U.S. Army Medical Research Institute

Pathophysiology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21701-5011... 

Tohoku University, 120,232 U.S. Army Medical Research Institute of Infectious Diseases, 176 U.S. Food and Drug Administration, 29,241 University of Alaska, 29 University of British Columbia, 312 University of California—Berkeley, 107,290 University of Chicago, 204 University of Florida, 279 University of Hawaii, 232 University of Maryland, 78,107333 University of Miami, 166 University of Rhode Island, 21 University of Utah, 256 University of Virginia, 347 University of Zurich, 347 University of the Philippines, 256 Varian Associates, Inc., 66 Wright State University, 87 Yale University, 29... 

Isolation Procedures Once a victim of chemical or biological agents or weapons gets to the hospital or another healthcare facility, that person may have to abide by patient isolation procedures. These include Standard Precautions, Airborne Precautions, Droplet Precautions, and Contact Precautions. These precautions are spelled out in the third edition of Medical Management Of Biological Casualties Handbook published by the U.S. Army Medical Research Institute of Infectious Disease located at Fort Detrick in Frederick, Maryland. 

Drugs There is an antitoxin stored at the CDC. To arrange to use this antitoxin, call your state health department (or CDC at 404-639-2206 or 404-639-3753 workdays, or call weekends or evenings at 404-639-2888). This chemotherapy (antitoxin) available from CDC is a licensed trivalent equine antitoxin for serotypes A, B, and E. There is no reversal of botulism disease with this drug, but the antitoxin does usually prevent further nerve damage. The U.S. Department of Defense (DOD) has a heptavalent equine despeciated antitoxin for serotypes A - G (IND). DOD also has pentavalent toxoid (vaccine) for serotypes A - E (IND). The currently recommended schedule is for use at zero, two, and twelve weeks with a one year booster. This vaccine is supposed to induce solidly protective antitoxin levels in greater that 90 percent of those vaccinated after one year. Contact USAMRIID, (U.S. Army Medical Research Institute of Infectious Diseases), Fort Detrick, Maryland. Tel. 301-619-2833. 

Information about clinical diagnosis and management can be found elsewhere.1-9 Additional information about responding to bioterrorism is available from CDC at http // www.bt.cdc.gov the U.S. Army Medical Research Institute of Infectious Diseases at http // www.usamriid.army.mil/education/bluebook.html the Association for Infection Control Practitioners at http //www.apic.org and the Johns Hopkins Center for Civilian Biodefense at http //www.hopkins-biodefense.org. 

U.S. Army Medical Research Institute of Infectious Diseases... 

Our initial expectations were that we would interview far more FDA officials than we did. However, we ended up interviewing more DoD officials, at all levels of policy and operations. Officials were interviewed in the following DoD offices Anthrax Vaccine Immunization Program (AVIP) J-4 Eogistics Directorate Office of the ASD(HA) JPO-BD the Defense Supply Center in Philadelphia Office of the Assistant to the Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs U.S. Army Soldier Biological and Chemical Command U.S. Army Medical Materiel Development Activity and U.S. Army Medical Research Institute of Infectious Diseases... 

Two research programs (science and technology base) remain under USAMRMC, one for medical chemical defense and the other for medical biological defense. USAMRMC exercises its responsibility for these programs through the U.S. Army Medical Research Institute of Chemical Defense for chemical warfare defense and USAMRllD for biological warfare defense (Parker interview, 2001). 

U.S. Army Medical Command. (1999). Medical management of chemical casualties course, medical response to chemical warfare and terrorism [Satellite broadcast]. Aberdeen Proving Ground, MD U.S. Army Medical Research Institute for Chemical Defense and U.S. Federal Drug Administration. 

Epidemiological Clues to a Biological Event. With awareness of the baseline data for their practice setting, nurses should be alert for unusual patterns of disease or health-related indicators. Representative examples of unusual patterns of diseases that might suggest a deliberate bioterrorist act are presented in Table 22.1 (U.S. Army Medical Research Institute of Infectious Diseases [USAMRIID], 2005 U.S. Department of Health and Human Services [USDHHS], 2001). 

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