 |
|
Hemorrhagic Fever Viruses as Biological Weapons
Medical and Public Health Management
Luciana Borio, MD;
Thomas Inglesby, MD;
C. J. Peters, MD;
Alan L. Schmaljohn, PhD;
James M. Hughes, MD;
Peter B. Jahrling, PhD;
Thomas Ksiazek, DVM, PhD;
Karl M. Johnson, MD;
Andrea Meyerhoff, MD;
Tara O'Toole, MD, MPH;
Michael S. Ascher, MD;
John Bartlett, MD;
Joel G. Breman, MD, DTPH;
Edward M. Eitzen, Jr, MD, MPH;
Margaret Hamburg, MD;
Jerry Hauer, MPH;
D. A. Henderson, MD, MPH;
Richard T. Johnson, MD;
Gigi Kwik, PhD;
Marci Layton, MD;
Scott Lillibridge, MD;
Gary J. Nabel, MD, PhD;
Michael T. Osterholm, PhD, MPH;
Trish M. Perl, MD, MSc;
Philip Russell, MD;
Kevin Tonat, DrPH, MPH;
for the Working Group on Civilian Biodefense
JAMA. 2002;287:2391-2405.
Objective To develop consensus-based recommendations for measures to be taken by medical and public health professionals if hemorrhagic fever viruses (HFVs) are used as biological weapons against a civilian population.
Participants The Working Group on Civilian Biodefense included 26 representatives from academic medical centers, public health, military services, governmental agencies, and other emergency management institutions.
Evidence MEDLINE was searched from January 1966 to January 2002. Retrieved references, relevant material published prior to 1966, and additional sources identified by participants were reviewed.
Consensus Process Three formal drafts of the statement that synthesized information obtained in the evidence-gathering process were reviewed by the working group. Each draft incorporated comments and judgments of the members. All members approved the final draft.
Conclusions Weapons disseminating a number of HFVs could cause an outbreak of an undifferentiated febrile illness 2 to 21 days later, associated with clinical manifestations that could include rash, hemorrhagic diathesis, and shock. The mode of transmission and clinical course would vary depending on the specific pathogen. Diagnosis may be delayed given clinicians' unfamiliarity with these diseases, heterogeneous clinical presentation within an infected cohort, and lack of widely available diagnostic tests. Initiation of ribavirin therapy in the early phases of illness may be useful in treatment of some of these viruses, although extensive experience is lacking. There are no licensed vaccines to treat the diseases caused by HFVs.
Author Affiliations: Johns Hopkins Center for Civilian Biodefense Strategies (Drs Borio, Inglesby, O'Toole, Henderson, and Kwik) and Departments of Microbiology and Neuroscience (Dr K. M. Johnson), Johns Hopkins Schools of Medicine and Public Health, and Division of Infectious Diseases, Johns Hopkins School of Medicine (Drs Bartlett and Perl), Baltimore, Md; Critical Care Medicine Department, Clinical Center (Dr Borio), Fogarty International Center (Dr Breman), and Vaccine Research Center (Dr Nabel), National Institutes of Health, Bethesda, Md; Center for Biodefense, University of Texas Medical Branch, Galveston (Dr Peters); US Army Medical Research Institute of Infectious Diseases, Frederick, Md (Drs Schmaljohn, Jahrling, and Eitzen); National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Hughes and Ksiazek); Departments of Biology and Medicine, University of New Mexico, Albuquerque (Dr R. T. Johnson); Office of the Commissioner, US Food and Drug Administration (Dr Meyerhoff), and Office of Emergency Preparedness, Department of Health and Human Services (Dr Tonat), Rockville, Md; Office of Public Health Preparedness, Department of Health and Human Services (Drs Ascher, Lillibridge, and Russell and Mr Hauer), and Nuclear Threat Initiative (Dr Hamburg), Washington, DC; Bureau of Communicable Diseases, New York City Health Department, New York, NY (Dr Layton); and Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis (Dr Osterholm).
RELATED ARTICLE
May 8, 2002
JAMA. 2002;287(18):2437-2438.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Unique Small Molecule Entry Inhibitors of Hemorrhagic Fever Arenaviruses
Lee et al.
J. Biol. Chem. 2008;283:18734-18742.
ABSTRACT
| FULL TEXT
Receptor determinants of zoonotic transmission of New World hemorrhagic fever arenaviruses
Radoshitzky et al.
Proc. Natl. Acad. Sci. USA 2008;105:2664-2669.
ABSTRACT
| FULL TEXT
Persistence of Category A Select Agents in the Environment
Sinclair et al.
Appl. Environ. Microbiol. 2008;74:555-563.
FULL TEXT
In Vitro and In Vivo Activities of T-705 against Arenavirus and Bunyavirus Infections
Gowen et al.
Antimicrob. Agents Chemother. 2007;51:3168-3176.
ABSTRACT
| FULL TEXT
Development of Recombinant Nucleoprotein-Based Diagnostic Systems for Lassa Fever
Saijo et al.
CVI 2007;14:1182-1189.
ABSTRACT
| FULL TEXT
Lassa Virus Infection in Experimentally Infected Marmosets: Liver Pathology and Immunophenotypic Alterations in Target Tissues
Carrion et al.
J. Virol. 2007;81:6482-6490.
ABSTRACT
| FULL TEXT
Task Force III: Prevention and Control of Cardiovascular Complications of Emerging Infectious Diseases and Potential Biological Terrorism Agents and Diseases
Cooper et al.
J Am Coll Cardiol 2007;49:1398-1406.
FULL TEXT
Identification of Differentially Activated Cell-Signaling Networks Associated with Pichinde Virus Pathogenesis by Using Systems Kinomics
Bowick et al.
J. Virol. 2007;81:1923-1933.
ABSTRACT
| FULL TEXT
Ribavirin, human convalescent plasma and anti-beta3 integrin antibody inhibit infection by Sin Nombre virus in the deer mouse model
Medina et al.
J. Gen. Virol. 2007;88:493-505.
ABSTRACT
| FULL TEXT
Cross-Protection against Marburg Virus Strains by Using a Live, Attenuated Recombinant Vaccine
Daddario-DiCaprio et al.
J. Virol. 2006;80:9659-9666.
ABSTRACT
| FULL TEXT
Immunization to Protect the US Armed Forces: Heritage, Current Practice, and Prospects
Grabenstein et al.
Epidemiol Rev 2006;28:3-26.
ABSTRACT
| FULL TEXT
Activation of Triggering Receptor Expressed on Myeloid Cells-1 on Human Neutrophils by Marburg and Ebola Viruses
Mohamadzadeh et al.
J. Virol. 2006;80:7235-7244.
ABSTRACT
| FULL TEXT
Laboratory Diagnostic Systems for Ebola and Marburg Hemorrhagic Fevers Developed with Recombinant Proteins
Saijo et al.
CVI 2006;13:444-451.
FULL TEXT
A Live Attenuated Vaccine for Lassa Fever Made by Reassortment of Lassa and Mopeia Viruses
Lukashevich et al.
J. Virol. 2005;79:13934-13942.
ABSTRACT
| FULL TEXT
RNA Interference-Mediated Virus Clearance from Cells both Acutely and Chronically Infected with the Prototypic Arenavirus Lymphocytic Choriomeningitis Virus
Sanchez et al.
J. Virol. 2005;79:11071-11081.
ABSTRACT
| FULL TEXT
Adverse Effects of Ribavirin and Outcome in Severe Acute Respiratory Syndrome: Experience in Two Medical Centers
Chiou et al.
Chest 2005;128:263-272.
ABSTRACT
| FULL TEXT
Pharmacists in the Omaha Metropolitan Medical Response System
Massoomi
Am J Health Syst Pharm 2005;62:1290-1298.
ABSTRACT
| FULL TEXT
Genetic and Biochemical Evidence for an Oligomeric Structure of the Functional L Polymerase of the Prototypic Arenavirus Lymphocytic Choriomeningitis Virus
Sanchez and de la Torre
J. Virol. 2005;79:7262-7268.
ABSTRACT
| FULL TEXT
Myristoylation of the RING Finger Z Protein Is Essential for Arenavirus Budding
Perez et al.
J. Virol. 2004;78:11443-11448.
ABSTRACT
| FULL TEXT
Severe acute respiratory syndrome: report of treatment and outcome after a major outbreak
Sung et al.
Thorax 2004;59:414-420.
ABSTRACT
| FULL TEXT
Cells Expressing the RING Finger Z Protein Are Resistant to Arenavirus Infection
Cornu et al.
J. Virol. 2004;78:2979-2983.
ABSTRACT
| FULL TEXT
The small RING finger protein Z drives arenavirus budding: Implications for antiviral strategies
Perez et al.
Proc. Natl. Acad. Sci. USA 2003;100:12978-12983.
ABSTRACT
| FULL TEXT
Children Hospitalized With Severe Acute Respiratory Syndrome-Related Illness in Toronto
Bitnun et al.
Pediatrics 2003;112:e261-261.
ABSTRACT
| FULL TEXT
Clinical Features and Short-term Outcomes of 144 Patients With SARS in the Greater Toronto Area
Booth et al.
JAMA 2003;289:2801-2809.
ABSTRACT
| FULL TEXT
Bioterrorism and catastrophe response: A quick-reference guide to resources
HAN et al.
Journal of the American Dental Association 2003;134:745-752.
ABSTRACT
| FULL TEXT
Identification of Severe Acute Respiratory Syndrome in Canada
Poutanen et al.
NEJM 2003;348:1995-2005.
ABSTRACT
| FULL TEXT
DC-SIGN (CD209) Mediates Dengue Virus Infection of Human Dendritic Cells
Tassaneetrithep et al.
J. Exp. Med. 2003;197:823-829.
ABSTRACT
| FULL TEXT
Commentary on "New Challenges for Public Health Care: Biological and Chemical Weapons Awareness, Surveillance, and Response"
Schoch-Spana
Biol Res Nurs 2003;4:251-254.
A Current Review of Ebola Virus: Pathogenesis, Clinical Presentation, and Diagnostic Assessment
Casillas et al.
Biol Res Nurs 2003;4:268-275.
ABSTRACT
Ebola Virus: Immune Mechanisms of Protection and Vaccine Development
Nyamathi et al.
Biol Res Nurs 2003;4:276-281.
ABSTRACT
Smallpox, Bioterrorism, and the Neurologist
Cleri et al.
Arch Neurol 2003;60:489-494.
FULL TEXT
Modes of Transmission of Hemorrhagic Fever
Rigau-Perez et al.
JAMA 2002;288:571-571.
FULL TEXT
|
