BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES

File: 120396_sep96_decls75_0003.txt
Page: 0003
Total Pages: 8

Subject: BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES                   

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES                                                   

Document Number:          1

Folder SEQ  #:        196






                                             UNCLASSIFIED


        PRIORITY                                                            T L) r.1




        FADE (:)5 RHIPAAA\\,,", S E C R F T-
            f-- .@ TR!f@t@fENT     -
        IF THE AGENT HAS EEEN ISOLATED AND    IDENTIFIED. SUSCEPTIBILITY
        TO CURRENT C-.I'JTIM ICROBIALS SHOULD BE DETERMINE) IN ORDER TO GUIDE
        THERAPY. IF THE AGENT IS UNI:'.'NOWN@ EMPIRIC, MULTI-DRUG THERAPY
        MAY SE PURSUED.   CIPROFLOXACIIJ. A O.UINOLOI@T:, HAS BROAD SPECTRUM
        ACTIVITY-THAT INCLUDES ANTHRAX. THE ARMED FORCES EPIDEMIOLOGY
        BOARD HAS RECOMMEI'Jr)EI3 THAT EVERY -SOLDIER BE ISSUFr-l SUFFICIENT
        CIPROFLOXACIN TO TREAT FOk'FIVE ]DAYS AT 500 MGM TWICE DAILY,
        THIS TIME FRAME SHOULD BE SUFFICIENT TO DETERMINE WHETHER OR NOT
        THERE HAS BEEN A BW ATTACK AND TO EITHER CONTINUE OR DISCONTINUE
        THERAPY. SUFFICIENT SUPPLIES TO TREAT EVERY SOLDIER FOR 3C) DAYS
        HAVE 85EN PROCUREE) AND ARE AVAILABLE THROUGH ROUTINE MEDICAL
        SUPPLY CHANNELS. OTHER BROAD SPECTRUM AGENTS THAT ARE WELL
        TOLERATED INCLUDE: THE TETRACYCLINES (DOXYCYCLINE ALSO HAS
        ACTIVITY AGAINST ANTHRAX) WHICH HAVE BROAD SPECTRUM ACTIVITY
        AGAINST RICKETTSIAS TO INCLUDE 0-FEVER; ERYTHROMYCIN, WHICH CAN
        COVER LEGIONELLA A140 ATYPICAL PNEUMONIA AGT7NTS; AND TH@
        ANTIFUNGAL AZOLES (KETOCONA@@OLE, FLUCONAZOLE) WHICH CAN COVER
        HISTOPLASMOSIS AND OTHER RESPIRATORY FUNGAL AGENTS.
            PRIOR TO IDENTIFICATION OF THE AGENT, A USEFUL APPROACH TO A




        PAGE 06 RHIPAAA\\\\
        LARGE NUMBER OF CASUALTIES WITH SIMILAR SYMPTOMS IS THE CLINICAL
        MINI-TRIAL. FIRST ASSIGN SEVERAL (10 TO 2(.@) PATIENTS TO TWO
        GROUPS WITH DIFFERENT COMBINATIONS OF EMPIRIC THERAPY (E.G. -
        CIPROFLOXAR,IN, ERYTHROMYCIN, [::'ETOCONAZOLE VERSUS TETRACYCLINE,
        ERYTHROMYCIN, FLUCONAZOLE) OR ANY COMBINATION AVAILABLE (E.G. -
 SHOW
        WHETHER EITHER COMBINATION IS EFFECTIVE. ONCE A RESPONSE TO A
        COMBINATION OF DRUGS IS IDENTIFIED, ANOTHER MINI-TRIAL TO
        IDENTIFY WHICH SINGLE DRUG OR COMBINATION IS MOST EFFECTIVE CAN
        GUIDE FUTURE THERAPY. RAPID IDENTIFICATION OF THE AGENT AND ITS
        SENSITIVITIES WILL GUIDE THERAPY AND COUNTERMEASURES.
        3. (U) METHODS OF DIESEMINATIDI'A:
        WHILE THE ROUTES BY WHICH INFECTIOUS DISEASES ARE NORMALLY
        SPREAD (AIR, WATER. FOOD, INSECT VECTOR) COULD BE USEE) FOR BW
        ATTACK. AEROSOLC@ SEEM THE MOST LIKELY METHOD. CONTAMINATION OF
        FOOD OR WATER SUPPLIES IS FEASIBLE AS A TERRORIST ACTIVITY BUT
        RELATIVELY IMPRACTICAL CONSIIDERING STANDARD WATER TREATMENT AND
        FODE) FREPARATIOII PROCEDURES. TARGETING OF THESE ATTACKS WOULD
        BE VERY DIFFICULT AND AFFECT A RANDOM POPULATION WITH RANDOM
        RESULTS.
        BT
        #2@914'

                                             UNCLASSIFIED



        PRIORITY                                  9 - E@

Document 8 f:/Week-36/BX003203/BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES/biological warfare defense medical guidelines:11259610131215
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES
Folder Seq # = 196
Subject = BIOLOGICAL WARFARE DEFENSE MEDICAL GUIDELINES
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 25-NOV-1996