Biological Warfare (cont.)

Medical Author:

Edmond Hooker, MD, DrPH

Edmond Hooker, MD, DrPH

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Staphylococcal enterotoxin B (SEB) is one of the best-studied and, therefore, best-understood toxins.

Staphylococcal enterotoxin is one of the most common causes of food poisoning. Nausea, vomiting, and diarrhea normally occur after someone eats or drinks contaminated food.

The toxin creates different symptoms when exposure is through the air in a biological warfare situation. Only a small, inhaled dose is necessary to harm people within 24 hours of inhalation.

Signs and Symptoms

After exposure, signs and symptoms begin in two to 12 hours. Mild-to-moderate exposure to SEB produces fever, chills, headache, nausea, vomiting, shortness of breath, chest pain, body aches, and a nonproductive cough. Severe exposures can lead to a toxic shock-type picture and even death. Depending on the severity of exposure, the illness may last three to 10 days.

Diagnosis

Diagnosis of SEB can be difficult. Laboratory tests and a chest X-ray may be performed. Nasal swabs may show the toxin for 12-24 hours after exposure.

Treatment

Doctors provide care to relieve symptoms. Close attention to oxygenation and hydration are important. People with severe SEB may need help breathing with a ventilator. Most victims are expected to do well after the initial phase, but the time to full recovery may be long.

Prevention

No approved human vaccine exists for SEB, although human trials are ongoing. Passive immunotherapy agents have demonstrated some promise when given within four hours of exposure, but such therapy is still being tested.

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