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Bioterrorism Agents

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| ANTHRAX | IONIZING RADIATION | SARIN GAS | Pathophysiologicactions | Caused by Bacillus Centhracis bacteria. 3 ways of contact, cutaneous, ingesting, inhalation. Inhalation is the most deadly. Inhaled spores produce toxins within the lungs and lymph system. | Causes | Inhibits the breakdown of the enzyme acetylcholinesterace. It over stimulates the parasympathetic nerves in smooth muscle | | | | | Signs and Symptoms | Cutaneous- bumps, blisters with black centersGI- nausea, vomiting, loss of appetite, fever, bloody diarrheaInhalation- sore throat, mild fever, fatigue, muscle aches, high fever, trouble breathing, shock, meningitis, coma, death.Resembles flu like symptoms. | Radiation sickness- nausea, vomiting, diarrhea, fatigue, skin erythema, necrosis, sterility, damage to DNA, low birth weight babies, mental retardation, developmental delays, cataracts, cancers. | Runny nose, blurred vision, sweating, muscle twitching, tightness of the chest, headache, cramps, nausea, vomiting, involuntary defecation and urination, convulsions, coma, respitory arrest. | | | | | Treatments | Treat skin lesions, Oral antibiotics like PCN, Tetracycline, Ethromycin, and Cirpo. | Treat symptoms as they appear. Many symptoms will not appear for days, weeks even years.Blood transfusions stem cell transplant, and cytokine therapy. | Treat symptoms as they appear. Give Atropine and Pralidozine (PAM) |

Bioterrorism is a constant concern today. As seen in the news, bioterrorism has been used recently in Syria and the outcome has been horrific. With tensions running high throughout the middle east and terrorist, it is possible for a bioterrorism attack here in the United States. As a medical professional, the need to understand how each works, the symptoms, and treatment is a necessity. Healthcare institution hold disaster drills on a frequent basis but not a bioterrorism drills why? The chances of tornadoes, blizzards, earthquakes, and hurricanes are real and so should a bioterrorism attack. For example Anthrax. Anthrax is a bacterium that can be found in animals. Anthrax is still very popular in countries with no Public Health regulations. Animal hides used for drums have been shown to affect the makers of drums and the users with Anthrax. Inhalation of Anthrax is the most deadly. Spores are inhaled into the lungs where they spread to the lymph glands in the chest, where they proliferate, spread and produce toxins, causing death (Bioterrism, 2013). Treatment is necessary before the patient has symptoms. Once the patient has symptoms, the toxins are in the lymph system. Antibiotics kill the bacteria not the toxins, so even treated death my occur (Bioterrism, 2013). People in high-risk occupations should be vaccinated like military, textile mills, and veterinarians/ techs. Anthrax is reportable to the CDC. Sarin gas was created in Germany in 1938 as a pesticide (Volans, 1996). It is a synthetic toxin. Sarin was recently used in Japan in 1994 and 1995 killing hundreds. Sarin is clear, colorless, tasteless liquid and has no odor in its pure form (Volans, 1996). Sarin is an immediate but short-lived threat. There is an estimated 11,700 tons of Sarin in Russia. The United States has approximately 6,000 tons (Volans, 1996). Sarin is heavier than air making low-lying areas a greater exposure. Ionizing Radiation is not a new problem. Just the name Chernobyl would give you a clue. Ionizing Radiation is in medical testing such as x-rays but at such a lower does than a nuclear power plant (Ryan, 2011). Even with x-rays, there is protection and concern with multiple exams. Ionizing Radiation destroys and damages human cells, interfering with vital organ function (Bioterrism, 2013). Ionizing Radiation has been used to treat certain cancers with positive results, again at a much lower dosage. Between these three bioterrorism agents, healthcare workers need to understand that an attack can happen and will be the go to people for treatment of mass causalities. Depending on the type of exposure, personal protection equipment will be needed. For example Anthrax, gloves, gowns, masks and or respirators. Ionizing radiation exposure has no real protection. Sarin gas exposure will require gowns, gloves, respirator masks. Treatment of patient will not only consist of treating the physical problems but to treat the physiological trauma that will go with a bioterrorism attack. Many patients may experience post-traumatic stress disorder or PTSD.. With the hope of never seeing an attack of this magnitude, we must be vigil and prepared.

References
Bioterrism. (2013, November 8). Bioterrism and Disaster Prepardness. Retrieved from American College of Physicans: http://www.ACPonline.org
Ryan, J. (2011, November 8). Ionizing Radiation: The Good, the Bad, the Ugly. Retrieved from National Insititue of Health: http://www.ncb.nim.nih.gov
Volans, A. (1996). Sarin: guidlines on the managment of victums of a nerve gas attack. Journal Accident Emergancy Medicine, 202-206.

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