American Medical Association Family Medical Guide - American Medical Association [28]
Plague
Possible use as a biological weapon: Could be released as an aerosol in an enclosed space or over a city. Can be transmitted from person to person by inhaling infected droplets coughed into the air.
Cause: The bacterium Yersinia pestis.
Prevention: No plague vaccine is currently available. Avoid contact with infected people. Taking antibiotics for 7 days protects those who have had close contact with an infected person.
Incubation period: Symptoms usually develop within 1 to 7 days.
Symptoms: Flulike symptoms including sudden fever, headache, and weakness, followed by shortness of breath, chest pain, cough, bloody or watery phlegm, respiratory failure, or shock.
Treatment: Antibiotics (given within 24 hours after the first symptoms appear). The person is kept as comfortable as possible. Breathing may be assisted with a ventilator. Fatal if not treated.
Smallpox
Possible use as a biological weapon: Could be released as an aerosol in an enclosed space or over a city.
Cause: The variola major virus.
Prevention: Vaccine.
Incubation period: Symptoms usually develop within 7 to 17 days.
Symptoms: High fever, headaches, body aches, and vomiting. A rash appears on the tongue and in the mouth; the rash turns into blisters that break open and spread the virus throughout the mouth and throat. The rash then spreads to the face, arms, legs, hands, feet, and trunk, and turns into pus-filled blisters. Blisters crust over and scab. Scabs begin to fall off, leaving scars.
Treatment: Vaccine (if given within 4 days of exposure). No antiviral treatment is available. The person is kept as comfortable as possible.
Chemical Attacks
A chemical attack is the deliberate release of a toxic gas, liquid (including aerosols), or solid particles (such as dry powders) into the atmosphere. Chemical agents can be released in bombs, sprayed from planes or boats, or discharged from a canister in an enclosed area (such as a building or the subway). A chemical agent can poison people directly or contaminate the environment. Most chemical agents cause symptoms immediately but some can take several hours or even days to have an effect. Symptoms depend on the type of chemical agent used. Chemical agents are classified into the following general categories based on how they affect the body:
• Damage the respiratory system, especially the lungs (phosgene or chlorine)
• Interfere with the body’s use of oxygen (cyanide)
• Affect the nervous system (sarin, malathion, soman, tabun, or VX)
• Stun or otherwise cause physical or mental incapacitation (fentanyl)
• Blister the skin (mustard gas)
• Cause irritation (such as chemicals used for crowd control) but usually not permanent or severe damage to health (tear gas, mace, or pepper spray)
Signs of a possible chemical attack:
• A number of people in an area seem to be sick or dying
• Many people have blisters or rashes
• Unusual numbers of birds, fish, insects, or animals are dying
• Vegetation is dead, discolored, or withered
• Strange odors
• An oily film or droplets on outdoor surfaces and water
• Unusual foglike clouds
• Spray devices such as metal canisters or other metal debris that look abandoned
What to do in case of a chemical attack:
• If you think you may have come into contact with a contaminated substance, seek medical help immediately.
• If you are at the scene of a chemical attack, call 911 or your local emergency number.
• If a chemical attack has occurred near your home, stay indoors unless authorities have told you to evacuate the area.
• Do not touch any suspicious substances; report them to the police.
• If the chemical is inside a building you are in, try to get out of the building without passing through the contaminated area.
Radiological Attacks
In a radiological attack, radioactive material could be released into the atmosphere in a number of ways. To contaminate a limited area, a concentrated radioactive material could be placed in a densely populated