BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES

File: 120396_sep96_decls75_0005.txt
Page: 0005
Total Pages: 8

Subject: BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES                   

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES                                                   

Document Number:          1

Folder SEQ  #:        196






                                           UNCLASSIFIED


       PRIORITY                                                         TOD



       DEPOSITED IN ALVEOLI  OR ALVEOLAR DUCTS WHERE THEY ARE
       PHAGOCYTI7-ED BY ALVEOLAR MACROPHAGES AND CARRIED TO MEDIASTINAL




       PAGE 03 RHIPAAA\'\",\ S E C R E T
       LYMPH NODES. A HEMORRHAGIC MEDIASTINITIS RESULTS, FOLLOWED BY
       BACTEREMIA AND INTRAVASCULAR MULTIPLICATION OF ORGANISMS.
       MENINGITIS OFTEN OCCURS AS A PART OF THE OVERWHELMING
       SEPTICEMIA.     INHALATION A14THRAX IS VERY DIFFICULT TO DIAGNOSE
       EARLY. 'THE DISEASE IS BIPHASIC, AND INITIAL SYMPTOMS MIMIC A
       SI=VERF VIRAL RESPIRATORY ILLNESS LII.-ZE INFLUENZA. THIS LASTS FOR
       2 TO 3 DAYS AND IS FOLLOWEII BY A SECOND MORE ACUTE PHASE
       CHARACTERIZED BY SEVERE HYPOXIM@ AND OYSPNEA- CHEST X-RAY FILMS
       CONSISTENTLY SHOW WIDENING OF THE MEI3IASTINUM. PATIENTS SOON
       BECOME HYPOTENSIVE, AND ABOUT ONE-HALF DEVELOP MERAINGEAL SIGNS.
           BACILLUS ANTHRACIS CELLS ARE LARGE. GRAM-POSITIVE BACILLI AND
       INDIVIDUAL CELLS HAVE SOUARE OR CONCAVE ENDS. OVOID,
       SUBTERMINAL ENDOSPORES THAT DO NOT CAUSE ANY SIGNIFICANT
       SWELLING OF THE CELLS MAY BE OBST:R%)FD. THE SPORES APPEAR AS
       UNSTAINED AREAS WITHIN THE BACTERIAL CELLS IN GRAM'S STAINED
       PREPARATION. THE ORGANISM GROWS WELL ON ORDINARY BLOOD AGAR
       WITHIN 13 TO 24 HOURS AT 35 DEGREES CENTIGRADE. THE COLONIES
       ARE TYPICALLY FLAT AND IRREGULAR. 4 MM TO 5 MM IN DIAMETER AND
       IS NOT HEMOLYTIC ON SHEEP BLOOD AGAR.
           FEW GOOI3 DATA EXIST ON THE TREATMENT OF INHALATION ANTHRAX BUT




       PAGE 04 RHIPAAA\\\\
       RECENT ANIMAL STUDIES HAVE PROMPTED THE ARMED FORCES
       EPIDEMIOLOGY BOARD TO RECOMMEND TREATMENT OF SUSPICIOUS CLINICAL
       SYMPTOMS WITH A LOADING DOSE OF CIPROFLOXACIN (IOOC) MGM)
       FOLLOWED BY 7@@O MGM TWICE A DAY, INTRAVENOUS IDOXYCYCLINE (2C)C)
       MGM LOADING DOSE FDLLOWED BY I(:)O MGM TWO TIMES DAILY), OR OTHER
  APPROPRIATE ANTIBIOTICS SUCH AS HIGH DOSE PENICILLIN. IF THE
       PATIENT HAS HA13 PRE-E'@'POSUPE VACCINATION, AN ADDITIONAL BOOSTER
       IS RECOMMENDED DURING THERAPY. IF NO PRE-EXPOSURE VACCINATION
       HAS OCCURED, INITIATION OF THE VACCINATION SERIES WHILE ON
       ANTIBIOTICS IS RECOMMENDED.
          THE HUMAN ANTHRAX '@'ACCINE IS FDA APPROVED AND CONSISTS OF
       ALUM-PRECIPITATr-'-l PROTECTIVE ANTIGEN FROM FERMENTOR CULTURES OF
       TOXIGENIC, NON-ENCAPSULATED STRAINS OF BACILLUS ANTHRACI-@. IT
       CONTAINS FORMALIN AND BEN-@ETHONIUM CHLORIDE.@ THE VACCINE SERIES
       IS A TWO SHOT SERIFS TWO WEEK@D APART WITH A BOOSTER RECOMMENDED.
       SIX PER CENT WILL EXPERIENCE MILD LOCAL DISCOMFORT AT THE
       INOCULATION SITE AWE, LESS THAN ONE PER CENT WILL HAVF MORE
       SEVERE LOCAL REACTION. ALL CAN EXPECT =SOME BURNING AT THE
       Ir4jECTIDII SITE FOR UP TD TWD MINUTES AFTER 11@IJECTIDII. 1%10
       ANAPHYL-"CTIC REACTIONS HAVE BEEN EXPERIENCED IN



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Document 8 f:/Week-36/BX003203/BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES/biological warfare defense medical guidelines:11259610131215
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES
Folder Seq # = 196
Subject = BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 25-NOV-1996