↵* 1. Skin decontamination is performed by showering victims unclothed in warm water for 8 to 10 minutes.
2. Standard equipment for infection control (gloves, masks, gowns) is ineffective in protecting health care workers. Avoid contact with victims and their clothing until personal protective gear is obtained.
3. Clothing should be considered hazardous waste and safely discarded.
Potential Candidates for Biological Weapons Development2,19,24
↵† See the Report of the Committee on Infectious Diseases (Red Book) 24th ed, 1997 (or the most current edition) for drug doses. Intravenous therapy for severely ill patients is usually indicated, but oral therapy can be effective and may be the only practical alternative when large numbers of people are exposed.
↵‡ Prophylaxis should only be initiated after consultation with public health officials in situations where exposure is highly likely. The duration of prophylaxis has not been determined for most agents.
↵§ If susceptibility unknown. Ciprofloxacin is not FDA approved for persons <18 years of age, but is indicated for potentially serious or life-threatening infections (see Red Book).
↵‖ If susceptibility unknown. Tetracyclines, including doxycycline, are not FDA approved and usually contraindicated in children less than 8 years, but treatment is warranted for selected serious infections (see 2000 Red Book).
↵¶ Penicillin should be used only if the organism is known to be susceptible.
↵# Special media required for culture, laboratory hazard: only immunized technicians should ordinarily process cultures.
* This table does not include all the agents listed in Table 2. Only those agents believed most likely to be used in a chemical-biological attack are included.
↵† The spectrum of clinical manifestations for many of these agents can be protean. The symptoms and signs noted in this table are those that would likely make someone initially seek medical attention and are based on the route of exposure during an attack (eg, the manifestations of anthrax differ for an inhalation versus food-borne exposure). Fever, headache, vomiting, and diarrhea are common early manifestations of many illnesses.
↵‡ Many of the diseases that cause petechiae or vesicular skin lesions will initially start as macular and/or papular rashes.