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November 24, 2009
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Bioterrorism (cont.)

What are the warning signs of a bioterrorism attack?

Although the government continues to search for an early detection systems for biological, chemical, and radiation terrorist attacks, none of these systems have been perfected. The medical community is advised to look out for unusual diseases not typically seen in the area. Other potential clues that raise suspicion for a bioterrorism attack include: new types of antibiotic resistance in bacteria, because some biologic agents are modified (weaponized) to make them more lethal, unusual numbers of cases of a disease, and atypical presentation of diseases.

The general public should constantly be vigilant for bioterrorism. Events that might suggest an attack include: a large number of ill or dead people in a small geographic area, multiple dead animals of different species, and patients with multiple different diseases, indicating a mixed attack.

What should I do if there has been a bioterrorism attack?

If you think that you have been exposed to a biological agent, the most important thing to do is to quickly remove your clothing and wash off your skin. Most biological agents cannot penetrate intact skin. Showering with soap and water will remove most agents from the skin. If you have already inhaled or ingested the agent, decontamination using soap and water my not help you, but might help prevent exposing other family members or coworkers.

If the biological agent has been released into the air, but you do not believe (or do not know) you have been exposed, you can utilize masks to help prevent inhalation of the agent. The problem is that standard surgical masks offer little protection. Specialized high-efficiency particulate air (HEPA) masks are available that offer better protection; however, they are more expensive, not easily found, and should be fitted to the person using them.

The two most important tools used by public health officials will be isolation and quarantine. Isolation is keeping people known to be ill away from other people. Quarantine is keeping people who may have been exposed away from other people. The problem is that many times we may not know who has been exposed. In these cases, the public-health officials will likely recommend that everyone stay in their homes and avoid all public gatherings. By doing this, we will isolate those sick and quarantine those infected but who do not yet have symptoms. Those cities that utilized this technique during the Spanish Flu pandemic of 1918 had much lower rates of death than did cities that did not practice good quarantine procedures.

If there has been a bioterrorism attack, the first important step is to get information immediately from the news media as to the right course of action. For some terrorist attacks, it may be correct to try and leave the area; however, for other events, it may be more appropriate to shelter in place. With bioterrorism, there may be the possibility of transmission of disease from one human to another (for example, measles, influenza, avian flu, smallpox, plague, and viral hemorrhagic fevers). In the case of either a bioterrorism attack or just a natural outbreak, it may be necessary to avoid contact with infected people or just remain inside for a period of time until the infected people are no longer contagious. Again, the key action is to understand the recommendations from public-health officials as delivered through the news media.



Next: How do I know if I have been exposed to a bioterrorism agent? »

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