MEDICAL COUNTERMEASURES AGAINST BIOLOGICAL MATERIAL

File: 123096_sep96_decls27_0022.txt
Page: 0022
Total Pages: 34

Subject: MEDICAL COUNTERMEASURES AGAINST BIOLOGICAL MATERIAL             

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003203

Folder Title: FREEDOM OF INFORMATION ACT REQUEST 3106                                                         

Document Number:          1

Folder Seq  #:         28





                                     UNCLASSIFIED








        Urinary retention or ileus may also occur. Motor symptoms
        usually are present early in disease; cranial nerves are
        affected first with blurred vision, diplopia, ptosis, and
        photophobia. Bulbar nerve dysfunction causes dysarthria,
        dysphonia, and dysphagia. This is followed by a symmetrical,
        descending, progressive weakness of the extremities along with
        weakness of the respiratory muscles. Development of
        respiratory failure may be abrupt.

           on physical examination, the patient is alert, orientated,
        and afebrile. Postural hypotension may be present. Ocular
        findings may include ptosis, extraocular muscle paralysis, and
        fixed and dilated pupils. Mucous membranes of the mouth may be
        dry and crusted. Neurological examination shows flaccid muscle
        weakness of the palate, tongue, larynx, respiratory muscles,
        and extremities. Deep tendon reflexes vary from intact to
        absent. No pathologic reflexes are present, and the sensory
        examination generally is normal (although reports suggest that
        obtundation or sensory involvement may sometimes occur).


        DIAGNOSIS

             Routine Laboratory Findings. Routine laboratory findings
           are of no value in diagnosis. The cerebrospinal fluid is
           normal.

           . Differential Diagnosis. The occurrence of an epidemic
           with large numbers of afebrile patients with progressive
           ocular, pharyngeal, respiratory, and muscular weakness and-
           paralysis hints strongly at the diagnosis. Single cases may
           be confused with various neuromuscular disorders such at
           atypical Guillian-Barre syndrome, myasthenia gravis, or tick
           paralysis. The edrophonium (tensilon) test may be
           transiently positive in botulism. Other considerations
er
           is present, paralysis is often asymmetrical, and the
           cerebrospinal fluid is abnormal. In the present setting, it
           will be necessary to distinguish nerve-agent and atropine
           poisoning from botulinum intoxication. Briefly,
           organophosphate nerve agent poisoning results in biotic
           pupils and copious secretions. In atropine poisoning, the
           pupils are dilated and mucous membranes are dry, but central
           nervous system excitation with hallucinations and delirium
           is present. See Section IV for a more comprehensive
           differential.



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                                      UNCLASSIFIED

Document 34 f:/Week-36/BX003203/FREEDOM OF INFORMATION ACT REQUEST 3106/medical countermeasures against biological mater:12179609282028
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = FREEDOM OF INFORMATION ACT REQUEST 3106
Folder Seq # = 28
Subject = MEDICAL COUNTERMEASURES AGAINST BIOLOGICAL MATER
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 = 17-DEC-1996