NBC BIOLOGICAL WARFARE THREAT ASSESTMENT

File: 970616_dec96_decls45_0003.txt
Page: 0003
Total Pages: 7
Subject = NBC BIOLOGICAL WARFARE THREAT ASSESTMENT                        

Parent Organization = MCCDC       

Unit = WDID        

Folder Title = NBC MISCELLANEOUS MESSAGES SEC   OF 2  WDID SWA 0008                                            

Document Number =         34

Box ID = BX600138




                                  UNC4'---ASSIFIED
           • Laboratory

                 •  Gram stain usually not helpful
                 a  Dark-Fiold or ph&%* contrast microscopy will show
                    large numbers of cholera organisms, exhibiting
                    characteristic "shooting star" motility
                 •  Culture/sensitivity pi stool or rectal swab
                 •  Seralogy not useful/.hot n*aws"ry
                 o  Blood cultures not r@wc*ssaryl'will.bw n*gattivo@

           • Sample collection/tran*pQrt

                 o Transmit stool$ rectal   swabs, or standard inoculated
                    rectal culture transport media
                         Do not 4r*vxw; avoid temporaturts > 100 F

           a  Regional laboratory

                 o  NAMRU3, Cairo
                 c  Recommend sot up NAMRU3 detachment at a large
                    local medical centers perhaps leasing local
                    4acilitiw%.
                 o  Hospital *hips can also culture +or cholera
                 o  Many large ships could do cholera cultures,
                    but demand would probably rapidly overwhelm
                    their lab% And exha@st their supplies

           a Egportable training package
                 a Simple handout shoul'd suffice

      TREATMENT


           a Field

                 •  Emergency roplaawmant'af--fluids/olectralytts is
                    critical to survival
                      -  Mar* w*ttr insui+ici-ent
                      -  N*wd salts, glucose
                 • Most  -rakse% can be manage bg oral fluids
                      -  Treat promi3tly.to avoid worsening patient
                         to point where IV is required
                      -  IV if stool @olume > 100 ml/kg/24 hr
                 o Estimate initial'iluid lo%* and replace rapidly
                      - Patients requiring IV should have initial
                         loss replaced within.the first hour
                      -  Continue fluios  to match stool output









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