Agents/Diseases |
Pathogen |
Likely Presentation When Used as a Bioweapon |
Cutaneous Manifestations |
Brucellosis (undulant fever) |
Brucella species |
Flulike symptoms (fever, sweats, headaches, back pains, and physical weakness) |
May cause wound infection |
Epsilon toxin |
Clostridium perfringens |
Pulmonary edema leading to renal failure and cardiovascular collapse* |
None |
Food safety threats |
Salmonella species Escherichia coli 0157:H7 Shigella |
GI symptoms “Rose spots” in typhoid fever (Salmonella typhi)† |
Glanders |
Burkholderia mallei |
Pulmonary: malaise, headache, pleurisy† |
Inoculation nodule and lymphadenitis, ulcerated nodule, mucous membrane ulceration with granulomatous reaction† |
Melioidosis |
Burkholderia pseudomallei |
Pulmonary: symptoms of mild bronchitis to severe pneumonia, but normal sputum
Bloodstream: Usually affects immunosuppressed patients and leads to septic shock
Chronic Suppurative: Organ abscesses throughout the body |
Inoculation through breaks in the skin may form nodule Pustules or subcutaneous abscesses (10-20%); in children, suppurative parotitis† |
Psittacosis |
Chlamydia psittaci |
Fever, chills, headache, muscle aches, dry cough, pneumonia |
Horder spots (pink macules similar to typhoid rose spots), acrocyanosis, superficial venous thrombosis, splinter hemorrhages, erythema multiforme, erythema nodosum† |
Q Fever |
Coxiella burnetti |
Pneumonia with nonproductive cough due to aerosolization and inhalation of organism; high fever, vomiting, diarrhea |
Occasionally can cause erythema nodosum and erythema annulare centrifugum† |
Ricin toxin |
From Ricinus communis (castor beans) |
Inhalation: Sudden onset congestion, respiratory distress (possibly leading to respiratory failure), flulike symptoms (fever, nausea, muscle pain)
Ingestion: mucosal ulceration and hemorrhage leading to severe GI distress; splenic, hepatic, and renal bleeding*, ‡ |
Allergic reaction: Erythema, vesication, irritation, and pain may occur |
Staphylococcal enterotoxin B |
From specific strains of Staphylococcus aureus |
Inhalation: Flulike symptoms, respiratory distress, chest pain, cough
Ingestion: food poisoning symptoms (nausea, vomiting, abdominal cramping, diarrhea)*, ‡ |
None |
Typhus |
Rickettsia prowazekii |
Malaise, myalgias, headaches, fever, chills; neurologic symptoms such as meningismus and coma may develop |
Centrifugally spreading eruption that spares the palms and soles; begins as erythematous, nonconfluent, blanching macules that become maculopapular and petechial |
Viral encephalitis |
Togaviridae (Eastern equine encephalitis, Venezuelan equine encephalitis, and Western equine encephalitis viruses)§
Flaviviridae (Japanese encephalitis, St. Louis encephalitis, West Nile Virus)
Bunyaviridae, Arenaviridae, Paramyxoviridae¶ |
Decreased consciousness, seizures, focal neurologic signs, encephalitis,§ fever, headache, flulike symptoms, nausea, vomiting, diarrhea¶ |
Facial/periorbital edema, jaundice, flushing, lymphadenopathy, alopecia, palatal vesicular or petechialeruption, cutaneous morbilliform or petechial eruption may be present¶ |
Water safety threats |
Vibrio cholerae (cholera) Cryptosporidium parvum (cryptosporidiosis) |
Nausea, vomiting, headache, diarrhea (described as rice-water stool in cholera) |
Skin infection through open wound and hemorrhagic bullous lesions have occurred with Vibrio, but are very rare |
From the CDC Web site unless otherwise indicated. |
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