MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL

File: 970101_sep96_decls37_0011.txt
Page: 0011
Total Pages: 23

Subject: MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL                     

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003201

Folder Title: MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL                                                     

Document Number:       1001

Folder Seq  #:         31





                                      UNCLASSIFIED









         Urinary retention or ileus may also occur. Motor symptoms
         usually are present early in disease; cranial nerves are
         affected first with blurred vision, diplopia, ptosis, and
         photophobia. Bulbar nerve dysfunction causes dysarthria,
         dysphonia, and dysphagia. This is followed by a symmetrical,
         descending, progressive weakness of the extremities along with
         weakness of the respiratory muscles. Development of
         respiratory failure may be abrupt.

            on physical examination, the patient is alert, orientated,
         and afebrile. Postural hypotension may be present. ocular
         findings may include ptosis, extraocular muscle paralysis, and
         fixed and dilated pupils. Mucous membranes of the mouth may be
         dry and crusted. Neurological examination shows flaccid muscle
         weakness of the palate, tongue, larynx, respiratory muscles,
         and extremities. Deep tendon reflexes vary from intact to
         absent. No pathologic reflexes are present, and the sensory
         examination generally is normal (although reports suggest that
         obtundation or sensory involvement may sometimes occur).




               Routine La)2oratoxy Findin=. Routine laboratory findings
            are of no value in diagnosis. The corebrospinal fluid is
            normal.

            0 niff,*rential Diagn@. The occurrence of an epidemic
            with large numbers of afebrile patients with progressive
            ocular, pharyngeal, respiratory, and muscular weakness and
            paralysis hints strongly at the diagnosis. Single cases may
            be confused with various neuromuscular disorders such at
            atypical Guillian-Barre syndrome, myasthenia gravis, or tick
            paralysis. The edrophonium (tensilon) test may be
            transiently positive in botulism. Other considerations
patients, fever
            is present, paralysis is often asymmetrical, and the
            cerebrospinal fluid is abnormal. in the present setting, it
            will be necessary to distinguish nerve-agent and atropine
            poisoning from botulinum intoxication. Briefly,
            organophosphate nerve agent poisoning results in biotic
            pupils and copious secretions. In atropine poisoning, the
            pupils are dilated and mucous membranes are dry, but central
            nervous system excitation with hallucinations and delirium
            is present. See Section IV for a more comprehensive
            differential.







                                       UNCLASSIFIED

Document 23 f:/Week-36/BX003201/MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL/medical defense against biological material:12249609313138
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003201
Unit = OTSG
Parent Organization = HSC
Folder Title = MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL
Folder Seq # = 31
Subject = MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL
Document Seq # = 1001
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 = 24-DEC-1996