Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Six organisms have been deemed the highest potential threats if utilized properly: anthrax, smallpox, plague, tularemia, botulism, and viral haemorrhagic fevers
DISEASE (AND AGENT) | DIAGNOSTIC ASSOCIATIONS | WEAPONIZATION RATIONALE | TREATMENT* |
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Anthrax (Bacillus anthracis) | Haemorrhagic mediastinitis | Highly lethal inhalational disease; stable spores survive desiccation; can be formulated as aerosol | Ciprofloxacin (400 mg TDS) or either (a) levofloxacin (750 mg OD) or moxifloxacin (400 mg OD) plus either (b) meropenem (2 g TDS) or imipenem (1 g QDS) or doripenem (500 mg TDS) plus (c) either linezolid (600 mg BD) or clindamycin (900 mg TDS) or rifampicin (600 mg BD) or chloramphenicol (1 g TDS/QDS) |
Smallpox (variola virus) | Synchronous exanthem | Virions stable in environment; population immunologically naïve | Supportive care; cidofovir and tecovirimat are promising investigational drugs |
Plague (Yersinia pestis) | Haemoptysis | Contagious through respiratory droplets; “Black Death” conjures fear | Gentamicin (5 mg/kg OD) or ciprofloxacin (400 mg BD) or doxycycline (200 mg × 1, then 100 mg BD) |
Tularemia (Francisella tularensis) | Plague-like illness | Bacteria stable in environment; very low infectious dose | Same as for plague |
Botulism (botulinum toxins) | Descending, flaccid paralysis | Highly potent toxin; lends itself to food and water use; cases consume vast resources | Supportive care; ventilator support; botulinum antitoxin may halt (but will not reverse) symptom progression |
Viral haemorrhagic fevers | Haemorrhagic diatheses | Fear factor is paramount; few countermeasures exist | Supportive care; ribavirin may be beneficial in select cases (e.g., Lassa fever, New World arenaviruses, Crimean-Congo hemorrhagic fever virus, hemorrhagic fever renal syndrome) when it is given under an experimental protocol: 30 mg/kg load, then 16 mg/kg QDS for 4 days, then 8 mg/kg TDS for 6 days |