Table 6
Assessing the Patient for Category A Agents (
Continued
)
Pathogen(incubation period)
Systemic symptoms
Central nervoussystem
Cardiorespiratory
Gastrointestinal
Skin and mucousmembranes
Miscellaneous
Viral hemorrhagic fevers [filoviruses (e.g., Ebola, Marburg) and arenaviruses (e.g., Lassa, Machupo)]
Arenaviridae
Lassa fever
(7–14
days; range5 days–3 wk)
Gradual onset of
malaise, fever,and myalgia.
30% develop
permanent latesensorineuraldeafness. Suddenonset of deafnesshas been noted andno correlation withseverity of illness.
Cough and chest pain.
60% of childrenhave cough.
Abdominal pain,
nausea, andvomiting. 60% ofchildren havevomiting.
Conjunctival injection,
pharyngitis withwhite and yellowexudates or ulcers.
Mild disease improves
in 10 days.
High fever poor
prognostic sign.
Other neurologic
complications(tremors, confusion,seizures, and comaassociated withdeath).
Patients with severe
disease developfacial and laryngealedema, cyanosis,bleeding, andshock.Complicationsinclude pleural andpericardialeffusions.
Bloody diarrhea poor
prognostic sign.
Pharyngitis poor
prognostic sign.
Overall mortality 1–2%.
Pregnant women havethe highest mortality(16%).
Tachypnea poor
prognostic sign.
Guanarito virus:
Venezuelanhemorrhagic
fever
(7–14 days)
(Continued )
Bioterrorism Infections in Critical Care 449