NCJ Number
191288
Journal
Morbidity and Mortality Weekly Report Volume: 50 Issue: 41 Dated: October 19, 2001 Pages: 893-897
Date Published
October 2001
Length
5 pages
Annotation
This document provides guidance for health-care providers and public health personnel about recognizing illnesses that might be associated with intentional release of biologic agents.
Abstract
Health care providers should be alert to illness patterns and diagnostic clues that might indicate an unusual infectious disease outbreak associated with intentional release of a biologic agent. They should report any clusters or findings to their local or State health department. Anthrax is an acute infectious disease caused by the spore-forming bacterium B. anthracis. Humans are infected through direct contact, resulting in cutaneous, inhalational, or gastrointestinal forms. Inhalational anthrax begins resembling a viral respiratory illness and is the most lethal form of anthrax. Plague shows clinical features of fever, cough with muco-purulent sputum, hemoptysis, and chest pain. A chest radiograph shows evidence of bronchopneumonia. Botulism clinical features include drooping eyelids, weakened jaw clench, difficulty swallowing or speaking, blurred vision, and respiratory dysfunction. Smallpox symptoms resemble other acute viral illnesses, such as influenza. The vesicular/pustular rash of smallpox is typically most prominent on the face and extremities, and lesions develop at the same time. Inhalational tularemia causes an abrupt onset of an acute nonspecific febrile illness beginning 3 to 5 days after exposure. Hemorrhagic fever is characterized by abrupt onset of fever, myalgia, and headache. A rash, prominent on the trunk, develops in most patients approximately 5 days after onset of illness. It is recommended that unidentified gram-positive bacilli be treated as a “finding” when they occur in a suspicious clinical setting. An unusually high number of samples, particularly from the same biologic medium, may alert laboratory personnel to an outbreak. Heightened awareness by infection-control professionals facilitates recognition of the release of a biologic agent. State health departments should implement plans for educating and reminding health-care providers about how to recognize unusual illnesses that might indicate intentional release of a biologic agent. 9 references