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A Primer on Biological Weapons for the Clinician, Part II
O'Byrne WT, Terndrup TE, Kiefe CI, Weissman NW. A Primer on Biological Weapons for the Clinician, Part II. Johns Hopkins Advanced Studies in Medicine. 2003 Mar 1; 3:157-167.
Unlike conventional weapons of war, agents of bioterrorism have subtlety as their devastating advantage. The creation of mass human casualty from the use of biological weapons that (in their early effects) can mimic naturally occurring disease is an increasing possibility. Clinicians must be vigilant in detecting the effects of such agents and prepared to manage the diseases they cause. Perhaps most at risk for the effects of bioterrorism are the old, the young, and those with an immunocompromised status. In this article, the history, epidemiology, clinical presentation, and effects of plague, tularemia, and viral hemorrhagic fevers are reviewed, as are methods of diagnosis and treatment. These agents can be easily weaponized, are extremely virulent, and can cause severe social upheaval if used in a bioterrorist attack. Their detection and management present unique challenges, especially for clinicians who provide care for elderly patients with comorbid conditions.