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Clinician’s Role

Detecting Bioterrorism: The Clinician’s Role


Healthcare providers are “first responders” in a public health emergency or bioterrorism attack.  Early detection by astute clinicians and rapid reporting to the local health department will be critical in minimizing the impact of a public health emergency.

Bioterrorism attacks are likely to present as acute outbreaks of an unusual syndrome, or outbreak of illnesses in the “wrong” season or geographic area.
Contact the Public Health Department if you see
patient(s) with any of the following clinical syndromes:
  1. Acute severe pneumonia or respiratory distress
  2. Encephalopathy
  3. Acute onset neuromuscular symptoms
  4. Otherwise unexplained rash with fever
  5. Fever with mucous membrane bleeding
  6. Unexplained acute icteric syndromes
  7. Massive diarrhea with dehydration and collapse


In the setting of any of the following:
  1. Atypical host characteristics
    • Young (< 50 years)
    • Immunologically intact
    • No underlying illness
    • No recent international travel or other exposure to potential source of infection
  2. Serious, unexpected, acute illness
    • Abrupt onset
    • Prostration
    • Cardiovascular collapse
    • Respiratory distress
    • Obtundation/change in mental status
    • Disseminated intravascular coagulation
  3. Multiple similar cases, especially if
    • Geographically associated, or
    • Closely clustered in time
  4. Increases in common syndromes occurring out-of-season:
    • Influenza-like-illness in the summer

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