Biomedical subjects
Publications and source records attributed to Larry I Lutwick.
The role of antimicrobial agent control in the war against the development of resistance is not the only issue in this conflict. In this article, the role the environment plays in the spread of pathogens is discussed.
With the development and licensure of a recombinant vaccine for the tick-borne infection Lyme disease, more attention has been paid to other vaccines that have been used or are being developed for the prevention of other tick-borne infections. This review highlights vaccine information for Lyme borreliosis, tick-borne encephalitis (TBE), Rocky Mountain spotted fever, tularaemia, Query (Q) fever, Kyasanur Forest disease (KFD) and tick paralysis. Additionally, discussion on the use of immunisation against the tick itself is included which not only can decrease veterinary tick burdens but may also decrease the transmission of arthropod-transmitted diseases.
Vaccination programmes are very successful as a preventive strategy against many infectious diseases which have had a major impact on human morbidity and mortality. One of these diseases, smallpox, has been eliminated as a natural infection. The recent concern about biological attacks has turned attention to the use of an immunisation programme to prevent infection with what are considered the most significant potentially harmful biowarfare pathogens. This review puts into perspective the available information on current immunisation and newer vaccine options for anthrax, smallpox, tularaemia, plague and botulism.
Agents of chemical warfare have inflicted mass casualties on military and civilian personnel. Although not yet deployed on populations in the United States, stockpiles exist in countries that view the United States with enmity. There are four groups of such agents. The inhalants, chlorine and phosgene, were the earliest such weapons. Cyanide gases, because of their volatility, exert their lethal consequences in enclosed spaces. The vesicants and nerve agents, currently the most successful agents of chemical mass destruction, are the major focus of this overview. Mustard, the prototype of the vesicants, and its sulfur and nitrogen analogues are aerosolized liquids that linger on victims, incapacitating through their effects on the skin, eye, and respiratory tract. Mortality is low, but morbidity is substantial and mass casualties strain health care resources. Nerve agents, by contrast, are designed to kill. All, including Tabun, Sarin, Soman, and VX, are organophosphates that inactivate acetylcholinesterase. Widespread manifestations of peripheral and central neuronal dysfunction can be fatal without timely administration of antidotes. Decontamination, axiomatic in the management of agents of chemical warfare, is outlined, and therapeutic strategies are summarized in the light of current understanding.
The often anticipated, sometimes dismissed, threat of biological terrorism became a reality in the United States in the fall of 2001 with cases of cutaneous and inhalation anthrax. As the public health sector is rapidly focusing on enhancing awareness and preparedness, this overview is intended as a primer for clinicians. The more probable events, their most prominent characteristics, and currently available management strategies are summarized. The biowarfare characteristics of plague, tularemia and botulism are summarized. The more problematic anthrax and smallpox are presented in greater detail. Epidemiological clues to a biological attack are outlined with reference to the recent literature.
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