MSDH Bioterrorism and Emergency Preparedness: Biological agents

Biological Agents

Anthrax	Exposure: Anthrax can enter the body through a cut in the skin or by contact with infected animals or animal products. Eating infected meat that has not been cooked sufficiently, or inhaling the anthrax spores into the lungs can also cause the disease. Inhalation anthrax is the most dangerous form of the disease. Anthrax is not contagious. It cannot spread from person to person.	Symptoms and treatment: Anthrax causes fever and sores on the skin from one to seven days after contact. Eating infected meat causes nausea, vomiting and sores on the tongue or in the mouth. Inhalation anthrax has symptoms of a cold or flu, that become more severe and progress to respiratory failure. Symptoms of inhalation anthrax may take up to 60 days to appear. Early treatment with antibiotics is essential for recovery from the disease.	More information about anthrax Fact sheet: Anthrax
Viral Hemorrhagic Fevers	Exposure: These viral diseases, such as Ebola, Dengue fever, and Hantavirus, cause infection when an animal carrying the virus bites a person, or when an infected animal is eaten. Contact with the blood or body fluids of an infected animal or person can also spread the disease.	Symptoms and treatment: From 2 to 21 days after exposure, fever, fatigue, and weakness appear, followed by bleeding beneath the skin or from eyes, ears, mouth and other parts of the body. Symptoms can progress to seizures, organ failure, and death. No cure for these diseases has yet been developed.	More information about VHFs Fact sheet: Hemorrhagic Fevers
Smallpox	Exposure: Smallpox spreads by prolonged contact with an infected person, their clothes, bedding, or body fluids.	Symptoms and treatment: A week or two after exposure, high fever, aches and a spreading skin rash appear. The rash develops into raised bumps that fill with pus that eventually burst and scab. Some severe forms of smallpox have a high fatality rate. There is no cure for smallpox, but vaccination can protect against the disease. Because smallpox spreads slowly, vaccination is an effective prevention if the disease is detected. Mississippi has a statewide smallpox vaccination plan.	Mississippi's smallpox response plan More information about smallpox Fact sheet: Smallpox
Plague	Exposure: Plague can be spread by inhaling the plague bacteria in water droplets (pneumonic plague), or through the skin (bubonic plague). Bubonic plague comes from the bite of an infected flea or through a break in the skin that is exposed to infectious material. Pneumonic plague can spread from person to person through sneezing or coughing. Bubonic plague is usually not contagious.	Symptoms and treatment: Symptoms appear within 6 days after exposure. Pneumonic plague causes pneumonia-like symptoms, fever, and weakness. Bubonic plague causes painfully swollen lymph glands, fever, and extreme exhaustion; it can develop into pneumonic plague as well. Both forms are life-threatening if left untreated. Plague can be cured by antibiotics, and can usually be prevented by treatement within a few days of exposure.	More information about plague Fact sheet: Pneumonic Plague
Botulism	Exposure: Botulism bacteria can grow in contaminated food and cause infection when eaten.	Symptoms and treatment: Botulism bacteria produce a nerve toxin that causes blurred vision, muscle weakness, and eventually paralysis in the infected person. Symptoms appear from a few hours to 10 days after exposure. Botulism can be fatal if left untreated. Hospital care is usually required.	More information about botulism Fact sheet: Botulism
Tularemia	Exposure: Tularemia is carried by rodents and rabbits, and spreads from handling infected animals or by the bites of ticks or fleas. Tularemia bacteria can be manufactured in an aerosol form that spreads the disease through the air.	Symptoms and treatment: Tularemia causes swollen lymph glands, fever, weakness, chest pain, and breathing difficulty. Tularemia is usually not life-threatening, though it can cause severe illness and can be dangerous to older people. It is routinely treated with antibiotics.	More information about Tularemia Fact sheet: Tularemia

Questions and Answers

What should I do to protect my family and myself if a biological agent were released in my community?
Emergency management teams will let you know if you need to evacuate the area. Isolation will protect you and your family from contagious diseases. Most agents are destroyed by bleach, or in some cases soap and water. Do NOT drink bleach or use on skin.

What should I do if I'm in a building during a biological attack?
Limit your movement so that dust or powders in your area are not disturbed. Cover your mouth with a handkerchief or clothing. If a letter or package is the source of the biological material, close the doors and windows of the room where the source is located and turn off air conditioning, heating and fans. Shout only as a last resort — shouting can cause you to inhale dangerous amounts of dust.

Is there a way to distinguish between anthrax and a cold or flu?
A runny nose is a rare symptom of anthrax. A person who has a runny nose along with other common flu-like symptoms is far more likely to have the common cold or flu than to have anthrax. Flu-like symptoms outside of the flu season should receive medical attention.

If smallpox is released in a cloud (aerosol) form, how long does the virus survive?
The smallpox virus is fragile. In lab experiments, when smallpox is put into a cloud form, 90% of the smallpox virus dies within 24 hours; in the presence of sunlight, this percentage is even greater.

Is smallpox contagious before the symptoms show?
A person with smallpox is sometimes contagious with onset of fever, but the person becomes most contagious with the onset of rash. The infected person spreads the disease into the air with his breath and from the scabs. Infected persons are contagious until the last smallpox scab falls off.

If someone is exposed to smallpox, is it too late to get a vaccination?
Vaccination within 3 days of exposure will completely prevent or significantly reduce the severity of the disease in the vast majority of people. Vaccination 4 to 7 days after exposure likely offers some protection from disease or may modify the severity of disease.

Should I keep a stockpile of antibiotics?
No. There is no single pill that can protect against all types of biological agents, and antibiotics have a limited shelf life before they lose their strength. Antibiotics can also cause side effects, and unless you store and take the drug properly, it may not work, or may cause you to become ill. For most bacterial agents, the antibiotic regime must be specific to the agent and prescribed by medical personnel.

Is it safe to drink water from the tap?
It would be extremely difficult for a terrorist to contaminate our drinking water supplies to cause widespread illness. Anything deliberately put into the water supply would be greatly diluted, and water treatment facilities routinely filter the water supply and add chlorine in order to kill harmful germs. However, citizens can protect themselves by boiling their drinking water, which will kill any microorganisms that may have survived the municipal filtration systems.

How can I recognize a bioterrorism hoax?
If you are not sure whether a bioterrorism report is true or not, check with credible sources, such as CDC's Health-Related Hoaxes and Rumors Web site at http://www.cdc.gov/hoax_rumors.htm. A number of Internet sites are available regarding urban legends and hoaxes, such as the Urban Legend Reference Page at http://www.snopes2.com and the Computer Incident Advisory Committee, and Department of Energy's HoaxBusters site at http://hoaxbusters.ciac.org. You can also get more information from the Centers for Disease Control and Prevention Public Response Hotline (CDC):

English (888) 246-2675
Español (888) 246-2857
TTY (866) 874-2646

Should I purchase disposable masks as part of a home emergency disaster kit?
Having disposable masks in a home emergency disaster kit is not a bad idea, but they are not absolutely necessary. In an emergency, you can get the same amount of protection by placing an article of clothing — a shirt or blouse, or a handkerchief — over your mouth and nose. It will likely be several days before we recognize that a biological weapon has been used against us. In some cases, even several days after an attack, medical authorities may want you to wear a simple paper mask when you go outside, so having them on hand would be convenient. (Listen to the radio and television for instructions.) Paper masks offer little, if any, protection against chemical weapons. In an emergency, simply covering your mouth and nose with clothing until you are out of the danger area is a better idea. In any situation where there is a lot of dust and debris — for example, following any type of explosion — it is a good idea to cover your mouth and nose to prevent your lungs from being damaged.