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     There has been a lot of science regarding Anthrax Response, but not much function as to actual on scene operations. Lets’ look at the facts regarding “Bioweaponized Anthrax” and then translate them into Haz Mat Team response activities.

1] Anthrax is the standard for creating operational plans to combat the affects of an intentional bioweapon release/attack, due to its virulence. It can be killed and decontaminated, but it is hardy in the environment.

2] If your system devised will neutralize anthrax, it will neutralize all other Bioweapons.

3] It is true that there are more virulent bioweapons, but these many times cannot be neutralized, so the deployment of these may very well destroy the attacker, such as smallpox. This is why these are not probable tactical weapons, only global suicide.

4] Many countries have weaponized this material making it a reasonable credible threat.

5] The preferred method of delivery for maximum affect would be in aerosol form. There are three forms of contracting anthrax; inhalational, cutaneous, and gastrointestinal.

6] The material resembles a white/gray color powder. The powder retains its shape when manipulated with a gloved hand keeping its “egg white” color.

7] Symptoms differ depending on the “form” of exposure.

     When responding to a possible anthrax release, first protect your responders. Ultimately, level “B” CPC should be used. Many times due to the response length, Level “C” CPC with the appropriate APR {Air Purifying Respirator} canisters can be used. Care must be taken to monitor the length of timed use for each set of canisters. Responders must rotate used canisters for replacement, before they become completely clogged with particulate. The benefit with this method relieves the wearer of carrying the SCBA weight. Also, the wearer is not hampered by 45 minute time periods between bottle exchanges. If this is not available, F/F turn out gear with SCBA will suffice. After the event the entire issue of decontaminating this equipment will need to be addressed at the site. Do not take contaminated gear back to your station!

Second, once your crew is protected, isolate the material from the victim, to an area of choice.

Third, investigate and confirm a credible threat while contacting law enforcement. Once the material is identified by immunoassay detection or other method, decontamination of the affected victims can begin.

     The preferred triple prong decontamination procedure for a large scale release is to saturate all materials in bleach. For decontamination teams treating victims, this equates to 1] strip, 2] bleach, 3] soap & shower. Other forms of decontamination may increase cross-contamination, so you will need to decide how and which system you will implement for your particular situation.

1] ALL clothing becomes waste so contain in garbage bags for disposal.

2] Ideally, spray the ENTIRE bare body with bleach in aerosol form. An aerosol is a liquid pressurized into air spray droplets, think spray bottle type application.

3] Provide soap & shower to the victim. After decontamination, release to EMS for treatment and transportation. The closer the victim was to the exclusion zone, the more demanding decontamination you implement, and the lower mortality rate. Once decontamination is completed, there is “NO” patient to responder infection risk.

     Since the infection affects vary from 2-43 days {10 days for the actual Sverdlovsk Russia incident in 1979} symptoms vary by the {form} of exposure. “Inhalational” exposure has a mortality of 86-100% despite medical treatment. Early stages of infection will present fever, sweating, respiratory distress, cyanosis, headaches, delirium, and septic shock. In general, worsening flu-like symptoms will be observed.  

     “Cutaneous” form of exposure has a mortality of <5% {treated} – 20% {untreated} and is accomplished through breaks in the skin contacting the agent. These symptoms are painless black skin ulcers at the point of contact, usually the hands, arms, neck and head. The incubation time for this form ranges from 3-5 days with 12 days at a maximum. If untreated, systemic disease can develop leading to gastrointestinal results. Good hand washing techniques demonstrate this lowered mortality.

     The “Gastrointestinal” form approaches 100% mortality and demonstrates poor hand washing techniques from contact with the agent prior to consumption. Early symptoms include oral or esophageal ulcers, edema, nausea, vomiting and malaise. Early diagnosis without blood work is difficult due to non-specific symptoms that are initially mild in nature. Also, there are no readily available, rapid, specific tests without hospitalization.  

     If the Haz Mat Team finds actual agent on the scene, it should be placed in a sealed bag such as a zip-lock type and secured for CDC {Center for Disease Control} analysis. Your decontamination of exterior sample containers must include contact bleaching and rinsing, before being passed to the aforementioned authorities.  

                                                                          Haz Mat Mike

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