BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES

File: 120396_sep96_decls75_0006.txt
Page: 0006
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







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           B. @      BOTULISM
        BOTULISM IS A LIFE THREATENING, PARALYTIC ILLNESS PRODUCED BY
        NEUROTOXIN ELABORATED BY CLOSTRIDIUII BOTULINUM. THE NATURAL
        DISEASE -IS PRIMARILY FROM FOOD POISONING ALTHOUGH WOUND BOTULISM
        AND INFANT BOTULISM 00 OCCUR. THE TOXIN RELEASED BY THT=
        BACTERIA DURING GROWTH HAS EIGHT IMMUNOLOGICALLY DISTINCT TOXIN
        TYPES AND A GIVEN BACTERIAL STRAIN PRODUCES ONLY A SINGLE TOXIN
        TYPE. THE TOXINS INTERFERE WITH NEUROTRANSMISSION AT PERIPHERAL
        CHOLINERGIC SYNAPSES BY BINDING TIGHTLY TO THE PPESYF4APTIC
        MEMBRAN;: AND PREVENTING THE RELEASE OF THE NEUROTRANSMITTFR
        ACETYLCHOLINE. THE SYMPTOMS ARE THEREFORE THOSE OF ATROPINE
        P'OI50NING AN13 EXACTLY THE OPPOSITE OF CHEMICAL NERVE AGENT
        POISONING. PARALYSIS IS A SYMMETRICAL, DESCENDING, FLACCID
        PARALYSIS AND OCCURS O.UICI-I'LY AFTER INHALATION (3 - 48 HOURS
        POST-EXPOSURE).
            THE INTERRUPTION OF CHOLINERGIC AUTONOMIC TRANSMISSION RESULTS
        IN DIMINISHED SALIVATION AND EXTREME DRYNESS OF THE MOUTH,
        TONGUE, AND PHARYNX, WHICH 15 UNRELIEVE13 BY DRINKING FLUIDS. THE




        PAGE C)6 RHIPAAA\\\\
        DRYNESS MAY BE QUITE PAINFUL AND CAUSE THE PATIENT TO COMPLAIN
        OF"'SORP THROAT". ILEUS, CONSTIPATION, ANI:) URINARY RETFIQTTI:)N
        CAN RESULT. A CONSTELLATION OF SIGNS SUGGEST THE DIAGNOSIS: 1)
        UNEXPLAINED POSTURAL HYPOTENTION; 2) DILATED, UHREACTIVE PUPILS;
        3) DRY MUCOUS MEMBRANES; 4) DESCENDING PARALYSIS WITH
        PROGRESSIVE RESPIRATORY WEAKNESS; AND 5) THE ABSENCE OF FEVER.
        DIAGNOSIS CAN BE CONFIRMED BY DEMONSTRATION OF BOTULINUM TOXIN
        IN THE BLOOD STREAM OF THE PATIENT AND CAN BE ACCOMPLISHEE) BY
        THE U.S. NAVY FORWARD LABORATORY.
SPIRATORY FAILURE WITH EARLY
        ELECTIVE TRACHEOSTOMY AN13 THE USE OF VENTILATORY ASSISTANCE CAN
        BE LIFE-SAVING. IF ILEUS IS PROFOUND, NASOGASTRIC C,UCTION AND
        PARENTERAL NUTRITION MAY BE NECESSARY. URINARY RETENTION WILL
        REQUIRE IR@OWELLING BLADDER CATHETERIZATION. FEVER SIGNIFIES A
        COMPLICATING NOSOCOMIAL BACTERIAL INFECTION. ANTITOXIN THERAPY
        IS RECOMMENDED ALTHOUGH ANTITOXIN IS IN SHORT SUPPLY AND SHOULD
        BE ADMINISTERED AS SOON AS POSSIBLE AFTER SPECIMENS FOR
        LABORATORY STUDY ARF- OBTAINED.   ANTITOXIN MAY El= BENEFICIAL EVEN
        IF DELAYED. THE HEPTAVALENT ANTITOXIN IS OF EQUINE ORIGIN AND
        UP TO 2(-.) PERCENT OF THE PATIENTS HAVE UNTOWARD REACTIONS.
        ST



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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