Supportive
Measures. Measures should be
taken to lower temperature; relieve pain;
maintain spontaneous respiration; and
secure an intravenous access for the
administration of drugs and fluids.
Symptomatic treatment and treatment of
coexisting injuries should follow
established principles.
Isolation
Procedures (Barrier Nursing). In
the context of biological agent patients,
adherence to principles of patient
isolation is essential to preventing
cross-infection with transmissible
agents.
Antibiotic
Therapy. Antibiotics must be
given to all biological agent patients,
even without a firm diagnosis, and
commenced at the earliest possible level
of medical care.
Antiviral
Therapy. The only
"broad-spectrum" antiviral drug
currently available is ribavirin. This
compound has been a useful nonspecific
adjunct to the treatment of some
potential viral threats. Ribavirin is an
investigational antiviral drug available
via compassionate use protocols for
therapy of Lassa fever, hemorrhagic fever
with renal syndrom (HFRS), Crimean-Congo
hemorrhagic fever, and Rift Valley fever.
Ribavirin has poor in vitro and in vivo
activity against the filoviruses (Marburg
and Ebola) and the flaviviruses (Dengue
fever, Yellow fever, Omsk HF, and
Kyanasur Forest disease).
Antitoxin
Therapy. Borad-spectrum
antitoxins do no currently exist.
However, specific antitoxins are
available for certain conditions. Several
antitoxins may be available for
post-exposure use in individuals exposed
to botulinum toxins.
Vaccination.
Vaccination is the preferred method of
biological defense. Fully licensed
vaccines are currently available for
anthrax, cholera, plague and smallpox.
Vaccines for botulinum toxoid, Q fever,
Rift Valley fever, tularemia, and VEE
currently exist as investigational new
drug (IND) products and would be
available only under protocol with
informed consent, therefore would not be
readily available. No vaccine is
currently available either FDA licensed
or under IND status, for glanders,
brucellosis, Staphylococcus enterotoxin
B, ricin, or T-2 mycotoxins.
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Medical
Management of Biological Agent Patients