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Anthrax
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Botulism
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Cholera
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Glanders
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Plague
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Q Fever
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Smallpox
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Tularemia
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Incubation period before symptoms
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12 hours - 5 days
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generally 12-72 hours
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12 hours - 5 days
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1-14 days
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1-6 days
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2-3 weeks
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10-14 days
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1-14 days. Following a terrorist attack, cases would
likely be reported in 3-5 days.
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Symptoms
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Cutaneous:
- Skin infections begin as itchy bumps resembling
insect bites, then develop into lesions about half
an inch to a little over an inch in diameter.
Lesions become covered by black scabs.
- swollen lymph nodes
Inhalation:
- fever, chills, headache, nausea and vomiting
- fluid in lungs, severe breathing difficulty
- shock and respiratory failure
Gastrointestinal:
- nausea, loss of appetite, vomiting, fever
- abdominal pain, severe diarrhea, abdominal
bleeding
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- nausea and vomiting (occurs in natural cases when
bacteria are ingested; may not appear if purified
toxin is spread on food.)
- difficulty speaking, seeing and/or swallowing
- drooping eyelids
- muscle weakness starting in the trunk and moving
to the limbs
- muscle paralysis and difficulty breathing
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- severe diarrhea, vomiting, and weakness
- leg cramps
- rapid fluid loss that can lead to shock
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General symptoms:
- fever and headaches
- muscle aches, muscle tightness, chest pain
Other symptoms vary according to how the organism
enters the body—through the skin, eyes, nose
or respiratory tract—but include:
- pustular lesions develop 1-5 days after bacteria
enter breaks in skin
- tearing of the eyes, light sensitivity
- increased mucus in the eyes, nose and respiratory
tract
- pneumonia
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- fever, chills, headache, weakness
- nausea, vomiting and abominal pain
- extreme lymph node pain (bubonic)
- chest pain, cough, bloody or watery sputum
(pneumonic)
- septic shock
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- high fever, chills, and throbbing headache
- profuse sweating
- visual and auditory hallucinations
- hepatitis
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- high fever
- headache, backache, and vomiting
- rash (pox) on the face and arms that spreads to
the trunk
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Various forms of the disease all begin with the
sudden onset of flu-like symptoms:
- fever, chills, headache, cough, and lethargy
Additional symptoms depend on the form but include:
- swollen and sore lymph nodes
- skin ulcers
- red and sore eyes
- abdominal pain, diarrhea, and vomiting
- pneumonia
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How it would be spread
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Letters with anthrax powder will cause only isolated
cases of disease, relatively few in number.
Poisoning of food is difficult to achieve with
anthrax and is not considered likely. Aerosol
spraying is the gravest threat. Anthrax diseases are
not contagious.
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Aerosol or food. The disease is not contagious.
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Food or water. It is not contagious with proper
hygene.
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Aerosol. Human-to-human transmission is possible,
but the disease is not considered highly contagious.
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Aerosol or person-to-person. Pneumonic plague is
contagious through respiratory droplets.
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Aerosol or food. Human-to-human transmission is
rare.
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Aerosol or person-to-person, potentialy by a
terrorist-"martyr." It is highly contagious.
However, smallpox victims show clear signs of the
disease, and anyone who came into contact with them
could be vaccinated post-exposure.
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Aerosol or food. Human-to-human transmission has not
been documented.
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Treatment
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A variety of antibiotics can treat all three forms
of the disease. Inhalation anthrax, however,
progresses so quickly that, once symptoms are clear,
it may be too late for drugs to prevent death.
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An antitoxin, available in the U.S. from the Centers
for Disease Control and Prevention, stops
progression of the disease and can prevent onset of
the disease following exposure.
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Rehydration is essential. A variety of antibiotics
shorten the course of illness and reduce its
severity.
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A variety of antibiotics can be used. However, even
when treated, the disease has a high mortality rate
(roughly 50%) in the few documented cases of human
glanders. Treatment protocols are not well
understood because the disease is so rare.
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A variety of antibiotics can treat the disease but
must be given soon after symptoms appear.
Antibiotics given immediately after exposure may
prevent disease onset.
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Even untreated, most people with Q fever will
recover. Treatment with a variety of antibiotics
shortens illness and results in fewer complications.
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There is no current treatment against the smallpox
virus. Vaccination given 3-5 days post-exposure can
prevent the disease.
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Early antibiotic therapy is effective, and if
started within 24 hours of exposure, may prevent
disease. A variety of antibiotics can be used,
although some antibiotics may be powerless against
strains genetically engineered to be resistant.
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Vaccine
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The vaccine for anthrax used by the U.S. military is
not currently available to the general public. It is
given in a series of six shots over 18 months.
Annual booster injections are recommended.
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No vaccine is available for the general public. An
investigational vaccine is available for the
military and lab workers.
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The manufacture of the only licensed cholera vaccine
in the U.S. has been discontinued. It was generally
not recommended because it protects only roughly
half of those vaccinated and immunity is short-term
(3-6 months). Two newly developed vaccines are
available in other countries.
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No vaccine is available.
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No vaccine is available to the general public. A
vaccine to prevent bubonic plague was licensed in
the U.S. but discontinued by its manufacturers in
1999. Even if this vaccine becomes available, it
does not prevent the pneumonic form of plague.
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A vaccine exists but is not available to the general
public.
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Vaccine exists but is currently not recommended for
the general public. Stockpiles of vaccine are being
increased. No one in the U.S. has been vaccinated
since 1972, and people vaccinated before then have
likely lost immunity.
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No vaccine available for the general public. The
U.S. Food and Drug Administration is investigating a
vaccine that is now available for high-risk lab
workers.
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