Warfare agent

 Is a biological or chemical substance that can cause mass destruction or fatality.

Anthrax:
 caused by bacillus anthracis
 3 ways to be contracted: digestive, abrasions in the skin, inhalation through lungs
 Taken through direct contact with bacteria and spores. (Spores are dormant
encapsulated bacteria that become active when they enter the living host)
 No person-to person spread.
 The infection is carried to the lymph nodes and then spreads to the rest of the body by
way of blood and lymph
 High level of toxin leads to shock and death
 In the lungs – anthrax can cause buildup of fluid, tissue decay, and death. (Fatal if
untreated)
 Diagnosis: a blood test is available to detect anthrax. (it magnifies DNA from the blood
sample and matches it to anthrax DNA)
 Anthrax medications:
o Ciproxacin
o Doxycycline
o Penicillin

SMALLPOX
 Mode of transmission: air droplet, contact
 Note: Highly contagious
 Symptom begins: 7 to 17 days after exposure
 Signs and symptoms:
o fever, back pain, vomiting, malaise, headache
o papules develop 2 days after symptoms develop and progress to pustular
vesicles that are abundant on the face and extremities initially.
 There is vaccine.

BOTULISM
 Serious paralytic illness caused by a nerve toxin produced by the bacterium “clostridium
botulinum” (death can occur within 24 hours)
 Its spores are found in the soil and can spread through the air or food (improperly
canned food) or via contaminated wound.
 CANNOT spread from person to person
 Signs and symptoms:
o Abdominal cramps, diarrhea, nausea and vomiting, double vision, blurred vision,
drooping eyelids, difficulty swallowing or speaking, dry mouth and muscle
weakness
 o Neurological symptoms begin 12-36 hours after ingestion of foodborne boltulism
and 24-72 hours after inhalation and can progress to paralysis of the arms, legs,
trunk or respiratory muscles (mechanical ventilation is necessary
o If diagnosed early, foodborne and wound botulis can be treated with an
antitoxin that blocks the action of toxin circulationg in the blood.
o Other treatments include induction of vomiting, enemas, and penicillin
o No vaccine available
PLAQUE
 Caused by YERSINIA PESTIS< a bacteria found in rodents and fleas
 Plaque is contracted by being bitten by a rodent or flea that is carrying the
plaque bacterium, by the ingestion of contaminated meat, or by handling an
animal infected with the bacteria
 Transmission is by direct person-to-person spread
 Forms include:
o Bubonic – most common
o Pneumonic
o septicemia – most deadly
 s/s: usually begin within 1-3 days and includes:
o fever
o chest pain
o lymph node swelling
o productive cough
 the disease rapidly progresses to dydpnea, stridor, cyanosis, death occurs from
respiratory failure, shock and bleeding
 antibiotics are only effective if administered immediately;
 the usual medications of choice : streptomycin and gentamycin
 A VACCINE IS AVAILABLE
TULAREMIA
 Also called: dee fly fever or rabbit fever
 An infectious disease of animals caused by the bacillus francisella tularensis
 The disease is transmitted by:
o Tick
o Deer flies
o Contact with an infected animal
 s/s:
o fever
o headache
o an ulcerated skin lesion with localized lymph node enlargement,
o eye infections
o gastrointestinal ulcerayions
o pneumonia
 treatment: antibiotics
 recovery produces lifelong immunity
  a vaccine is available

HEMORRHAGIC FEVER
 caused by several viruses, including Marburg, Lassa, Junin, Ebola
 the virus is carried by the rodents and mosquitos
 the disease can be transmitted directly by person to person spread via body fluids
 S/s:
o Fever
o Headac
o Malaise
o Conjunctivitis
o Nausea
o Vomiting
o Hypotension
o Hemorhagic of tissues and organs
o Organ failure
o No specific treatment is available
o Treat: symptomatically

CHEMICAL WARFARE AGENTS

A. SARIN
a. Is a highly toxic nerve gas that can cause death within minutes of exposure
b. It enters the body through the eyes and skin and acts by paralyzing the
respiratory muscles
B. PHOSGENE
a. Is a colorless gas normally used in chemical manufacturing that if inhaled at high
concentrations for a long enough period will lead to severe respiratory distress,
pulmonary edema and death.
C. MUSTARD GAS
a. Is a yellow to brown and has a garlic-like odor that irritates the eyes and causes
skin burns and blisters
D. IONIZING RADIATION
a. Acute radiation exposure develops after s substantial exposure to radiation.
b. Exposure can occur from external radiation or internal radiation.
c. Symptoms depend on the amount of exposure to the radiation and range from:
i. Nausea and vomiting
ii. Diarrhea
iii. Fever
iv. Electrolyte imbalances
v. Neurological and cardiovascular impairment to leukopenia, purpura,
hemorrhage and death

NURSE’S ROLE FOR EXPOSURE TO WARFARE AGENTS

  Be aware that initially, a bioterrorism attack may resemble a naturally occurring
outbreak of an infectious disease
 Nurses and other health care workers must be prepared to assess and determine what
type of event occurred, the number of clients who may be affected and how and when
clients will be expected to arrive to the health care agency.
 It is essential to determine any changes in the microorganism that may increase its
virulence or make it resistant to conventional antibiotics or vaccines.

EMERGENCY RESPONSE PLAN AND DISASTER

 Know the emergency response plan of the agency
 INTERNAL DISASTER
o Are those in which the agency is in danger
 EXTERNAL DISASTER
o Occur in the community, and victims are brought to the health care facility of
care
 When the health care agency is notified of a disaster, the nurse would follow the
guidelines specified in the emergency response plan of the agency