Brussels, 09 Sep 2004
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Of the numerous agents that may be used as biological weapons, a first set has been identified as deserving immediate attention in the context of this EU action. Ten clinical guidelines have been written so far, on anthrax, smallpox, botulism, tularemia, plague, viral hemorrhagic fevers, viral encephalitis, Q fever, brucellosis, glanders and melioidosis (1-10). Nearly fifty pathogens are covered in the papers that follow. Most of these agents have been studied or used as biological warfare agents. Historical data are available for most of them. All could be used in an aerosolised form which is the most effective route of contamination in a bioterrorist attack. Medline databases and pertinent articles in books and on the worldwide web were scanned for information published between 1962 to February 2003 on the agents selected.
In each of the papers that follow, after a short introduction, there is a summary of the epidemiology of the agent and its potential use in bioterrorism. In addition, recent data are included concerning the microbiological characteristics of the agent, the microbiological diagnosis and the treatment. The clinical features of the disease, the main issue of these guidelines, are then described.
The clinical guidelines were reviewed in draft form by the Task Force and by two experts designated by each Member State of the European Union. This review was completed at the end of February 2003. The revised drafts were submitted to the Health Security Committee which approved them in April 2003 and agreed their publication to a peer-review medical journal so as to permit their dissemination to as large an audience as possible. We are grateful to the reviewers of this journal for their work and valuable contribution to these guidelines.
It is hoped that the European Union Clinical Guidelines that are presented here would become a useful tool in the hands of clinicians that might be confronted by a patient infected with a bioterror agent. To keep them up to date, regular revisions will be made based on new medical knowledge and developments in science and technology. Guidelines on other agents may also be produced in the future, if circumstances so require.
References:
1) Bossi P, Tegnell A, Baka A, Van Loock F, Hendriks J, Werner A, Maidhof H, Gouvras G., European Guidelines for the clinical management of anthrax and bioterrorism-related anthrax (177 KB)
2) Bossi P, Tegnell A, Baka A, Van Loock F, Werner A, Hendriks J, Maidhof H, GouvrasG., European Guidelines for the clinical management of plague and bioterrorism-related plague (162 KB)
3) Bossi P, Tegnell A, Baka A, Van Loock F, Werner A, Hendriks J, Maidhof H, Gouvras G., European Guidelines for the clinical management of smallpox and bioterrorism-related smallpox (154 KB)
4) Bossi P, Tegnell A, Baka A, Van Loock F, Werner A, Hendriks J, Maidhof H, Gouvras G., European Guidelines for the clinical management of tularemia and bioterrorism-related tularemia (178 KB)
5) Bossi P, Tegnell A, Baka A, Van Loock F, Hendriks J, Werner A, Maidhof H, Gouvras G., European Guidelines for the clinical management of haemorrhagic fever viruses and bioterrorism-related haemorrhagic fever viruses (161 KB)
6) Bossi P, Baka A, Tegnell A, Werner A, Van Loock F, Hendriks J, Maidhof H, Gouvras G., European Guidelines for the clinical management of botulism and bioterrorism-related botulism (159 KB)
7) Bossi P, Tegnell A, Baka A, Van Loock F, , Hendriks J, Werner A Maidhof H, Gouvras G., European Guidelines for the clinical management of brucellosis and bioterrorism-related brucellosis (243 KB)
8) Bossi P, Tegnell A, Baka A, Van Loock F, Hendriks J, Werner A, Maidhof H, Gouvras G., European Guidelines for the clinical management of glanders and melioidosis and bioterrorism-related glanders and melioidosis (153 KB)
9) Bossi P, Tegnell A, Baka A, Van Loock F, Werner A, Hendriks J, Maidhof H, Gouvras G., European Guidelines for the clinical management of Q fever and bioterrorism-related Q fever (156 KB)
10) Bossi P, Tegnell A, Baka A, Van Loock F, Werner A, Hendriks J, Maidhof H, Gouvras G., European guidelines for the clinical management of viral encephalitis and bioterrorism-related viral encephalitis (198 KB)
Item source: http:///europa.eu.int/comm/health/ph_threats/Bioterrorism...