Bioterrorism Agents ndash; PlagueLesson 8.ppt

Bioterrorism Agents – PlagueLesson 8 Scenarios and Questions Overview Developing scenario Questions to review knowledge Additional questions for laboratorians and veterinarians Plague Scenario Question 1 Physician in Hartford, Connecticut 35yo male, no underlying Fever, chills, malaise, myalgias x 3 days Productive cough, watery mucoid sputum, chest pain x 1 day What would you review to rule out other diseases? Plague Scenario Question 1 What would you review to rule out other diseases? Mediastinum on x-ray Progression of disease Presence of influenza A and C A, B and C Plague Scenario Question 1 What would you review to rule out other diseases? A, B and C Mediastinum on x-ray Progression of disease Presence of influenza Plague Scenario Question 2 Patient deteriorating rapidly No widening of mediastinum No influenza in community You suspect plague What specimens will you collect for laboratory workup? Plague Scenario Question 2 What specimens will you collect for laboratory workup? Pharyngeal swabs Tracheal wash or aspirates Sputum specimens Serology All of the above Plague Scenario Question 2 What specimens will you collect for laboratory workup? E. All of the above Pharyngeal swabs Tracheal wash or aspirates Sputum specimens Serology Plague Scenario Question 3 Laboratory initial report Small, gram-negative, bipolar-staining, plump rods in single, short chains Catalase positive Oxidase and urease negative Unable to rule out Y. pestis You suspect plague What is your next step? Plague Scenario Question 3 What is your next step? Shut down the hospital Refer to hospitals reference laboratory Call public health All of the above Plague Scenario Question 3 What is your next step? C. Call public health Plague Scenario Question 4 You’ve contacted your hospitals infection control practitioner What should your infection control practitioner recommend to you? Plague Scenario Question 4 What should your infection control practitioner recommend to you? Patient on r