מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Healthcare providers should remain alert to illness patterns and diagnostic clues that might indicate illnesses caused by the intentional release of biologic agents, the US Centers for Disease Control and Infection said Thursday. Such findings should be reported to local or state health departments.
The CDC is most concerned about agents that cause anthrax, plague, smallpox, botulism, tularemia, and viral hemorrhagic fevers, according to a report in the Atlanta-based agency's Morbidity and Mortality Weekly Report for October 19.
The indications would be unusual temporal or geographic clustering of cases among previously healthy individuals, an unusual age distribution for what at first inspection resembles chickenpox, or cases of acute flaccid paralysis with prominent bulbar palsies.
Infection control professionals may be the first to recognize changing patterns or clusters in a hospital or community. The CDC recommends that they work with any clinical microbiology laboratories that may be testing specimens from their facility.
In addition, they should be responsible for distributing current telephone numbers for appropriate contact, including the following internal contacts: infection control professionals, epidemiologists, infectious disease specialists, administrators, and public affairs officials.
They should also maintain a list of important external contacts: state and local health departments, Federal Bureau of Investigation field office, and the CDC Emergency Response office (404-639-2807).
Today's CDC report also describes the clinical features of potential disease outbreaks:
— Anthrax, inhalational — Nonspecific prodrome, perhaps followed by a brief period of improvement, then respiratory failure and hemodynamic collapse.
— Anthrax, cutaneous — Local edema developing into a pruritic macule or papule, with subsequent enlargement and ulceration; then a painless, depressed, black eschar appears. Lymphangitis and painful lymphadenopathy may be present.
— Plague, pneumonic — Fever, cough with mucopurulent sputum, hemoptysis, and chest pain.
— Botulism, inhalational — Symmetric cranial neuropathies, blurred or double vision, descending weakness in a proximal to distal pattern, respiratory muscle paralysis or upper airway obstruction without sensory deficits.
— Smallpox — Several-day prodrome of fever and myalgia followed by rash development. Vesicular/pustular rash differs from that of chickenpox in its prominence on the face and extremities, and lesions develop at the same time rather than in successive groups over several days.
— Tularemia, inhalational — Abrupt onset of acute febrile illness, often followed by pleuropneumonitis.
— Hemorrhagic fever — Abrupt onset of fever, myalgia and headache, vomiting, abdominal pain, diarrhea, chest pain, cough, and pharyngitis. Subsequent development of maculopapular rash primarily on the trunk, plus bleeding manifestations such as petechiae, ecchymoses, and hemorrhages.
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