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Bioterrorism Deliberate release of bacteria, viruses or other agents that may cause death or illness in people, animals and plants. Agents may be spread through the air, water or food. There are three categories: A (pose highest risk to public and national security), B (Moderately easy to spread) and C (emerging pathogens that could be engineered for mass spread) (CDC, 2006). If you suspect someone is infected-quarantine the person and area Agents ANTHRAX-spore forming bacteria 3 types: skin, lungs, digestive Spread person/animal to person 2001-anthrax spread via postal system Category A GI anthrax more severe causing 25-60% of deaths in these cases Caused by eating contaminated meat S/S: cutaneous-small sore develops into blister then ulcer; GInausea, anorexia, bloody diarrhea, fever; lungs-cold/flu symptoms, mild fever and muscle ages Symptoms appear in 7 days after coming in contact with anthrax TX: antibiotics (60 days) Precautions-standard* Ricin o Toxic protein made from castor beans, toxin is extracted from the beans and treated to form a powder that can be suspended in air and inhaled CANNOT be spread from person to person Can be injected and has caused several deaths to date If placed directly on skin, causes death within minutes Incubation period for ingestion-less than 6 hours, inhalation-8 hours S/S: dyspnea, fever, cough, n/v/d (ingestion), tight chest, internal bleeding TX-supportive; hydration, O2 Cyanide (hydrogen cyanide, cyanogen chloride or sodium or potassium cyanide) Colorless gas, with (bitter almond) or without an odor Inhalation causes most harm, prevents cells from getting oxygen, can also be absorbed into skin or eating foods that contain this gas S/S appear within minutes: rapid breathing, restless, dizziness, h/a, n/v, tachycardia; large exposure can result in convulsions, low blood pressure, LOC, **respiratory failuredeath in 6-8 minutes Cyanide Tx- antidote is amyl nitrite via inhalation or sodium nitrite IV-frees cyanide that is bound to hgb to allow 02 transport NERVE AGENTS *MOST TOXIC OF ALL CHEMICAL AGENTS Smallpox o Serious, contagious and possibly fatal disease; potential biological weapon S/S- mylagia, fever, h/a, rash (disease is most contagious) distributed asynchronously over the body Most infectious 7-10 days after rash appears Transmitted-respiratory droplets, direct contact Tx-isolate! AIRBORNE!!, post-exposure immunization 3-4 days after exposure, VIG (vaccinia immune globulin) Smallpox *Contraindications for vaccine administration include HIV/AIDS Life threatening allergies to antibiotics Dx with eczema Prevention-vaccine People with non-active eczema are most at risk* VHF-Viral Hemorrhagic Fever Causative agents: ebola, yellow and dengue fevers S/S-abrupt onset of fever, myalgia, H/A, exhaustion, n/v/d, Transmitted-person to person by infected hosts or vectors Tx-isolate-airborne (neg. pressure room), RIBAVIRIN X 4 DAYS Pneumonic Plague Pneumonic plague is a life-threatening infection of the lungs It can be deadly if not treated quickly, preferably within 24 hours of the appearance of symptoms (CDC, 2007). Implement standard & droplet precautions * Disaster/Emergency Preparedness/Bioterrorism Terrorism-use of violence to intimidate or cause fear and to influence society (Wikepedia (on-line), 2006). induces fear and modifies social behavior Disasters-Natural, be aware of bacterial infections from impure water or molding after flooding Disaster Management Primary-prevent, prepare, develop and educate Developing a 911 sx The first person to notify is the local health officer commander. Secondary-screening, activating 911, triaging disaster victims Tertiary-rehab, post exposure Nursing Care Provide emotional support, monitor v/s, administer medications You may need to quarantine people Be alert for several people in close proximity become ill **Remember previous disaster victims have an increased risk for physiological and mental-health disorders. Nursing care During decontamination-the primary material used is tepid water* The purpose of a decontam rooom is to prevent contamination of patients and health care workers *If responders do not know what type of PPE’s to use-choose the highest level of equipment available.