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Health Department EH Mobile Site

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Biological Attack
General Guidance

Be alert to the following:

  • Groups of individuals becoming ill around the same time.

  • Sudden increase of illness in previously healthy individuals.

  • Sudden increase in the following non-specific illnesses:

  • Pneumonia, flu-like illness, or fever with atypical features

    • Bleeding disorders

    • Unexplained rashes and mucosal or skin irritation, particularly in adults

    • Neuromuscular illness like muscle weakness and paralysis

    • Diarrhea

  • Simultaneous disease outbreaks in human and animal or bird populations.

  • Unusual temporal or geographic clustering of illness (for example, patients who attended the same public event, live in the same part of town, etc.)


  • Decontamination of patients usually not required for biological agents.

  • Clothing removal and biosafety bagging is recommended.

  • Handle equipment used according to standard infection control practices.


  • Incubation - 2 to 6 days

  • Range - 2 days to 8 weeks

  • Symptoms - flu-like symptoms, nausea, vomiting, abdominal pain, fever, respiratory distress

  • Transmission & precautions - aerosol inhalation, no person-to-person transmission, standard precautions


  • Incubation - 12 to 72 hours

  • Range - 2 hours to 8 days

  • Symptoms - difficulty swallowing or speaking, symmetric descending weakness, respiratory dysfunction, no sensory dysfunction, no fever

  • Transmission & precautions - aerosol inhalation, food ingestion, no person-to-person transmission, standard precautions


  • Incubation - 1 to 3 days by inhalation

  • Symptoms - Sudden onset of fever, chills, headache, myalgia,

    • Pneumonic: cough, chest pain, dyspnea, fever

    • Bubonic: painful lymph nodes

  • Transmission & precautions - person to person transmission in pneumonic forms, droplet precautions until patient treated for at least 3 days

Tularemia "pneumonic"

  • Incubation - 2 to 5 days

  • Range - 1 to 21 days

  • Symptoms- Fever, cough, chest tightness, pleuritic pain, hemoptysis rare

  • Transmission & precautions - Inhalation of agents, no person to person transmission but laboratory personnel at risk, standard precuations


  • Incubation - 12 to 14 days

  • Range - 7 to 17 days

  • Symptoms - high fever and myalgia, itching, abdominal pain, delirium, rash on face extremities, hands and feet which can be confused with chickenpox which has a less uniform rash

  • Transmission & precautions - person to person transmission, airborne precautions, negative pressure, clothing and surface decontamination.

This is a scaled down version
of our main environmental health site. For more detailed information please visit our main site at http://www.doh.state.fl.us/chd/volusia/EH/index.html