category | a | biological agents

Category |A| Biological Agents

Louisiana Office of Public HealthCenter for Community Preparedness

OPH Center for Community Preparedness

Training Objectives

• Describe the CDC’s Category A biological threat agents.• Describe the public health considerations involved in

the release of a biological threat agent.• Discuss the recognition of potential bioterrorism

events and the formulation of an appropriate response strategy.


BIOLOGICAL WEAPONSCategory |A| Biological Agents


Biological Weapons• Biological warfare (BW), also known as germ warfare,

is the deliberate use of disease-causing biological agents such as protozoa, fungi, bacteria, protists, or viruses, to kill or incapacitate humans, other animals, or plants.

• Biological weapons (bioweapons) are living organisms or replicating entities (virus) that reproduce or replicate within their host victims.


Biological Weapons | Uses

• Mass casualties– Morbidity– Mortality

• Destruction of resources – Agriculture – Drinking water

• Societal disruption– Overwhelm local resources– Breakdown of order– Panic and fear– Economic hardship


Biological Weapons | Historical • Offensive biological warfare (developing and stockpiling

bioweapons) was outlawed in 1972 by the Biological Weapons Convention (BWC). As of 2009, 163 nations had ratified the BWC.

• The United States’ biological weapons program ran from 1943 to 1969.– Biodefense research is now conducted by the United States Army Medical

Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Maryland.

• The Soviet Union’s biological weapons program began in the 1920’s and was know as Biopreparat after 1973. Program was reportedly ended in 1992.

• Both the United Kingdom and Japan have developed advanced bioweapon programs.


BIOLOGICAL AGENT CATEGORIESCategory |A| Biological Agents


CDC Biological Agent CategoriesCategory A

High-priority agents include organisms that pose a risk to national security because they:– Can be easily disseminated or

transmitted from person to person;

– Result in high mortality rates and have the potential for major public health impact;

– Might cause public panic and social disruption; and

– Require special action for public health preparedness.

Agents• Anthrax (Bacillus anthracis)• Botulism (Clostridium

botulinum toxin) • Plague (Yersinia pestis) • Smallpox (variola major) • Tularemia (Francisella

tularensis) • Viral hemorrhagic fevers

(Ebola, Marburg, Lassa, Machupo)


CDC Biological Agent CategoriesCategory B

Second highest priority agents include those that– Are moderately easy to

disseminate;– Result in moderate morbidity

rates and low mortality rates; and

– Require specific enhancements of CDC's diagnostic capacity and enhanced disease surveillance.

Agents

• Brucellosis (Brucella species) • Epsilon toxin of Clostridium perfringens• Food safety threats (e.g., Salmonella species,

Escherichia coli O157:H7, Shigella)• Glanders (Burkholderia mallei)• Melioidosis (Burkholderia pseudomallei)• Psittacosis (Chlamydia psittaci) • Q fever (Coxiella burnetii) • Ricin toxin from Ricinus communis (castor beans)• Staphylococcal enterotoxin B• Typhus fever (Rickettsia prowazekii)

• Viral encephalitis (alphaviruses [e.g., Venezuelan equine encephalitis, eastern equine encephalitis, western equine encephalitis])

• Water safety threats (e.g., Vibrio cholerae, Cryptosporidium parvum)


Category C• Third highest priority agents

include emerging pathogens that could be engineered for mass dissemination in the future because of:– Availability;– Ease of production and

dissemination; and– Potential for high morbidity

and mortality rates and major health impact.

Agents• Emerging infectious

diseases such as Nipah virus (found in fruit bats).

CDC Biological Agent Categories


Biological Agents | Characteristics

As a bioweapon• Effectiveness

– Morbidity and Mortality• Transmission

– Environmental– Person-to-person

• Ease of Use– Special handling– Production complexity

• Accessibility– Commonly available– Few legal controls

• Prevention

As a disease• Symptoms• Diagnosis– Clinical– Laboratory

• Transmission– Environmental– Person-to-person

• Treatment– Curative– Supportive


THE AGENTSCategory |A| Biological Agents


ANTHRAXCategory |A| Biological Agents


Anthrax | Description

Anthrax: An infection caused by the spore-forming bacteria Bacillus anthracis. Also called “wool sorter’s disease.”

Types• Inhalational (rare)

– Acquired by inhaling anthrax spores. This is the form most likely caused by a biological attack using aerosolized anthrax spores.

• Cutaneous (more common)– Acquired when anthrax bacteria enter a break in the skin.

• Gastrointestinal (rare)– Acquired by eating food contaminated with anthrax bacteria.


Inhalational Anthrax | As a DiseaseOrganism – Bacillus anthracisIncubation Period – less than 1 week (range 1 to 60 days)Symptoms -• low-grade fever • nonproductive cough• malaise• fatigue• myalgias • profound sweats• chest discomfort


Inhalational Anthrax | As a Disease

Later Symptoms• 1–5 days after onset of initial symptoms .• May be preceded by 1–3 days of improvement.• Abrupt onset of high fever and severe respiratory

distress.• Shock, death within 24–36 hours .


Inhalational Anthrax | As a Disease

Diagnosis• Specific chest X-Ray findings (Ex. widened mediastinum)• Gram-positive bacilli in blood or cerebrospinal fluid.• Aerobic blood culture growth of large, Gram-positive bacilli

provides preliminary identification of Bacillus species. • Confirmation by polymerase chain reaction (PCR)Treatment• Antibiotics (doxycycline, ciprofloxacin)• Survival chances decrease dramatically if not treated within

48 hours of exposure.


• Effectiveness– In the 20th century, 18 cases of (natural exposure) anthrax in the US

had a case-fatality rate of 85%.– In the 2001 anthrax attacks, where the victims received aggressive

supportive and antibiotic therapy, the case fatality rate was 45%.– The 2001 anthrax attacks caused widespread panic and fear.

• Transmission– No person-to-person transmission.– Spores can survive for decades in the environment.– Weaponized varieties remain suspended in air for substantial periods.

• Ease of Use– Multiple distribution methods available.

Inhalational Anthrax | As a Bioweapon


• Accessibility– Occurs naturally in the soil.– Is a common disease in livestock in some parts of the world.– The technology is available on the open market with few controls to

purchase.• Prevention

– A vaccine is available, but not widely used outside the military.– Detection methods include air-sampling machinery, and indirect

methods such as syndromic surveillance and other pattern-recognition methods. These are only useful after an anthrax release has occurred.

Inhalational Anthrax | As a Bioweapon


Inhalational Anthrax | Public Health Actions

Detection• Direct detection of agent• Clinician reports to state health department.• Syndromic detection of illness• Laboratory confirmation

Isolation and quarantine• Not useful for this illness (not person-to-person)

Prophylaxis• Treatment more useful to those not yet exhibiting symptoms.• Delays in treatment greatly increase mortality.

Decontamination• People and clothing can be washed.• Contaminated possessions may need to be incinerated.• Environmental cleaning difficult and expensive.


Inhalational Anthrax | Historical Notes• Used against Russian forces in Finland in 1916 by Scandinavian

freedom fighters (sponsored by Germany).• First extensively developed as a bioweapon by Unit 731 (Japan) in

Manchuria in the 1930’s. The USSR later captured the labs used in this project, thus beginning that nation’s bioweapon program.

• In 1942 the United Kingdom conducted anthrax bioweapon trials on Gruinard Island in Scotland, making the isle uninhabitable until it was decontaminated in 1990.

• Sverdlovsk, Russia – April 2nd 1969, weaponized anthrax spores accidentally released in the city of Sverdlovsk. At least 94 people were infected, and at least 68 died.

• In 1990, Iraq deployed two 600 km range missiles loaded with anthrax.


BOTULISMCategory |A| Biological Agents


Botulism | Description

Botulism – a disease caused by the toxin-producing bacteria Clostridium botulinum.

Types• Botulinum Intoxication occurs when a person ingests or

inhales a pre-formed toxin that leads to illness within a few hours to days. This toxin is used in the production of biological weapons.

• Infant botulism occurs in a small number of susceptible infants each year who harbor C. botulinum in their intestinal tract.

• Wound botulism occurs when wounds are infected with C. botulinum that secretes the toxin.


Botulism | As a Disease

Organism – Clostridium botulinumIncubation Period – 12 to 36 hours (range 6 hours to 10 days)Symptoms –• Double vision• Blurred vision• Drooping eyelids• Slurred speech• Dry mouth• Muscle weakness (paralysis) moving down the body• Paralysis of breathing muscles can lead to death


Botulism | As a Disease

Diagnosis• Based on symptoms

– Although this disease resembles Guillain-Barré syndrome, stroke, and myasthenia gravis.

• Neurologic tests• Testing for botulinum toxin can be performed at some state

health departments and the CDC.Treatment• Supportive care (such as mechanical breathing assistance).• Antitoxin is available from CDC (at no cost).• Immune globulin for infant botulism is available from

California Department of Public Health ($45,300 per dose)


Effectiveness• Botulinum toxin is the most poisonous substance known. A single gram of

crystalline toxin, evenly dispersed and inhaled, is sufficient to kill more than 1 million people.

• Case fatality rate for untreated botulism (toxin) is 60%.

Transmission• Not person-to-person.• Must be ingested or inhaled.

Ease of Use• Distribution accomplished through simple methods.

– Direct contamination of food or water.– Spraying of aerosolized toxin.

Botulism | As a Bioweapon


Accessibility• Bacterium occurs naturally in the soil.• Production methods are relatively unsophisticated for contaminating food

and water sources. Aerosolization of the toxin is more difficult.

Prevention• No vaccine available.

Botulism | As a Bioweapon


Botulism| Public Health ActionsDetection• Clinician report to state health department.• Syndromic detection of illness.• Laboratory confirmation.

Isolation and quarantine• Not useful for this illness (not person-to-person)Prophylaxis• Effectively none, although antitoxin might be used in some cases as

prophylaxis.• No patient-contact prophylaxis necessary.Decontamination• Destruction of contaminated food.• Standard healthcare sanitization of surfaces and durable equipment.• Standard healthcare sanitization of bedding and clothing.


• Tested as a bioweapon by Unit 731 (Japan) in Manchuria in the 1930’s. C. botulinum cultures were fed to prisoners.

• Aerosolized C. botulinum was dispersed on at least three occasions in Japan by Aum Shinrikyō.

• Believing that Nazi Germany had developed weaponized botulinum toxin, the US created 1 million doses of botulinum toxoid vaccine to protect Allied soldiers participating in the invasion of Normandy (June 6th 1944).

• By 1991, Iraq had produced 19,000 liters of botulinum toxin, 10,000 liters of which were in weapons. This is approximately three times the amount necessary to kill the entire population of the Earth.

Botulism | Historical Notes


PLAGUECategory |A| Biological Agents


Plague | DescriptionA disease caused by the bacterium Yersinia pestis, which is carried by rodents and

their fleas.

• Bubonic plague occurs when an infected flea bites a person or when materials contaminated with Y. pestis enter through a break in a person's skin. Patients develop swollen, tender lymph glands (called buboes) and fever, headache, chills, and weakness. Bubonic plague does not spread from person to person. An epidemic in 14th century Europe is known as “the Black Death.”

• Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person-to-person through the air. Pneumonic plague may also occur if a person with bubonic or septicemic plague is untreated and the bacteria spread to the lungs. This form of the illness will be the most likely result of a biological attack involving Y. pestis.

• Septicemic plague occurs when plague bacteria multiply in the blood. It can be a complication of pneumonic or bubonic plague or it can occur by itself. Septicemic plague does not spread from person to person.


Pneumonic Plague| As a Disease

Organism – Yersinia pestisIncubation Period – 1 to 6 daysSymptoms –• fever• weakness• rapidly developing pneumonia with

– shortness of breath– chest pain – cough– sometimes bloody or watery sputum

• Nausea, vomiting, and abdominal pain may also occur. • Without early treatment, pneumonic plague usually leads to

respiratory failure, shock, and rapid death.


Pneumonic Plague| As a Disease

Diagnosis• Lab testing of blood, sputum, or lymph node aspirate. Treatment– Single patient: streptomycin and gentamycin (intravenous).– Mass casualty: doxycycline and ciprofloxacin.


Effectiveness• The mortality rate for untreated pneumonic plague is almost 100%.• Treatment started more than 24 hours after exposure has reduced

effectiveness.

Transmission• Person-to-person (mainly respiratory secretions).

Ease of Use• Aerosolized Y. pestis persists in the air for up to 1 hour after release.• High lethality of the agent requires extreme care in handling.

Pneumonic Plague| As a Bioweapon


Accessibility• Available commercially.• Infects many types of rodents.• Endemic in many areas of the world, including the Southwestern U.S.

(prairie dogs).

Prevention• An approved vaccine exists, but is no longer commercially available.

Pneumonic Plague| As a Bioweapon


Pneumonic Plague | Public Health ActionsDetection• Clinician report to state health department.• Syndromic detection of illness.• Laboratory confirmation.

Isolation and quarantine• Federally mandated isolation and quarantine disease.• Can be as simple as wearing a proper mask.• May require isolation in a hospital negative pressure room .

Prophylaxis• Antibiotic treatment of close contacts.

Decontamination• Y. pestis is susceptible to sunlight and drying.• Standard healthcare sanitization of surfaces and durable equipment. • Standard healthcare sanitization of bedding and clothing.


• In ancient China and medieval Europe, infected carcasses were used to contaminate enemy water supplies.

• Mongol invasion of Caffa - the bodies of plague victims were launched by catapult into the city during the siege.

• Plague of Justinian – in the 6th and 7th centuries is the first recorded plague outbreak. It is estimated that one half of Europe's population died.

• Black Death – 1348 to 1350. This epidemic killed between 75 million to 100 million people.

• After World War II, both the US and USSR developed techniques for weaponizing plague.

• In 1994, an outbreak of suspected pneumonic plague occurred in India, resulting in 52 deaths and large internal migrations.

Plague| Historical Notes


SMALLPOXCategory |A| Biological Agents


Smallpox | DescriptionA disease caused by the virus variola major. Smallpox as

a naturally occurring disease was eradicated in 1979.Types• Ordinary: the most frequent type, accounting for 90% or more

of cases.• Modified: mild and occurring in previously vaccinated

persons.• Flat: rare and very severe. Occurs more often in children.

Usually lethal.• Hemorrhagic: rare and very severe. More common in

immuno-deficient individuals. Usually lethal.


Smallpox| As a Disease

Organism – variola major (a virus)Incubation Period – 7 to 17 days (not contagious)Symptoms – by phase.• Prodrome: 2 to 4 days duration (possibly contagious)

– Fever (101 to 104 °F)– malaise– head and body aches – sometimes vomiting– During this phase, people are generally too sick to carry on daily

activities.



• Early rash: 4 days duration (most contagious phase)– Small red spots develop on the tongue and in the mouth, which break

open and release the virus– At this time, a rash appears on the body, concentrated on the arms and

legs, but spreading everywhere within 24 hours.– By the third day, the spots become raised bumps.– By the fourth day, the bumps fill with a thick, opaque fluid and often

have a depression in the center that looks like a bellybutton.– Fever usually returns at this point and remains until the bumps scab over.

• Pustular rash: 5 days duration (contagious)– Bumps become pustules (sharply raised, round, and firm to the touch). – Pustule feels as though something like a small ball bearing is embedded

in it.



• Pustules and scabs: 5 days duration (contagious)– The pustules begin to form a crust and then scab. – By the end of the second week after the rash appears, most of the sores have

scabbed over.

• Resolving scabs: ~ 6 days duration (contagious)– Scabs begin to fall off. The resulting marks on the skin will eventually become

pitted scars. – Most scabs will have fallen off three weeks after the rash first appeared.– The person is contagious until all of the scabs have fallen off.

• Scabs resolved (not contagious)



Diagnosis• Clinical diagnosis: acute onset of fever >101°F (38.3°C) followed by a rash

characterized by firm, deep seated vesicles or pustules in the same stage of development without other apparent cause.

• Laboratory confirmation: Polymerase chain reaction (PCR).

Treatment• No proven treatment available, though antivirals may be useful in some

cases.• Supportive care.• Vaccination can reduce the severity of disease if given within 2 to 3 days of

exposure or decreases the symptoms if given within one week of exposure.


Effectiveness• In unvaccinated individuals, smallpox is fatal in 30% of cases.• Causes severe illness (most patients are effectively incapacitated).• Transmission rates are high – in past outbreaks, it is estimated that each

infected person infected 10 others.

Transmission• Person-to-person transmission (mainly respiratory secretions).• Large portions of the global population have no immunity.

Ease of Use• Working with smallpox requires highly sophisticated equipment and

advanced knowledge.

Smallpox| As a Bioweapon


Accessibility• Variola major is not naturally occurring. It was wiped out as a natural

disease in 1979 after a long-standing global vaccination campaign.• Viral stocks are maintained by only (reportedly) two nations: the United

States and the Russian Federation.

Prevention• A vaccine is available, but its use in the general public was discontinued in

1976. • In response to concerns of bioterrorism in the US, a vaccination campaign

to immunize medical personnel and first responders was conducted in 2002 - 2003.

Smallpox| As a Bioweapon


Smallpox| Public Health Actions

Detection• Clinician reports to state health department.• Syndromic detection of illness.• Laboratory confirmation.

Isolation and quarantine• Federally mandated isolation and quarantine disease.• Severity of illness makes isolation at home impractical.

Prophylaxis• Vaccination soon after exposure reduces severity of illness.

Decontamination• Standard healthcare sanitization of surfaces and durable equipment. • Standard healthcare sanitization of bedding and clothing.


• In the 18th century, smallpox killed approximately 400,000 Europeans.

• In 1763, during the French and Indian War, a local trader (and British sympathizer) gave a French-allied Native American tribe (the Delawares) two blankets and a handkerchief from a smallpox hospital.

• During World War II, extensive research on the weaponization of smallpox was conducted by the United States, United Kingdom, and Japan.

• In 1992, Soviet defector and Biopreparat scientist Ken Alibek revealed that the USSR had stockpiled at least 20 tons of weaponized smallpox, which may have been engineered to reduce the effectiveness of the vaccine.

Smallpox| Historical Notes


TULAREMIACategory |A| Biological Agents


Tularemia | Description

A disease caused by the bacterium Francisella tularensis. Also known as “rabbit fever.”– There are approximately 200 reported cases of tularemia in

the US each year.– The bacterium is commonly found in rodents, rabbits, and

hares.– Routes of infection include:

• Hunters being exposed while handling game carcasses.• Being bitten by an infected tick, deerfly, or other insect.• Consuming contaminated food and water.• Inhaling the bacteria.


Tularemia| As a Disease

Organism – Francisella tularensisIncubation Period – 3 to 5 days after exposure (range 1 to 14 days).Symptoms • Sudden fever• Chills• Headaches• Diarrhea• Muscle aches• Joint pain• Dry cough• Progressive weakness• Pneumonia with chest pain and bloody sputum


Tularemia| As a Disease

Diagnosis• Symptoms are non-specific.• Laboratory testing: F. tularensis can be identified in certain body fluids by

microscopy in properly equipped labs. Growth of the bacterium in culture is considered a confirmed diagnosis.

Treatment• Antibiotics

– Single patient: streptomycin and gentamycin (intravenous).– Mass casualty: doxycycline and ciprofloxacin.


Effectiveness• F. tularensis is one of the most infectious pathogenic bacteria known.• Fewer than 50 organisms can cause disease. Compare to salmonella

species which require 103 to 106 organisms to cause disease.

Transmission• Not person-to-person• F. tularensis can survive in soil and water for several weeks.

Ease of Use• Aerosolization of the bacteria would be the most likely scenario for use as

a bioweapon. This would require substantial technical expertise to accomplish.

Tularemia| As a Bioweapon


Accessibility• Naturally occurring in many species of wildlife.• Technology to grow cultures of the bacteria relatively easy to obtain.

Prevention• An approved vaccine was in use to protect laboratory workers, but was

discontinued.

Tularemia| As a Bioweapon


Tularemia| Public Health Actions

Detection• Clinician reports to state health department.• Syndromic detection of illness.• Laboratory confirmation.Isolation and quarantine• Not useful for this illness (not person-to-person)Prophylaxis• Antibiotics useful in reducing risk of severe illness in exposed persons.• No patient-contact prophylaxis necessary.Decontamination• Standard healthcare sanitization of surfaces and durable equipment.• Standard healthcare sanitization of bedding and clothing.


• Named after Tulare County in California.• First isolated in 1912 in a US Public Health Service laboratory.• Researched as a bioweapon by several countries as a more

desirable alternative to anthrax.• In the US, development of F. tularensis as a bioweapon was

done at the Pine Bluff Arsenal in Arkansas.• In September 2005, six air sampling devices around the Mall

in Washington DC detected F. tularensis. This occurred during a well-attended anti-war rally on September 24th 2005. 100,000 to 300,000 people were present. No illnesses were reported and it was declared a natural occurrence.

Tularemia| Historical Notes


VIRAL HEMORRHAGIC FEVERCategory |A| Biological Agents


Viral Hemorrhagic Fevers | Description

“Viral hemorrhagic fever“ (VHF) is used to describe a severe syndrome affecting multiple organ systems that is caused by a variety of viruses.• A common symptom of all types is hemorrhage (bleeding). • Some of these diseases are found in rodents and can transmitted to

humans: – by insects that have fed on infected rodents.– through contact with the urine, feces, or saliva of infected animals.– through contact with the body fluids of an infected person.

Viral families• Arenaviruses (Laasa fever, Crimean-Congo Hemorrhagic Fever)• Filoviruses (Hantavirus, Rift Valley Fever) • Bunyaviruses (Ebola, Marburg)• Flaviviruses (Omsk Hemorrhagic fever, tick-borne encephalitis)


Viral Hemorrhagic Fevers | Examples• Laasa Fever

– Named after the town in Nigeria where it was first identified.– 100,000 to 300,00 cases per year; 5000 deaths per year.– In epidemics, case fatality can reach 50%.

• Hantavirus Pulmonary Syndrome– First recognized in 1993 in the southwest US. In that outbreak, half of

the patients declined rapidly and died.– Acquired by breathing air contaminated with the feces and urine of

infected mice.• Ebola Hemorrhagic Fever

– First recognized in 1976; named after a river in the Democratic Republic of Congo.

– The reservoir (host) animal for Ebola is unknown.


Viral Hemorrhagic Fevers | As a Disease

Organism – viruses in the families arenaviridae, filoviridae, bunyaviridae, and flaviviridae.

Incubation Period – varies by organism, but usually one to three weeks.

Symptoms – vary by disease.• General

– fever, fatigue, dizziness, muscle aches, loss of strength, and exhaustion.

• Severe cases– Bleeding under the skin, in internal organs, or from body orifices

like the mouth, eyes, or ears.– Shock, nervous system malfunction, coma, delirium, and seizures.


Viral Hemorrhagic Fevers | As a Disease

Diagnosis• Early stages of some fevers are non-specific (such as a rash or breathing

difficulty).• The most severe forms of the illness are easily recognized, though

identification of the specific virus generally requires laboratory analysis.

Treatment• For most diseases in this category, there is no specific treatment, other

than supportive care. In many cases, patients will require ventilator support or other advanced forms of care.


Effectiveness• Mortality varies by type, but most VHF agents cause severe illness and

some diseases are fatal without aggressive medical treatment.

Transmission• Insect bites.• Contact with infected animals.• Contact with body fluids of infected people (person-to-person).

Ease of Use• The highly lethal nature of these agents requires extreme caution when

handling.• Distribution of the agent is relatively easy (low tech) for small scale

operations (which may be sufficient for causing panic and disruption).

Viral Hemorrhagic Fevers | As a Bioweapon


Accessibility• Each disease agent is geographically limited, only occurring where the

host animals live. For some viruses (Ebola and Marburg) the host animals are unknown.

• Laboratory stocks are tightly controlled in bio-safety level 4 containment facilities.

Prevention• With the exception of one disease (Argentine HF), no vaccine is available

for viral hemorrhagic fevers.• For naturally occurring disease, the only prevention is avoidance of host

animals and insect vector control.

Viral Hemorrhagic Fevers | As a Bioweapon


Viral Hemorrhagic Fevers | Public Health Actions

Detection• Because of the unusual presentation, this syndrome will be rapidly

identified.Isolation and quarantine• Federally mandated isolation and quarantine disease.• The only truly effective method of containment.• Most cases will require hospitalization.Prophylaxis• NoneDecontamination• Standard healthcare sanitization of surfaces and durable equipment .• Standard healthcare sanitization of bedding and clothing.• Incineration of non-reusable equipment.


• Some researchers claim that the Black Death was actually a VHF and not plague.

• No confirmed attempt to weaponize VHF-causing viruses is known.

• Some former Soviet scientists have claimed that Biopreparat attempted to engineer other bioweapons to include characteristics of the Ebola virus.

Viral Hemorrhagic Fevers | Historical Notes


LEARNING MORECategory |A| Biological Agents


Additional Information

• The Centers for Disease Control website has extensive information on biological threat agents.– General information– Clinical guidance– Emergency preparedness planning– Links to many other sources of information

CDC Bioterrorism Preparednesshttp://emergency.cdc.gov/bioterrorism

http://emergency.cdc.gov/bioterrorism

http://emergency.cdc.gov/bioterrorism


Other Resources World Health Organization

http://www.who.int/en/

Responder Knowledge Base (FEMA)http://www.rkb.gov

National Library of Medicine – PubMedhttp://www.ncbi.nlm.nih.gov/pubmed/

Louisiana Office of Public Healthhttp://www.dhh.louisiana.gov/offices/?ID=79

http://www.who.int/en/

http://www.rkb.gov/

http://www.ncbi.nlm.nih.gov/pubmed/

http://www.ncbi.nlm.nih.gov/pubmed/

http://www.dhh.louisiana.gov/offices/?ID=79

http://www.dhh.louisiana.gov/offices/?ID=79


QUESTIONS?Category |A| Biological Agents

category | a | biological agents

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