Age of Bioterrorism: Are You Prepared? Review of Bioweapons and Their Clinical Presentation for Otolaryngologists.

http://www.ncbi.nlm.nih.gov/pubmed/24757076

Abstract

OBJECTIVES:

This review on Category A bioweapons is intended to help otolaryngologists (1) understand the concepts of bioterrorism, (2) identify a bioterrorism attack, and (3) recognize specific otolaryngologic symptoms and signs of Category A bioweapons.

DATA SOURCES:

PubMed and Medline databases.

REVIEW METHODS:

Review of current literature regarding Category A agents of biological warfare and their relationships to otolaryngology was performed using PubMed, Medline, and articles written by experts in the field of bioterrorism. Each Category A agent was paired with the term otolaryngology and then paired with epistaxis, sinusitis, airway obstruction, pharyngitis, tonsillitis, hearing loss, otitis media, and lymphadenopathy individually. For the latest accepted treatment and diagnostic strategies, bioterrorism was searched with filters for human studies, English language, and the past 5 years. Titles, abstracts, and papers were read for relevancy.

CONCLUSION:

While the use of bioweapons initially leads to nonspecific symptoms, a high index of suspicion and clustering of abnormal pathology will often lead the astute physician to the correct diagnosis of bioweapons. Some disease presentations of Category A agents (anthrax, smallpox, tularemia, botulism, plague, hemorrhagic fever) will involve the realm of otolaryngology( Ear, Nose & Throat Specialist).

IMPLICATIONS FOR PRACTICE:

The head and neck manifestations of a Category A bioweapon attack will require knowledgeable otolaryngologists for prompt diagnosis, treatment, and notification of public authorities. This will help decrease the morbidity and mortality of any potential bioterrorism attack.

© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

KEYWORDS
Category A agents; anthrax; bioterrorism; bioweapons; botulism; hemorrhagic fevers; plague; smallpox; tularemia

CDC – Laboratory diagnosis of Ebola virus disease

http://www.cdc.gov/vhf/ebola/diagnosis/
Ebola virus is detected in blood only after onset of symptoms, most notably fever, which accompany the rise in circulating virus within the patient’s body. It may take up to three days after symptoms start for the virus to reach detectable levels. Laboratory tests used in diagnosis include:

Timeline of Infection	Diagnostic tests available
Within a few days after symptoms begin	Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing IgM ELISA Polymerase chain reaction (PCR) Virus isolation
Later in disease course or after recovery	IgM and IgG antibodies
Retrospectively in deceased patients	Immunohistochemistry testing PCR Virus isolation