis for plague? |
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Definition
- Tx: Gentamycin or streptomycin for 10 days. Support for sepsis
- Prophylaxis: Doxy or cipro x7 days |
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Term
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Definition
| Caused by Francisella tularensis - gram(-) which lives in animals and soil. Easily aerosolized and high mortality, but no person to person transmission |
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Term
| How is tularemia treated? |
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Definition
- Tx - Cipro, streptomycin, or gent x10 days. OR doxy x14-21 days
- Prophylaxis - Doxy or cipro x14 days |
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Term
| What is the strategic national stockpile? |
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Definition
| In case of an attack or outbreak, can be deployed in 12 hours |
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