Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
How do I know if I have been exposed to a bioterrorism agent?
The symptoms of illness caused by the different bioterrorism agents are
frequently very nonspecific. Many of the agents cause a "flu-like" illness.
These symptoms would include fever,
cough, nausea, vomiting, and headache. It
is very hard to differentiate many of the different diseases initially, and
tests to confirm the diagnosis often must be done at specialized state
laboratories and may require weeks until the results are received.
It is best to stay informed through local news media on what symptoms to look
for and when to seek medical care. The health care system simply cannot handle
every member in the community demanding to be tested for the disease. Many
diseases do not even have a treatment other than supportive care which can often
be done at home.
Should I have some antibiotics on hand just in case I get exposed?
While there are a few biological agents that can be prevented by taking
antibiotics (for example, anthrax), it is not recommended that you stockpile
antibiotics. Antibiotics have a limited shelf life and would likely be unusable
by the time the attack occurred. Also, there are many different types of
infectious agents, each
requiring different antibiotics. All drugs, including antibiotics, have side
effects, and taking them inappropriately could cause more harm than good.
Since the likelihood of a biological attack is small, it is better to wait
until there has been an attack before getting medications. The U.S. government
has stockpiles of drugs that will be immediately flown into a community that has
experienced a biological attack (these supplies are rotated to keep them
current). Additionally, many large communities also have stockpiles of
medications for emergency use.
REFERENCES:
Stern, E.J., K.B. Uhde, S.V. Shadomy, and N. Messonnier. "Conference Report on Public Health and Clinical Guidelines for Anthrax." Emerging Infectious Diseases 14.4 (2008): e1.
United States. Centers for Disease Control and Prevention. "Bioterrorism." <http://www.bt.cdc.gov/bioterrorism>.
Dengue fever is contracted from the bite of a striped Aedes aegypti mosquito. Symptoms of dengue include headache, fever, exhaustion, severe joint and muscle pain, rash, and swollen glands. Since dengue is caused by a virus, there is no specific medicine to treat it. Treatment instead focuses on relieving the symptoms.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Botulism is an illness caused by a neurotoxin produced by the bacterium Clostridium botulinum. There are three types of botulism: food-borne, wound, and infant. Symptoms include muscle paralysis, dry mouth, constipation, slurred speech, and blurred vision. If food-borne and wound botulism are detected early enough, they may be treated with an antitoxin. Infant botulism is treated intravenously with BabyBIG (Botulism Immune Globulin).
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Plague is an infectious disease caused by the Yersinia pestis bacteria, which is primarily found in rodents the fleas that feed off of them. The bacteria are passed to humans through flea or rodent bites. There are three forms of plague: bubonic, septicemic, and pneumonic. The symptoms and method of transmission vary with each form of plague. Plague can be treated with antibiotics.
Cholera is an infectious disease characterized by intense vomiting and profuse watery diarrhea and that rapidly lease to dehydration and often death. Cholera is caused by infection with the bacteria Vibrio cholerae, which may be transmitted via infected fecal matter, food, or water.
Brucellosis is an infectious disease caused by the Brucella bacteria. Symptoms and signs include sweating, fever, fatigue, dizziness, headache, cough, chest, joint, and abdominal pain, and enlarged liver and/or spleen. Brucellosis is treated with antibiotics.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flulike and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Arsenic comes in two forms, inorganic and organic. Organic arsenic poisoning is usually not poisonous to humans; however, inorganic arsenic in large enough amounts can lead to shock and death. Symptoms of arsenic poisoning include nausea, abdominal pain, diarrhea, dehydration, dark urine, vertigo, delirium, shock, and death. Treatment for arsenic poisoning includes Hemodialysis and a variety of drugs.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Thallium is a metal that can be found in small amounts in the soil. When thallium enters the environment through coal-burning or smelting, it stays in the air, soil, and water for a long time and doesn't break down. Thallium exposure may come from eating contaminated foods, smoking cigarettes, touching or eating contaminated soil, living near a hazardous-waste site, or breathing workplace air in industries that use thallium.
Cryptosporidiosis is an intestinal disease caused by the Cryptosporidium parasite. Symptoms include watery diarrhea, stomach cramps, nausea and vomiting, fever, weight loss, dehydration, and weight loss. Antibiotics are used in the treatment of cyptosporidiosis.
Ricin is a biological toxin that can be made from processing castor beans. Symptoms of ricin poisoning include fever, cough, nausea, low blood pressure, diarrhea, seizures and blood in the urine. As there is no antidote, treatment focuses on minimizing the effects of poisoning.
Typhus is a disease caused by Rickettsia bacteria. Symptoms and signs include fever, headache, nausea, vomiting, diarrhea, and rash. Antibiotics are recommended as the treatment for endemic and epidemic typhus infections.
Melioidosis (Whitmore's disease) is an infectious disease caused by Burkholderia pseudomallei bacteria. Symptoms include bronchitis, pneumonia, fever, headache, loss of appetite, cough and chest pain. Treatment involves antibiotics or surgical removal of the lung abscess in severe cases.
Smallpox is a disease caused by the variola virus. Symptoms and signs include a characteristic rash and high fever. Treatment focuses on supporting the patient. Smallpox may be prevented with the ACAM2000 smallpox vaccine.
Tularemia (rabbit fever) is an infection caused by the Francisella tularensis bacteria. People can become infected with tularemia by coming into contact with infected animals or via a tick bite. Symptoms and signs include fever, headache and rash. Tularemia is treated with streptomycin or gentamicin.
Extensively drug-resistant tuberculosis (XDR TB) is a rare form of multidrug-resistant tuberculosis (MDR TB) that's transmitted when TB germs are expelled into the air by sneezing, speaking, singing, or coughing.