Medical Management of Biological Casualties Handbook
U.S. Army Medical Research Institute of Infectious Diseases,Fort Detrick,
Frederick, Maryland
Peer Review Status: Internally Peer
Reviewed
Face or Acute & Nasal Blood Convalescent
Agent Swab1 Culture Smear Sera Stool Urine Other
Anthrax + + Pleural and + - - Lesion aspirates
CS fluids
mediastinal
lymph node
spleen
Brucellosis + + - + - - Bone marrow and
spinal fluid
cultures;
tissues, exudates
Cholera - - - + +
Plague + + Sputum + - - Lymph node, buboes, CSF, and
sputum culture
Tularemia + - +2 + - -
Q-fever - 4 Lesions + Lung, spleen,
lymph cultures
__________________________________________________
1Within 18-24 hours
2Fluorescent antibody test on infected lymph node smears. Gram stain has little value.
3Virus isolation from blood in appropriate containment.
4C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood
preferred. Culturing should not be done except in BL3 containment.
Face or Acute & Nasal Blood Convalescent
Agent Swab1 Culture Smear Sera Stool Urine Other
Congo-Crimean - 3 - + - - Liver
Hemorrhagic Fever
VEE - 3 - + - CSF
Clostridial + Wound + + -
Toxins tissues
SEB Toxin + - - + + + Lung
Ricin Toxin + - - + Spleen, lung,
kidney
1Within 18-24 hours
2Fluorescent antibody test on infected lymph node smears. Gram stain has little value.
3Virus isolation from blood in appropriate containment.
4C. burnetti can persist for days in blood and resists desiccation. EDTA anticoagulated blood
preferred. Culturing should not be done except in BL3 containment.
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