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PEDIATRICS Vol. 109 No. 4 April 2002, pp. 685-692

SPECIAL ARTICLE

Diagnosis and Management of Suspected Cases of Bioterrorism: A Pediatric Perspective

Hanoch A. Patt, MD, Ralph D. Feigin, MD

From the Department of Pediatrics, Baylor College of Medicine, Houston, Texas.

--> Since October 3, 2001, the Centers for Disease Control and Prevention and other organizations have been investigating potential bioterrorist-related anthrax cases. The pediatrician may be faced with complex issues related to diagnosis and treatment of illnesses caused by intentionally released biological agents. The agents that pose a major potential bioterrorist threat are reviewed by the clinical syndromes they produce: acute respiratory distress with fever, influenza-like illnesses, acute rash with fever, neurologic syndromes, and blistering syndromes. Specific and detailed diagnostic, treatment, and prophylaxis information is provided for anthrax, plague, tularemia, smallpox, botulism, viral hemorrhagic fevers, and other diseases. In cases of suspected bioterrorism, the pediatrician must be able to obtain diagnostic and treatment information efficiently and expeditiously. The system controlling the interaction between public and nonpublic health laboratories in suspected cases of bioterrorism is described. Finally, information regarding emergency contacts and links to educational resources is provided.

Key Words: bioterrorism • biological agents • anthrax • plague • tularemia • smallpox • botulism • viral hemorrhagic fevers

Abbreviations: CDC, Centers for Disease Control and Prevention • ELISA, enzyme-linked immunosorbent assay • PCR, polymerase chain reaction • SEB, staphylococcal enterotoxin B • USAMRIID, United States Army Medical Research Institute of Infectious Diseases

Received for publication Dec 26, 2001; Accepted Dec 26, 2001.


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