Presentation on theme: "Unit F: Infectious Diseases"— Presentation transcript:
1Unit F: Infectious Diseases BioterrorismAgents and ContainmentBT 06.05
2BioterrorismTerrorism is defined as violent acts or acts dangerous to human life that appear to be intended to:Intimidate or coerce a civilian populationInfluence the policyof a govtAffect the conduct ofa govt
3Bioterrorist Agents Bacterial – like Anthrax and Plague Viral – like smallpoxToxins – like Botulism and Ricin
4ANTHRAX Acute infectious disease caused by bacillus anthracis Infection in humans:Skin contact – cutaneous, ingestion-gastrointestinal, inhalation-pulmonaryPerson-to-person transmission of inhalation disease does not occur.
5Pulmonary Anthrax S/SFlu-like symptoms that may briefly improve 2-4 days after initial symptomsAbrupt onset of respiratory failureHemodynamic collapseThoracic edemaWidened mediastinum on xrayPositive blood culture in 2-3 days of illnessIncubation Period: 2-60 days
6Pulmonary Anthrax cont: Prognosis is good only if treated early.Increased mortality rate if treated after respiratory onset.
7Cutaneous Anthrax S/S Local skin involvement with direct contact Commonly seen on head, forearms, or handsLocalized itching followed by papular lesion that turns vesicular within 2-6 days – develops into depressed black eschar.Incubation period: 1-7 daysPrognosis good if treated with antibiotics.
8Gastrointestinal Anthrax S/S:Abdominal pain, nausea, vomiting, & feverBloody diarrhea, hematemesisPositive culture after 2-3 daysIncubation period: 1-7 daysPrognosis:If progression to toxemia and sepsis, prognosis is poor
9Anthrax overview Modes of Transmission Incubation Periods: Inhalation of sporesSkin contactIngestion of contaminated foodIncubation Periods:Pulmonary: 2-60 daysCutaneous: 1-7 daysGastrointestinal: 1-7 daysTransmission: Anthrax IS NOT airborne person to person. Direct contact with infectious skin lesions CAN transmit infections.Prevention: Vaccine available – quantities limited
10BOTULISMPotent neurotoxin caused by an anaerobic bacillus-clostridium botulinumTransmissionContaminated foodinhalationS/SGI symptomsDrooping eyelidsWeakened jaw clenchDifficulty swallowing orspeakingBlurred visionRespiratory distress
11Botulism Cont: Incubation period: Prevention: Neurological S/S for food borne botulism – hours after ingestionNeurological S/S for inhalation botulism – hours after exposurePrevention:Vaccine is availableBotulism CANNOT betransmitted from personto person
12PLAGUE Plague is an acute bacterial disease caused by yersinia pestis. S/SFever - Chest pains - Hemoptysis - Watery sputumCough - Bronchopneumonia on xrayMode of Transmission:Plague normally transmitted form an infected flea (that has bitten an infected rat!)Can be aerosol-probably use in bioterrorismCan be transmitted person to person
13Plague Cont: Incubation period: Prognosis: Flea bite – 2-8 days Aerosol – 1-3 daysPrognosis:Good if treated with antibiotics early.
14RICINRicin is a potent protein toxin derived from Castor beans. The toxin is fairly easily produced.Can be used as a biological weapon with relative ease.
16Ricin Cont: S/S continued: Prognosis: Within 36-72 hours: Severe respiratory distressDeath from hypoxemiaPrognosis:Poor – No vaccine availableYou’re GOING TO DIE!Ricin DOES NOT spread easily from person to person
17SMALLPOXSmallpox is an acute viral illness caused by the variola virus.Mode of transmission:Airborne :droplets (sneeze, cough, drip, or exhale)S/S:Flu like symptoms – fever, myalgiaSkin lesions quickly progressing from macules to papules to vesiclesRash scabs over in 1-2 weeksRash occurs in all areas at once, not in crops
18Smallpox Cont. Incubation Period: Prognosis: From 7-17 days, average is 12 daysContagious when the rash is apparent and remains infectious until scabs separate (appx 3 weeks)Prognosis:Vaccine available and effective post-exposurePassive immunization is also available in the form of a vaccina immune globulin (Vig) antibody transferSmallpox has a high mortality rate.
19CONTAINMENT OF BIOTERRORISM AGENTS 1. Isolation PrecautionsAll pts in healthcare facilities, including symptomatic pts with suspected or confirmed bioterrorism-related illnesses, should be managed utilizing STANDARD PRECAUTIONSStandard precautions include things like:Handwashing - after touching blood, body flds, etcWearing gloves – clean gloves, exchange b/w tasks and procedures. Remove gloves and wash hands B4 leaving a pt care area.
20Standard Precautions Cont. GownsWorn to protect skin and prevent soiling of clothesSoiled gowns are promptly removed and hands are washed when finishedMasks/ Eye protection or Face ShieldsWorn to protect mucus membranesPrevent splashes of blood, body fluids
21Containment of bioterrorism agents 2. Patient placement Normal infection control practices should be followed if numbers allow.With large numbers, group affected patients together into designated ward or floor (possibly even a separate building)Consult with engineering staff (airflow and ventilation, plumbing and waste disposal, and capacity)
22Containment of bioterrorism agents 3. Patient Transport Most bioterroristic agents cannot be transmitted from patient to patient.Transport and movement of pts should be limited to movement that is essential to provide pt care.This SHOULD reduce the opportunities for transmission of microorganisms within healthcare facilities.
23Containment of bioterrorism agents 4 Containment of bioterrorism agents 4. Cleaning, disinfection, and sterilization of equipment & environmentStandard precautions should be followed.All facilities have in place procedures.Cleaning agents should be available for spills and disinfecting equipment.Contaminated equipment – wear glovesSterilize all instruments
24Containment of bioterrorism agents 5. Discharge management Pts will not be discharged until they are deemed non-infectiousHome care instructions should include barrier precautions, handwashing, waste mgmt, and cleaning and disinfection.
25Containment of bioterrorism agents 6. Post-mortem care Pathology depts and labs should be informed!All autopsies should be performed carefully using PPE and standard precautions.Instruct funeral directors of diagnosis
26Containment of bioterrorism agents 7. Handwashing Push sleeves and watch 4-5 inches up on armsStand back from sink and adjust water temperature until warmWet wrists and hands without splashing and with fingertips pointed downwardApply soap using frictionLater well, keeping hands lower than elbowsRush hands together in circular motion, being sureto wash between fingers and two inches above wristsClean under nails by rubbing against palmsWash for at least 15 seconds or longer if contaminatedRinse wrists and hands with running waterDry hands thoroughly with paper towel and discard towel into trashcanTurn faucets off with a new paper towel and discard into trash can
27Response to bioterrorism agents Internal reporting requirements (within a facility)Infection control personnelEpidemiologist (local and state)Administration (health care facility)Office of public affairs (media coverage)
28Response to bioterrorism agents External contacts (outside of facility)Local health departmentState health departmentFBICDCLocal policeEMS