CLINICAL RECOGNITION AND MANAGEMENT OF PATIENTS EXPOSED TO BIOLOGICALWARFARE AGENTS

Concern regarding the use of biological agents-bacteria, viruses, or t oxins-as tools of warfare or terrorism has led to measures to deter th eir use or, failing that, to deal with the consequences. Unlike chemic al agents, which typically lead to violent disease syndromes within mi nutes at the site of exposure, diseases resulting from biological agen ts have incubation periods of days. Therefore, rather than a paramedic , it will likely be a physician who is first faced with evidence of th e results of a biological attack. We provide here a primer on 10 class ic biological warfare agents to increase the likelihood of their being considered in a differential diagnosis. Although the resultant diseas es are rarely seen in many countries today, accepted diagnostic and ep idemiologic principles apply; if the cause is identified quickly, appr opriate therapy can be initiated and the impact of a terrorist attack greatly reduced.