Plague as a biological weapon: Medical and public health management

Thomas V. Inglesby, David T. Dennis, Donald A. Henderson, John G. Bartlett, Michael S. Ascher, Edward Eitzen, Anne D. Fine, Arthur M. Friedlander, Jerome Hauer, John F. Koerner, Marcelle Layton, Joseph McDade, Michael T. Osterholm, Tara O'Toole, Gerald Parker, Trish M. Perl, Philip K. Russell, Monica Schoch-Spana, Kevin Tonat

Research output: Contribution to journalArticle

747 Citations (Scopus)

Abstract

Objective: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a Civilian population. Participants: The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence: MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000. Consensus Process: The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions: An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.

Original languageEnglish (US)
Pages (from-to)2281-2290
Number of pages10
JournalJournal of the American Medical Association
Volume283
Issue number17
StatePublished - May 3 2000

Fingerprint

Biological Warfare Agents
Plague
Public Health
MEDLINE
Biological Warfare
Medical Subject Headings
Bioterrorism
Yersinia pestis
Weapons
Hemoptysis
Fluoroquinolones
Bibliography
Streptomycin
Septic Shock
Gentamicins
Tetracycline
Chest Pain
Cough
Biomedical Research
Pneumonia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Inglesby, T. V., Dennis, D. T., Henderson, D. A., Bartlett, J. G., Ascher, M. S., Eitzen, E., ... Tonat, K. (2000). Plague as a biological weapon: Medical and public health management. Journal of the American Medical Association, 283(17), 2281-2290.

Plague as a biological weapon : Medical and public health management. / Inglesby, Thomas V.; Dennis, David T.; Henderson, Donald A.; Bartlett, John G.; Ascher, Michael S.; Eitzen, Edward; Fine, Anne D.; Friedlander, Arthur M.; Hauer, Jerome; Koerner, John F.; Layton, Marcelle; McDade, Joseph; Osterholm, Michael T.; O'Toole, Tara; Parker, Gerald; Perl, Trish M.; Russell, Philip K.; Schoch-Spana, Monica; Tonat, Kevin.

In: Journal of the American Medical Association, Vol. 283, No. 17, 03.05.2000, p. 2281-2290.

Research output: Contribution to journalArticle

Inglesby, TV, Dennis, DT, Henderson, DA, Bartlett, JG, Ascher, MS, Eitzen, E, Fine, AD, Friedlander, AM, Hauer, J, Koerner, JF, Layton, M, McDade, J, Osterholm, MT, O'Toole, T, Parker, G, Perl, TM, Russell, PK, Schoch-Spana, M & Tonat, K 2000, 'Plague as a biological weapon: Medical and public health management', Journal of the American Medical Association, vol. 283, no. 17, pp. 2281-2290.
Inglesby TV, Dennis DT, Henderson DA, Bartlett JG, Ascher MS, Eitzen E et al. Plague as a biological weapon: Medical and public health management. Journal of the American Medical Association. 2000 May 3;283(17):2281-2290.
Inglesby, Thomas V. ; Dennis, David T. ; Henderson, Donald A. ; Bartlett, John G. ; Ascher, Michael S. ; Eitzen, Edward ; Fine, Anne D. ; Friedlander, Arthur M. ; Hauer, Jerome ; Koerner, John F. ; Layton, Marcelle ; McDade, Joseph ; Osterholm, Michael T. ; O'Toole, Tara ; Parker, Gerald ; Perl, Trish M. ; Russell, Philip K. ; Schoch-Spana, Monica ; Tonat, Kevin. / Plague as a biological weapon : Medical and public health management. In: Journal of the American Medical Association. 2000 ; Vol. 283, No. 17. pp. 2281-2290.
@article{57904a6f73cb42728cc60c17c61d91be,
title = "Plague as a biological weapon: Medical and public health management",
abstract = "Objective: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a Civilian population. Participants: The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence: MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000. Consensus Process: The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions: An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.",
author = "Inglesby, {Thomas V.} and Dennis, {David T.} and Henderson, {Donald A.} and Bartlett, {John G.} and Ascher, {Michael S.} and Edward Eitzen and Fine, {Anne D.} and Friedlander, {Arthur M.} and Jerome Hauer and Koerner, {John F.} and Marcelle Layton and Joseph McDade and Osterholm, {Michael T.} and Tara O'Toole and Gerald Parker and Perl, {Trish M.} and Russell, {Philip K.} and Monica Schoch-Spana and Kevin Tonat",
year = "2000",
month = "5",
day = "3",
language = "English (US)",
volume = "283",
pages = "2281--2290",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "17",

}

TY - JOUR

T1 - Plague as a biological weapon

T2 - Medical and public health management

AU - Inglesby, Thomas V.

AU - Dennis, David T.

AU - Henderson, Donald A.

AU - Bartlett, John G.

AU - Ascher, Michael S.

AU - Eitzen, Edward

AU - Fine, Anne D.

AU - Friedlander, Arthur M.

AU - Hauer, Jerome

AU - Koerner, John F.

AU - Layton, Marcelle

AU - McDade, Joseph

AU - Osterholm, Michael T.

AU - O'Toole, Tara

AU - Parker, Gerald

AU - Perl, Trish M.

AU - Russell, Philip K.

AU - Schoch-Spana, Monica

AU - Tonat, Kevin

PY - 2000/5/3

Y1 - 2000/5/3

N2 - Objective: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a Civilian population. Participants: The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence: MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000. Consensus Process: The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions: An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.

AB - Objective: The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a Civilian population. Participants: The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence: MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000. Consensus Process: The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions: An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.

UR - http://www.scopus.com/inward/record.url?scp=0034600229&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034600229&partnerID=8YFLogxK

M3 - Article

C2 - 10807389

AN - SCOPUS:0034600229

VL - 283

SP - 2281

EP - 2290

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 17

ER -