N 510 Module 8: Discussion Question

N 510 Module 8: Discussion Question

N 510 Module 8: Discussion Question
N 510 Module 8: Discussion Question:
Choose one of the following biological agents and discuss epidemiology, pathogenesis, and safety issues. Then, in your response to a classmate discuss public health and vaccination considerations of your classmate’s chosen agent.

anthrax
botulism
plague
tularemia
smallpox
viral hemorrhagic fevers

Your initial posting should be 200 to 300 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be between 100 and 200 words in length. To properly “thread” your discussion posting, please click on REPLY.
N 510 Module 8: Discussion Question
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N 510 Module 8: Discussion Question – Smallpox
Potter (2011), described smallpox as the most horrible minister of death; which have been creating mayhem since the seventeen centuries. Smallpox can be released in the form of bioterrorism. This disease has been eliminated since the nineteen eighties. However, they are stilled be stored in cold storages in some countries. Countries such as North Korea is believed to have this virus and could use it for terrorist attacks.

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Smallpox is an acute contagious disease that is caused by the variola virus; this virus belongs to the genus orthopoxvirus family. This virus gains entry to the body through the skin, and respiratory system; where an inflammatory response is initiated due to the chemical protein released from the virus. Interferons, inflammatory cells, and natural cell killers will attempt to fight the invading virus; but the virus renders the body’s immune response useless and continue to spread to small blood vessels, and oropharyngeal mucosa. The skin, lungs, and bones may also be infected by the virus. The massive inflammation often results in shock and multi organs failure. Thirty percent of its victim often die (Potter 2011).
The incubation period is ten to twelve days; clinical manifestations include; fever, headache, backache, malaise, abdominal pain, vomiting, maculopapular lesions on the mucosa or the oropharynx, face, arms, trunks, and legs; pustules later develops.  Safety measure involves isolation  and avoids skin contact with affected individuals. Nutritional support and medications to treat the inflammatory process such as antibiotics and antiviral (Imperato and Imperato 2014).
Imperato, P. J., & Imperato, G. H. (2014). Smallpox inoculation (variolation) in East Africa with special reference to the practice among the Born and Gabra of northern Kenya. Journal of Community Health, 39(6), 1053-62. doi:http://dx.doi.org/10.1007/s10900-014-9928-5
Potter P. (2011). The fragrance of the Heifer’s breath. Emerging Infectious Diseases, 17(4), 763–764. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104904528&site=ehost-live
Veenema, T. G. (2018). Disaster Nursing and Emergency Preparedness for Chemical, Biological, and Radiological Terrorism and other Hazards. (4. Ed). Springer Publishing Company.
N 510 Module 8: Discussion Question – Viral Hemorrhagic Fever
Viral hemorrhagic fever includes viruses such as filovirus, arenavirus, bunyavirus, and filovirus.  Common names for these viruses include Ebola, Marburg, and yellow fever.  Symptoms of viral hemorrhagic fever include fever, malaise, vomiting, mucosal and gastrointestinal bleeding, edema, and hypotension (Veenema, 2013).  Viral hemorrhagic fever affects multiple organs of the body, damage the vascular system, and affects the bodies ability to regulate its systems (Centers for Disease Control {CDC}, 2014).
Epidemiology
Viral hemorrhagic fever transmission occurs via various routes depending on the type of virus responsible for the disease.  The filovirus, responsible for Ebola and Marburg diseases, is transmitted through primate and human contact with body fluid (Veenema, 2013).  Bats have also been identified as a reservoir for the Ebola virus (Murdoch, 2017).    Arenavirus, which causes Lassa fever, is transmitted through rodents, often in rural locations.  Bunyavirus and flavivirus are spread through mosquito and tick bites.  Mortality rates for all viral hemorrhagic fever are high, and isolation is recommended to control outbreaks (Veenema, 2013).
Pathogenesis
Viral hemorrhagic fevers attack the vascular system leading to severe hemorrhage and hypovolemia.  During the active part of viral hemorrhagic fever, the body releases cytokines which increase vascular permeability.  Due to increased permeability, the vascular system is unable to maintain volume, and circulatory shock occurs. The virus causes liver failure and disseminated intravascular coagulation.  The body’s clotting factors are depleted, and thrombocytopenia occurs (Veenema, 2013).
Safety Concerns
            Viral Hemorrhagic fever is highly contagious.  Vaccines and treatment protocols are being researched.  Strict isolation precautions are necessary when caring for patients infected with viral hemorrhagic fever.  Specimens must be transported with strict precautions and properly sealed.  There are only a few labs which can care for specimens of viral hemorrhagic fever with the proper equipment.  Safety recommendations from the Working Group for Civilian Biodefense recommends caregivers caring for patients with viral hemorrhagic fever use strict handwashing, double glove, use impermeable gowns, N-95 masks, leg and shoe coverings, face shields, and goggles.  Patients are placed on strict isolation in a quarantined area and visitors are limited.  The room the patient is in should be a negative-pressure room (Veenema, 2013).  Healthcare workers caring for patients with viral hemorrhagic fever are to be monitored for a period of twenty-one days to prevent the spread of the disease.  If an individual  is concerned about exposure to viral hemorrhagic fever, they should contact their health care provider before going to the emergency room.  The healthcare team can establish proper precautions to decrease the risk of further exposure (CDC, 2014).
References
Murdoch, D. (2017). Diseases potentially acquired by travel to Central America. Retrieved from https://www.uptodate.com/contents/diseases-potentially-acquired-by-travel-to-central-africa.
Veneema, T.G. (2013). Disaster nursing and emergency preparedness: For chemical, biological, and radiological terrorism and other hazards. New York, NY: Springer Publishing. ISBN: 978-0-8261-0865-4
Viral hemorrhagic fevers (VHFs).  (2014).  Retrieved from https://www.cdc.gov/vhf/index.html.
N 510 Module 8: Discussion Question – Botulism
Botulism is a neuroparalytic, foodborne disease caused by Clostridium botulinum, a common soil contaminant. Home processed food comprises 94% of US cases. When an infant ingests food contaminated with C. botulinum, it is infantile botulism. Wound botulism occurs in drug users when they inject intravenously or subcutaneously. This is extremely poisonous to humans. Universal and droplet precaution is practiced to care for those affected, with the strict implementation of personal protective equipment such as gloves, coat, face shields, and protective cabinet when in care. Elimination of toxin-containing food items is done to add to more morbidity and mortality, and C. Botulinum antitoxin is available (Veenema, 2013, p. 401-403).
C. botulinum is all throughout the environment, in the soil, water, saltwater sediments, dust and surfaces of many foods. Once ingested and enters the bloodstream it binds with receptors to presynaptic terminals of cholinergic synapses, traveling to vesicle and cytosol interfering with the acetylcholine release. This results in blockade of neurotransmitter release affecting the peripheral cholinergic nerve terminals (neuromuscular junction, postganglionic parasympathetic nerve endings, and peripheral ganglia) initiating bilateral descending paralysis of the muscles stimulated by cranial, spinal. And cholinergic autonomic nerves (Tailac, 2015)
References
Tailac, P. P. (2015). CBRNE – Botulism. Retrieved from https://emedicine.medscape.com/article/829125-overview
Veenema, T. G. (2013). Disaster Nursing and Emergency Preparedness: For chemical, biological, and radiological terrorism and other hazards (3rd ed.). New York: Springer Publishing Company.
N 510 Module 8: Discussion Question – Plague
Plague is caused by the bacteria, Yersinia pestis, and it exists in rodents and their fleas (Centers for Disease Control and Prevention, n.d.). The plague bacteria can be found in underdeveloped areas with a dense rat population. The last known urban outbreak of the plague in the United States associated with rats was in Los Angeles in 1924-1925 (Centers for Disease Control and Prevention, n.d.). The bacteria can be transmitted to humans from flea bites, contact with contaminated fluid or tissue, and infectious droplets. There is three type of plague: bubonic, septicemic, and pneumonic.
Bubonic plague has a sudden onset of fever, headache, chills, weakness, and swollen lymph nodes. This type is generally from the bite of an infected flea (Centers for Disease Control and Prevention, n.d.). Septicemic plaque has fever, chills, extreme weakness, abdominal pain, and skin and other tissues may become necrotic (Kugeler, Staples, Hinckley, Gage, & Mead, 2015). This results from bites of infected fleas or from handling an infected animal (Kugeler et al., 2015). Patients with pneumonic plague may develop a fever, headache, weakness, and a rapid onset of pneumonia with dyspnea, chest pain, and cough (Kugeler et al., 2015). Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs (Kugeler et al., 2015). Treatment is antibiotics and identifying the type of plague. Prevention is keeping animals free of fleas.

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