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Bioterrorism Agents

(click on each agent to read about it)

Anthrax

Botulism

Plague

Smallpox

Tularemia

Viral hemorrhagic fever

Ricin

What should I know about anthrax? Anthrax is a serious disease caused by Bacillus anthracis, a bacterium that forms spores. A bacterium is a very small organism made up of one cell. Many bacteria can cause disease. A spore is a cell that is dormant (asleep) but may come to life with the right conditions.
There are three types of anthrax:

  • skin(cutaneous)

  • lungs inhalation)

  • digestive gastrointestinal)

What are the symptoms of anthrax? The symptoms(warning signs) of anthrax are different depending on the type of the disease:

  • Cutaneous: The first symptom is a small sore that develops into a blister. The blister then develops into a skin ulcer with a black area in the center. The sore, blister and ulcer do not hurt.

  • Gastrointestinal: The first symptoms are nausea, loss of appetite, bloody diarrhea, and fever, followed by bad stomach pain.

  • Inhalation: The first symptoms of inhalation anthrax are like cold or flu symptoms and can include a sore throat, mild fever and muscle aches. Later symptoms include cough, chest discomfort, shortness of breath, tiredness and muscle aches.

Caution: Do not assume that just because a person has cold or flu symptoms that they have inhalation anthrax.

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 What should I know about botulism? Botulism is a muscle-paralyzing disease caused by a toxin made by a bacterium called Clostridium botulinum. There are three main kinds of botulism:

  • Foodborne botulism occurs when a person ingests pre-formed toxin that leads to illness within a few hours to days. Foodborne botulism is a public health emergency because the contaminated food may still be available to other persons besides the patient.

  • Infant botulism occurs in a small number of susceptible infants each year who harbor C. botulinum in their intestinal tract.

  • Wound botulism occurs when wounds are infected with C. botulinum that secretes the toxin.

What are the symptoms of botulism? The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone. These are all symptoms of the muscle paralysis caused by the bacterial toxin. If untreated, these symptoms may progress to cause paralysis of the arms, legs, trunk and respiratory muscles. In foodborne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can occur as early as 6 hours or as late as 10 days.

With foodborne botulism, symptoms begin within 6 hours to 2 weeks (most commonly between 12 and 36 hours) after eating food that contains the toxin. Symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness that moves down the body, always affecting the shoulderskeep descends first, then the upper arms, lower arms, thighs, calves, etc. Paralysis of breathing muscles can cause a person to stop breathing and die, unless assistance with breathing (mechanical ventilation) is provided. Botulism is not spread from one person to another. Foodborne botulism can occur in all age groups.

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What should I know about the plague? The plague is transmitted by fleas that become infected with bacteria Yersinia pestis that cause plague. People get the plague by the bite of fleas infected with the plague bacteria

 What are the signs and symptoms of plague?
The typical sign of the most common form of human plague is a swollen and very tender lymph gland, accompanied by pain. The swollen gland is called a "bubo" (hence the term "bubonic plague"). Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas.

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What should I know about smallpox? Smallpox is an acute, contagious, and sometimes fatal disease caused by the variola virus (an orthopoxvirus), and marked by fever and a distinctive progressive skin rash.

What are the symptoms of smallpox? The symptoms of smallpox begin with high fever, head and body aches, and sometimes vomiting. A rash follows that spreads and progresses to raised bumps and pus-filled blisters that crust, scab, and fall off after about three weeks, leaving a pitted scar. (added Nov 13, 2002)

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 Tularemia. Tularemia is a potentially serious illness that occurs naturally in the United States. It is caused by the bacterium Francisella tularensis found in animals (especially rodents, rabbits, and hares).

What are the Symptoms of Tularemia? Symptoms of tularemia could include:

  • sudden fever

  • chills

  • headaches

  • diarrhea

  • muscle aches

  • joint pain

  • dry cough

  • progressive weakness

People can also catch pneumonia and develop chest pain, bloody sputum and can have trouble breathing and even sometimes stop breathing.Other symptoms of tularemia depend on how a person was exposed to the tularemia bacteria. These symptoms can include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and a sore throat.

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What should I know about viral hemorrhagic fevers? Viral hemorrhagic fevers (VHFs) refer to a group of illnesses that are caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the body are affected).  Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired.  These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is itself rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease.

What are the symptoms of viral hemorrhagic fever illnesses? Specific signs and symptoms vary by the type of VHF, but initial signs and symptoms often include marked fever, fatigue, dizziness, muscle aches, loss of strength, and exhaustion. Patients with severe cases of VHF often show signs of bleeding under the skin, in internal organs, or from body orifices like the mouth, eyes, or ears. However, although they may bleed from many sites around the body, patients rarely die because of blood loss. Severely ill patient cases may also show shock, nervous system malfunction, coma, delirium, and seizures. Some types of VHF are associated with renal (kidney) failure.

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What I should know about ricin? Ricin is a poison that can be made from the waste left over from processing castor beans. It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid. It is a stable substance. For example, it is not affected much by extreme conditions such as very hot or very cold temperatures.

What are the signs and symptoms of ricin exposure? The major symptoms of ricin poisoning depend on the route of exposure and the dose received, though many organs may be affected in severe cases. Initial symptoms of ricin poisoning by inhalation may occur within 8 hours of exposure. Following ingestion of ricin, initial symptoms typically occur in less than 6 hours.

Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be respiratory distress (difficulty breathing), fever, cough, nausea, and tightness in the chest. Heavy sweating may follow as well as fluid building up in the lungs (pulmonary edema). This would make breathing even more difficult, and the skin might turn blue. Excess fluid in the lungs would be diagnosed by x-ray or by listening to the chest with a stethoscope. Finally, low blood pressure and respiratory failure may occur, leading to death. In cases of known exposure to ricin, people having respiratory symptoms that started within 12 hours of inhaling ricin should seek medical care.

If someone swallows a significant amount of ricin, he or she would develop vomiting and diarrhea that may become bloody. Severe dehydration may be the result, followed by low blood pressure. Other signs or symptoms may include hallucinations, seizures, and blood in the urine. Within several days, the person’s liver, spleen, and kidneys might stop working, and the person could die.

Skin and eye exposure: Ricin in the powder or mist form can cause redness and pain of the skin and the eyes. Death from ricin poisoning could take place within 36 to 72 hours of exposure, depending on the route of exposure (inhalation, ingestion, or injection) and the dose received. If death has not occurred in 3 to 5 days, the victim usually recovers. Showing these signs and symptoms does not necessarily mean that a person has been exposed to ricin.

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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