biological warfare

category a

• highest priority agents

• highly transmittable and high mortality rates

• special action is required for public health preparedness

anthrax

causative agent: bacillus anthracis

insects and cattles

anthrax vector

mot anthrax

production of 3 proteins to induce toxin production

• protective antigen + lethal factor =lethal toxin

• protective antigen + edema factor = edema toxin

cp anthrax

blister, swelling of sores, painless sore that has a black center, chest pain, stomach pain, tiredness, swelling of neck glands, sore throat, odynophagia, red face and eyes

antibiotics, inhalational, sc ventilators, fluids, vasopressors

treatment anthrax

mot botulism

blocks acetylcholine presynaptic release at the neuromuscular junction and reversible denervation of muscle fibers

cp botulism

ocular palsy, muscle weakness, diplopia, dysphagia, difficulty moving the eyes and ptosis, slurred speech

antitoxins (heptavalent and babyBIG), sc ventilation, wound debridement, psychosocial support

treatment botulism

plague

causative agent: yersinia pestis

flea and rodents

plague vector

mot plague

affects the immune system by disarming phagocytes and suppressing immune processes like cytokine production

cp plague

painful & swollen lymph nodes, weakness, fever, chills, blackening of skin, sob, pnuemonia

antibiotic treatment, gentamicin, doxycycline, cipro, levofloxavin, chloramphenicol

treatment plague

smallpox

causative agent: variola virus

mot smallpox

initiates viremia that spreads the virus to different organs and causes complications

cp smallpox

fever fatigue, severe backpain, rash with bumps full of clear liquid, pus-filled rash, development of crust, dries, falls-off

antiviral drugs tecovirimat, brincidofovir

treatment smallpox

ebola

causative agent: tai forest virus, bundibugyo virus, sudan virus

mot ebola

decrease cell surface molecules and MHCI. Cell detachment, altered immune recognition and cell death

cp ebola

severe headache, viral hemorrhagic fever, myalgia, unexplained bleeding

category b

• 2nd highest priority

• moderate transmission, moderate morbidity rates and low mortality rates, requires specific enhancements of CDC’s diagnostic capacity and enhanced disease surveillance

typhus fever

causative agent: rickettsia prowazekii (louse-borne),rickettsia typhi (flea-borne)

body lice and fleas

vector typhus fever

mot typhus

mutiplies inside the endothelial cells→cytolysis→cell death and release of organisms, infecting more cells

cp typhus

fever chills, headache, rash, myalgia, cough, n/v, confusion

doxycycline

treatment typhus

category c

• 3rd highest priority

• emerging pathogens which could be engineered for mass dissemination

• high morbidity and mortality potential

nipah virus

causative agent: paramyxovirus

fruit bats aka flying foxes

vector nipah virus

mot nipah virus

enters the CNS through choroid plexus → disrupts BBB → neurological problems like encephalitits

cp nipah virus

encephalitis, coma, fever, headache, cough, sore throat, difficulty breathing

rodents (mice and rats)

vectors hantavirus

mot hantavirus

increased capillary permeability resulting to abrupt hypotension and shock

cp hantavirus

fatigue, fever, myalgia gi symptoms, intense HA, blurred vision, low bp, internal bleeding

no treatment available

treatment hantavirus

intubation

supportive care for hantavirus pulmonary syndrome

dialysis

supportive care for hemorrhagic fever with renal syndrome