MHhAwQt60n

4)Clinical diagnostic tests: no tests available but source assessment may help identify exposure characteristics (majority of trucking incidents generating exposures to humans have labels on vehicle).

5)Decontamination: none usually needed.

6)Exposure route and treatment: inhalation supportive care. Specific treatment depends on agents.

7)Differential diagnostic considerations: inhalation exposures are the single most common form of industrial agent exposure. Mucosal irritation, airways reactions, and deep lung effects depend on the specific agent.

V.Ricin (castor bean toxin):

1)Symptom onset: 18 – 24 hours.

2)Symptoms:

−Ingestion: nausea, diarrhea, vomiting, fever, abdominal pain.

−Inhalation: chest tightness, coughing, weakness, nausea, fever.

3)Signs: clusters of acute lung or GI injury; circulatory collapse and shock.

4)Clinical diagnostic tests: ELISA (from commercial laboratories) using respiratory secretions, serum, and direct tissue.

5)Decontamination: clothing removal, water rinse.

6)Exposure route and treatment: inhalation & ingestion; supportive care. For ingestion: charcoal lavage.

7)Differential diagnostic considerations: tularemia, plague, and Q fever may cause similar syndromes, as may CW agents such as Stapylococcal enterotoxin B and phosgene.

VI. T-2 mycotoxin:

1)Symptom onset: 2 – 4 hours.

2)Symptoms: dermal & mucosal irritation; blistering, necrosis; blurred vision, eye irritation; nausea, vomiting, and diarrhea; ataxia; coughing and dyspnea.

3)Signs: mucosal erythema and hemorrhage; red skin, blistering; tearing, salivation; pulmonary edema; seizures and coma.

4)Clinical diagnostic tests: ELISA from commercial laboratories; gas chromatography / mass spectroscopy in specialized laboratories.

5)Decontamination: clothing removal, water rinse.

6)Exposure route and treatment: inhalation & dermal contact; supportive care. For ingestion: charcoal lavage. Possibly high dose steriods.

7)Differential diagnostic considerations: pulmonary toxins may cause similar syndromes though with less mucosal irritation.

*The information in this card is not meant to be complete but to be a quick guide; please consult other references and expert opinion, and check drug dosages, particularly for pregnancy and children.

71

9. Use the previous text to compare various chemical terrorism agents. Which one is the most dangerous in your opinion? Why? These conversational formulas may be useful for you:

This is my way of looking at it; if you ask me …; I’d like to point out that …; to be similar in …; to have much (little) in common; that’s what I thought …; there is much variety in …; it goes without saying that … .

10. Read the text and fill in the gaps.

Biological terrorism. Confirmation and technical support

•To confirm cases, contact in-house or consulting infectious disease specialist

•Alert local diagnostic laboratory

•Department of Justice Domestic Preparedness National Response Hotline (800- 424-8802)

•If you need further help in clinical diagnosis, ______ (1) CDC hotline (770-488- 7100)

•Information about clinical diagnosis and management

CDC website for bioterrorism: www.bt.cdc.gov

Johns Hopkins Center of Civilian Biodefense: www.hopkins-biodefense.org/

Army Handbook of Medical Management of Biological Casualties (http://www.usamriid.army.mil/education/bluebook.html)

Decontamination considerations

•Decontamination of patients usually not required for biological agents

•Clothing removal & biosafety bagging is recommended

•Handle equipment used according ______ (2) standard infection control practices (see infection control practitioner or APIC website at www.APIC.org).

Institutional reporting

•If reasonable suspicion of biological warfare agent exposure, contact hospital leadership (Chief of Staff, Hospital Director, etc)

•Immediately discuss hospital emergency planning implications

Public Health Reporting

•Contact local public health office

•If unable to ______ (3) local public health officer, contact CDC: 770-488-7100

•If needed, contact the FBI (for location of nearest office, see www.fbi.gov/contact/fo/info.htm)

72

Diagnosis: Be alert to the following --

•Groups of individuals becoming ______ (4) around the same time

•Sudden increase of illness in previously healthy individuals

•Sudden increase in the following non-specific illnesses:

Pneumonia, flu-like illness, or fever with atypical features

Bleeding disorders

Unexplained rashes, and mucosal or skin irritation, particularly in adults

Neuromuscular illness, like muscle weakness and paralysis

Diarrhea

•Simultaneous disease outbreaks in human and animal or bird populations

•Unusual temporal or geographic clustering of illness (for example, patients who

______ (5) the same public event, live in the same part of town, etc.).

11.Look through the text again and say whether the statements are true or false:

−Biological agents demand decontamination of patients.

−One of the signs of biological terrorism is a large amount of people becoming ill simultaneously.

−Sudden decrease in some non-specific illnesses may warn against biological terrorism.

−In case of biological agents people, animals and birds may suffer at the same time.

12.Read the text. It contains a lot of medical terms. Look them up in the dictionary.

−Inhalation: fever, followed by abrupt onset of respiratory failure, confusion, adenopathy, bloody pleural effusions, atypical pneumonia;

−Cutaneous: initial itching papule, 1-3 cm painless ulcer, then necrotic center, lymphadenopathy;

4) Transmission and precautions: aerosol inhalation, no person-to-person transmission, standard precautions;

73

5) Prophylaxis: ciprofloxacin 500 mg or doxycycline 100 mg po q 12 hr ~ 8 weeks; amoxicillin in pregnancy and children (if susceptible); vaccine if available.

II. Botulism:

1)Incubation: 12-72 hours (range: 2 hrs – 8 days);

2)Symptoms: difficulty swallowing or speaking, symmetric descending weakness, respiratory dysfunction, no sensory dysfunction, no fever;

3)Signs: dilated or un-reactive pupils, drooping eyelids, double vision, slurred speech, descending flaccid paralysis, intact mental state;

4)Transmission and precautions: aerosol inhalation, food ingestion, no per- son-to-person transmission, standard precautions;

5)Prophylaxis: experimental vaccine has been used in laboratory workers.

III. Plague:

1)Incubation: 1-3 days by inhalation;

2)Symptoms: sudden onset of fever, chills, headache, myalgia; pneumonic; bubonic: painful lymph nodes;

3)Signs:

−Pneumonic: hemoptysis, radiographic pneumonia -- patchy, cavities, confluent consolidation, hemoptysis, cyanosis;

−Bubonic: typically painful enlarged lymph nodes in groin, axilla, and neck; 4) Transmission and precautions: person-to-person transmission in pneu-

monic forms; droplet precautions until patient treated for at least three days;

5) Prophylaxis: asymptomatic contacts or potentially exposed; doxycycline 100 mg po q 12 hr, ciprofloxacin 500 mg po q 12 hr, tetracycline 250 mg po q 6 hr (all x 7 days); vaccine production discontinued.

IV. Tularemia “pneumonic”:

1)Incubation: 2-5 days (range: 1-21 days);

2)Symptoms: fever, cough, chest tightness, pleuritic pain, hemoptysis rare;

3)Signs: community-acquired, atypical pneumonia; radiographic: bilateral patchy pneumonia with hilar adenopathy; diffuse, varied skin rash; may be rapidly fatal;

4)Transmission and precautions: inhalation of agents, no person-to-person transmission but laboratory personnel at risk; standard precautions;

5)Prophylaxis: ciprofloxacin 500 mg po q 12 hr, doxycycline 100 mg po q 12 hr, tetracycline 250 mg po q 6 hr (all x 2 wks); experimental live vaccine.

V. Smallpox:

1) Incubation: 12-14 days (range: 7-17 days);

74

2)Symptoms: high fever and myalgia, itching, abdominal pain, delirium; rash on face, extremities, hands, feet; confused with chickenpox which has less uniform rash;

3)Signs: maculopapular then vesicular rash -- first on extremities (face, arms, palms, soles, oral mucosa); rash with hard, firm pustules; rash is synchronous on various segments of the body;

4)Transmission and precautions: person-to-person transmission, airborne precautions, negative pressure, clothing and surface decontamination;

5)Prophylaxis: vaccination (vaccine available from CDC).

13.Look through the text once more and fill in the table. The first agent is already introduced in the table.

14. Translate from Russian into English.

Террористы часто выбирают для атак места массового скопления народа. Помимо собственно поражающего фактора террористического акта, люди гибнут и получают травмы еще и в результате давки, возникшей вследствие паники. Поэтому необходимо помнить следующие правила поведения в толпе:

•Выберите наиболее безопасное место. Оно должно быть как можно дальше от середины толпы, трибун, мусорных контейнеров, ящиков, оставленных пакетов и сумок, стеклянных витрин, заборов и оград.

•В случае возникновения паники обязательно снимите с себя галстук, шарф.

•При давке надо освободить руки от всех предметов, согнуть их в локтях, застегнуть одежду на все пуговицы.

•Нельзя хвататься за деревья, столбы, ограду.

•Надо стараться всеми силами удержаться на ногах.

•В случае падения необходимо свернуться клубком на боку, резко подтянуть ноги, и постараться подняться по ходу движения толпы.

75

•Не привлекайте к себе внимание провоцирующими высказываниями и выкрикиванием лозунгов.

•Не приближайтесь к агрессивно настроенным лицам и группам лиц.

•Не вмешивайтесь в происходящие стычки.

•Постарайтесь покинуть толпу.

15.Consult extra sources and speak on the following:

a)precautions taken against terrorism in Russia;

b)the way to survive being a hostage;

c)transport terrorism precautions;

d)dealing with a bomb found out.

II. Fill in the gaps with the following words:

1.Contact radiation _____ officer for help.

2.Obtain complete blood _____.

3.Externally irradiated patients are not _____.

4.Acute radiation syndrome follows a predictable pattern after substantial

_____ or catastrophic events.

5.Sudden increase in some non-specific illnesses may warn against biological

_____.

6.If reasonable _____ of a radiation event, contact hospital leadership.

7.Have your _____ done.

III. Find the correct alternative:

Terrorists often keep their activities in secret. They try to remain unseen both by the police and ordinary people. But their _____ (1) may seem unusual or

_____ (2). If the _____ (3) of strange behavior can’t have a normal explanation, _____ (4) the militia at once. Be attentive. Try and remember their appearance, names, topics of conversations, and so on. Don’t try to stop the terrorists yourself so that you would not become their first _____ (5).

76

IV. Make up sentences with the words:

1.without, Exposure, contamination, no, decontamination, requires.

2.effective, iodide, is, Potassium, within, few, hours, first.

3.warfare, agents, require, of, Chemical, usually, clothing, removal.

4.not, agents, do, Biological, demand, of, decontamination, patients.

5.usually, for, choose, places, their, public, attacks, Terrorists.

FINAL TEST

Choose the correct item.

1) ……… has affected large areas of Sub-Saharan Africa for years and many

other zones are becoming drier.

6) Yesterday’s antinuclear energy protest ……. coordinated by Greenpeace.

78

79

V.Training Students in Safety of Life

1.Read and translate the article. Compare it with your education.

Safety is always material. It does not exist in general. When people mention safety they mean safety of people in the wide sense.

Population defense envisages defense of each person in case of emergency and this is state's responsibility. Responsibility of citizens consists, first and foremost, in studying of basis of self-care and mutual aid in case of emergency, ability to implement this knowledge.

Ability of people to defend themselves is established on the grounds of training and formation of a special kind of consciousness instigating the demand to master corresponding skills and means of protection as well as activity motivation aimed at receipt of additional information, determination of corresponding choice in certain situation and participation in risk management on the level of society. Formation of this type of consciousness is based on the grounds of knowledge of risk and in its turn represents a ground for active, well-considered and goaloriented actions. Thus the most important issue in the area of human protection lies in necessity to point people's mind towards the goal of harmonious development of man, nature, technosphere and so to harness elemental forces.

In RF Constitution (Article 72) measures of prevention of catastrophes, natural disasters, epidemics and liquidation of their consequences refer to the subject of common competence of federal authority and state power machinery of entities of the Russian Federation. Federal laws "About protection of population and territories from emergencies of natural and man-caused character", "About rescue services and statue of rescuers", "About civil defense" create a basis for efficient and valuable activity in the area of emergency protection of population; dozens of by-laws, standards and provisions add to the legal basis of management.

State policy aimed at people training in the sphere of civil defense (CD) and protection in case of emergency is brought into practice in the following main directions:

•training of leaders and officials of federal bodies of executive authority, local bodies of executive authority of RF entities, local authorities in charge of CD and emergency;

•training of managers, leaders, officials and experts of organizations in charge of CD and emergency regardless proprietary form;

•training of employees of organizations being a part of civil organizations of

CD;

•training of population engaged in the sphere of production and service as well as training of population not engaged in the sphere of production and service;

•training of schoolchildren and students of general and professional educa-

tion.

RF Federal law of 21.12.94 No 68-ФЗ "About protection of people and territories from natural and man-caused emergencies" (Article 11) established obliga-

80