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Biological Threats

Health emergencies may occur naturally (more likely) or as the result of intentional actions by those who wish to harm others. Each health emergency will differ in the population of people affected, the number of people affected, and the type and severity of illness in the affected persons.

Many health emergencies are the result of infectious diseases. Infectious diseases are caused by microbes, including bacteria, viruses, fungi or protozoa. To cause disease, a microbe must enter a person's body. Though there are multiple methods for microbes to enter the body, the most frequent routes of microbe entry are through the lungs, ingestion, mucous membranes (eyes, nose or mouth), and contact with injured skin. Typically, when a microbe enters a person's body, the person's immune system works to fight it off and prevent infection. If the immune system is unsuccessful and the microbe encounters an environment favorable for growth, the person will likely develop an infection. Types of viral illnesses that may be considered health emergencies, depending on the situation, include various influenza (flu) strains, measles, SARS, West Nile Virus, and an intentional release of smallpox. Types of bacterial illness that may be considered health emergencies include bacterial meningitis, botulism (caused by a bacterial toxin), and anthrax. Bacterial illness can usually be successfully treated with antibiotics. Some microbes can be spread from person to person while others require direct contact with the primary source.

Unlike an explosion, a biological attack may or may not be immediately obvious. While it is possible that you will see signs of a biological attack, as was sometimes the case with the anthrax mailings, it is perhaps more likely that local health care workers will report a pattern of unusual illness or there will be a wave of sick people seeking emergency medical attention. You will probably learn of the danger through an emergency radio or TV broadcast, or some other signal used in your community. You might get a telephone call or emergency response workers may come to your door.

In the event of a biological attack, public health officials may not immediately be able to provide information on what you should do. It will take time to determine exactly what the illness is, how it should be treated, and who is in danger. However, you should watch TV, listen to the radio, or check the Internet for official news including the following:

Are you in the group or area authorities consider in danger?
What are the signs and symptoms of the disease?
Are medications or vaccines being distributed?
Where? Who should get them?
Where should you seek emergency medical care if you become sick?

During a declared biological emergency

If a family member becomes sick, it is important to be suspicious.
Do not assume, however, that you should go to a hospital emergency room or that any illness is the result of the biological attack. Symptoms of many common illnesses may overlap.
Use common sense, practice good hygiene and cleanliness to avoid spreading germs, and seek medical advice.
Consider if you are in the group or area authorities believe to be in danger.
If your symptoms match those described and you are in the group considered at risk, immediately seek emergency medical attention.

If you are potentially exposed

Follow instructions of doctors and other public health officials.
If the disease is contagious expect to receive medical evaluation and treatment. You may be advised to stay away from others or even deliberately quarantined.
For non-contagious diseases, expect to receive medical evaluation and treatment.

If you become aware of an unusual and suspicious substance nearby

Quickly get away.
Protect yourself. Cover your mouth and nose with layers of fabric that can filter the air but still allow breathing. Examples include two to three layers of cotton such as a t-shirt, handkerchief or towel. Otherwise, several layers of tissue or paper towels may help.
Wash with soap and water.
Contact authorities.
Watch TV, listen to the radio, or check the Internet for official news and information including what the signs and symptoms of the disease are, if medications or vaccinations are being distributed and where you should seek medical attention if you become sick.
If you become sick seek emergency medical attention.

If There is a Biological Threat

If you become aware of an unusual and suspicious release of an unknown substance nearby, it doesn't hurt to protect yourself. Be prepared to improvise to protect your nose, mouth, eyes and cuts in your skin.
Cover your mouth and nose with layers of fabric that can filter the air but still allow breathing. For example, two to three layers of cotton such as a t-shirt, handkerchief or towel. Otherwise, several layers of tissue or paper towels may help.
Wash with soap and water.
Contact authorities.

Cover Your Nose and Mouth

Be prepared to improvise with what you have on hand to protect your nose, mouth, eyes and cuts in your skin. Anything that fits snugly over your nose and mouth, including any dense-weave cotton material, can help filter contaminants in an emergency. It is very important that most of the air you breathe comes through the mask or cloth, not around it. Do whatever you can to make the best fit possible for children. There are also a variety of face masks readily available in hardware stores that are rated based on how small a particle they can filter in an industrial setting. Simple cloth face masks can filter some of the airborne "junk" or germs you might breathe into your body, but will probably not protect you from chemical gases. Still, something over your nose and mouth in an emergency is better than nothing.

Antibiotics

While antibiotics are often an appropriate treatment for the diseases associated with biological weapons, the specific drug must match the illness to be effective. One antibiotic, for example, may be appropriate for treating anthrax exposure, but is inappropriate for treating smallpox. All antibiotics can cause side effects including serious reactions. Plan to speak with your health care provider in advance about what makes sense for your family.

Use Common Sense

At the time of a declared biological emergency, if a family member becomes sick, it is important to be suspicious. Do not automatically assume, however, that you should go to an emergency room or that any illness is the result of the biological attack. Symptoms of many common illnesses may overlap. Use common sense, practice good hygiene and cleanliness to avoid spreading germs, and seek medical advice.

Stay healthy. Eat well. Get plenty of rest.
Use common sense to determine if there is immediate danger.
Wash your hands with soap and water frequently.
In a declared biological emergency or developing epidemic, there may be reason to stay away from crowds where others may be infected.
There may be times when you would want to consider wearing a face mask to reduce spreading germs if you yourself are sick, or to avoid coming in contact with contagious germs if others around you are sick.

Symptoms

If a family member develops any of the symptoms below, keep them separated from others if possible, practice good hygiene and cleanliness to avoid spreading germs, and seek medical advice.

A temperature of more than 100 degrees
Nausea and vomiting
Stomachache
Diarrhea
Pale or flushed face
Headache
Cough
Earache
Thick discharge from nose
Sore throat
Rash or infection of the skin
Red or pink eyes
Loss of appetite
Loss of energy or decreases in activity

Hygiene

If someone is sick, you should practice good hygiene and cleanliness to avoid spreading germs.
Wash your hands with soap and water frequently.
Do not share food or utensils.
Cover your mouth and nose when coughing or sneezing.
Consider having the sick person wear a face mask to avoid spreading germs.
Plan to share health-related information with others, especially those who may need help understanding the situation and what specific actions to take.