Journal ArticleDOI
Botulinum Toxin as a Biological Weapon: Medical and Public Health Management
Stephen S. Arnon,Robert Schechter,Thomas V. Inglesby,Donald A. Henderson,John G. Bartlett,Michael S. Ascher,Edward M. Eitzen,Anne D. Fine,Jerome Hauer,Marcelle Layton,Scott R. Lillibridge,Michael T. Osterholm,Tara O'Toole,Gerald W. Parker,Trish M. Perl,Philip K. Russell,David L. Swerdlow,Kevin Tonat +17 more
TLDR
People potentially exposed to botulinum toxin should be closely observed, and those with signs of botulism require prompt treatment with antitoxin and supportive care that may include assisted ventilation for weeks or months.Abstract:
ObjectiveThe Working Group on Civilian Biodefense has developed consensus-based
recommendations for measures to be taken by medical and public health professionals
if botulinum toxin is used as a biological weapon against a civilian population.ParticipantsThe working group included 23 representatives from academic, government,
and private institutions with expertise in public health, emergency management,
and clinical medicine.EvidenceThe primary authors (S.S.A. and R.S.) searched OLDMEDLINE and MEDLINE
(1960–March 1999) and their professional collections for literature
concerning use of botulinum toxin as a bioweapon. The literature was reviewed,
and opinions were sought from the working group and other experts on diagnosis
and management of botulism. Additional MEDLINE searches were conducted through
April 2000 during the review and revisions of the consensus statement.Consensus ProcessThe first draft of the working group's consensus statement was a synthesis
of information obtained in the formal evidence-gathering process. The working
group convened to review the first draft in May 1999. Working group members
reviewed subsequent drafts and suggested additional revisions. The final statement
incorporates all relevant evidence obtained in the literature search in conjunction
with final consensus recommendations supported by all working group members.ConclusionsAn aerosolized or foodborne botulinum toxin weapon would cause acute
symmetric, descending flaccid paralysis with prominent bulbar palsies such
as diplopia, dysarthria, dysphonia, and dysphagia that would typically present
12 to 72 hours after exposure. Effective response to a deliberate release
of botulinum toxin will depend on timely clinical diagnosis, case reporting,
and epidemiological investigation. Persons potentially exposed to botulinum
toxin should be closely observed, and those with signs of botulism require
prompt treatment with antitoxin and supportive care that may include assisted
ventilation for weeks or months. Treatment with antitoxin should not be delayed
for microbiological testing.read more
Citations
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Journal ArticleDOI
2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.
TL;DR: The ability of hospital ventilation systems to filter Aspergillus and other fungi following a building implosion and the impact of bedside design and furnishing on nosocomial infections are investigated.
Journal ArticleDOI
Tularemia as a Biological Weapon.Medical and Public Health Management
David T. Dennis,Thomas V. Inglesby,Donald A. Henderson,John G. Bartlett,Michael S. Ascher,Edward M. Eitzen,Anne D. Fine,Arthur M. Friedlander,Jerome Hauer,Marcelle Layton,Scott R. Lillibridge,Joseph E. McDade,Michael T. Osterholm,Tara O'Toole,Gerald W. Parker,Trish M. Perl,Philip K. Russell,Kevin Tonat +17 more
TL;DR: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if tularemia is used as a biological weapon against a civilian population.
Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings 2007.
TL;DR: The ability of hospital ventilation systems to filter Aspergillus and other fungi following a building implosion and the impact of bedside design and furnishing on nosocomial infections are investigated.
Journal ArticleDOI
Public health assessment of potential biological terrorism agents.
TL;DR: This report outlines the overall selection and prioritization process used to determine the biological agents for public health preparedness activities and helps facilitate coordinated planning efforts among federal agencies, state and local emergency response and public health agencies, and the medical community.
Journal ArticleDOI
SV2 is the protein receptor for botulinum neurotoxin A.
Min Dong,Felix L. Yeh,William H. Tepp,Camin Dean,Eric A. Johnson,Roger Janz,Edwin R. Chapman +6 more
TL;DR: It is found that BoNT/A enters neurons by binding to the synaptic vesicle protein SV2 (isoforms A, B, and C), and SV2 acts as the protein receptor for Bo NT/A.
References
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Journal ArticleDOI
From the Centers for Disease Control and Prevention
TL;DR: This report summarizes the clinical features of these cases and the epidemiologic investigations by the Texas Department of Health and the New Jersey State Department of health and Senior Services, which indicated that a bat-associated variant of the rabies virus was responsible for infection in both cases.
Book
Textbook of pediatric infectious diseases
Ralph D. Feigin,James D. Cherry +1 more
TL;DR: Textbook of pediatric infectious diseases, Textbook of Pediatrics , کتابخانه دیجیتال جندی شاپور اهواز
Journal ArticleDOI
Smallpox as a Biological Weapon Medical and Public Health Management
Donald A. Henderson,Thomas V. Inglesby,Thomas V. Inglesby,John G. Bartlett,John G. Bartlett,Michael S. Ascher,Edward M. Eitzen,Peter B. Jahrling,Jerome Hauer,Marcelle Layton,Joseph E. McDade,Michael T. Osterholm,Tara O'Toole,Gerald W. Parker,Trish M. Perl,Philip K. Russell,Kevin Tonat +16 more
TL;DR: In this paper, the Working Group onCivilian Biodefense has proposed a set of guidelines for the use of bio-medical data for defense against cyber-attacks against the US government.
Journal ArticleDOI
Management of Pain in Elderly Patients With Cancer
Roberto Bernabei,Giovanni Gambassi,Kate L. Lapane,Francesco Landi,Constantine Gatsonis,Robert Dunlop,Lewis A. Lipsitz,Knight Steel,Vincent Mor +8 more
TL;DR: Evaluating the adequacy of pain management in elderly and minority cancer patients admitted to nursing homes found age, gender, race, marital status, physical function, depression, and cognitive status were independently associated with the presence of pain.
Journal ArticleDOI
Plague as a biological weapon. Medical and public health management.
Thomas V. Inglesby,David T. Dennis,Donald A. Henderson,John G. Bartlett,Michael S. Ascher,Edward M. Eitzen,Anne D. Fine,Arthur M. Friedlander,Jerome Hauer,John F. Koerner,Marcelle Layton,Joseph E. McDade,Michael T. Osterholm,Tara O'Toole,Gerald W. Parker,Trish M. Perl,Philip K. Russell,Monica Schoch-Spana,Kevin Tonat +18 more
TL;DR: The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members.
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