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Subject: MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL                     

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003203

Folder Title: MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL                                                     

Document Number:          1

Folder Seq  #:         47




                                        UNCLASSIFIED









             be confused with a wide variety of viral, bacterial, and
             fungal infectious diseases. Progression over 2-3 days with
             the sudden development of severe respiratory distress
             followed by shock and death in 24-36 hours in essentially
             all untreated cases eliminates diagnoses other than
             inhalation anthrax. The presence of a widened mediastinum
             on chest X-ray, in particular, should alert one to the
             diagnosis. Other suggestive findings include chest-wall
             edema, hemorrhagic pleural effusions, and hemorrhagic
             meningitis. other diagnoses to consider include aerosol
             exposure to SEB; but in this case, onset would be more rapid
             after exposure (if known), and no prodrome would be evident
             prior to onset of severe respiratory symptoms. Mediastinal
             widening on chest X-ray will also be absent. Patients with
             plague or tularemia pneumonia will have pulmonary
             infiltrates and clinical signs of pneumonia (usually absent
             in anthrax).

             . Specific Laboratory Diagnosis. Bacillus anthracis will
             be readily detecable by blood culture with routine media.
             Smears and cultures of pleural fluid and abnormal
             cerebrospinal fluid may also be positive. Impression smears
             of mediastinal lymph nodes and spleen from fatal cases
             should be positive. Toxemia is sufficient to permit anthrax
             toxin detection in blood by immunoassays, and such assays
             will be available in field-deployed laboratories (see
             Section III).

             Therapy. Almost all cases of inhalation anthrax where
          treatment was begun after patients were symptomatic have been
          fatal, regardless of treatment. Historically, penicillin has
oice, with 2 million units
          given intravenously every 2 hours. Tetracycline and
          erythromycin have been recommended in penicillin-sensitive
          patients. The vast majority of anthrax strains are sensitive
          in vitro to penicillin. However, penicillin-resistant strains
          exist naturally, and one has been recovered from a fatal human
          case. Moreover, it is not difficult to induce resistance to
          penicillin, tetracycline, erythromycin, and many other
          antibiotics through laboratory manipulation of organisms. All
          naturally-occurring strains tested to date have been sensitive
          to erythromycin, chloramphenical, gentamicin, and
          ciprofloxacin. In the current setting, treatment should be
          instituted at the earliest sign of disease with ciprofloxacin



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                                        UNCLASSIFIED

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Document 40 f:/Week-36/BX003203/MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL/medical defense against biological material:12179609282229
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL
Folder Seq # = 47
Subject = MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL
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