What is Bio-Terry ®?
Bio-Terry ® is a STAT manual for the identification and management of the principal diseases associated with a terrorist assault. The keystone is Bio-Terry ®, a unique homunculus that allows the user to envision what organs or systems are impacted by each of the twelve principal agents in a highly graphic format. The signs and symptoms associated with each disease are differentiated into early and delayed onset. In addition, particular syndromes (e.g. neurological, dermatological, respiratory) are highlighted in each chapter. Some of the biological agents are associated with classical findings that are unique to the disease, if not pathognomonic, and these, too are well demarcated.
Besides the Bio-Terry ® homunculus, what other information is found in each disease chapter?
Each chapter contains the incubation period, the specific means of dissemination, speed of onset, duration of illness, lethality, persistence, transmissibility, diagnostic samples to be taken, differential diagnosis, therapy, prophylaxis, and isolation/decontamination precautions. The material was written in a fashion not only to take care of the victims, but also to meet the psychological and physical needs of responders.
What about therapy and prophylaxis?
Drug dosages for both the adult and pediatric population are given. In addition, besides the first-line choice based on consensus of opinion in the literature, alternatives are also available, if needed, for whatever reason. Naturally, it is most definitely recommended that the user be familiar with the drugs, dosages, contraindications, side effects, and other precautions prior to administration. Because routine guidelines may be altered during an actual assault (risk versus benefit), it is advisable to contact local and Federal authorities prior to therapy.
What are the Biological Agents contained in Bio-Terry?
| Anthrax (Inhalational) | Botulinum Toxin |
| Brucellosis | Primary Pneumonic Plague |
| Q Fever | Ricin Toxin |
| Smallpox | Staphylococcal Enterotoxin B |
| Trichothecene (T2) Mycotoxin |
Typhoidal Tularemia |
| Viral Encephalitides | Viral Hemorrhagic Fever |
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What other material is contained in Bio-Terry?
Agencies of Assistance
Covert Assault Clues
Timelines
Infection Control Precautions
Major Biological Syndromes
Victim Discharge Instructions
Cross Reference
Abbreviations
Glossary
References
What are the Agencies of Assistance?
These are the major agencies with their contact numbers that should be utilized for information regarding bioterrorism and for advice should a presumed or potential attack be taking place.
What are Covert Assault Clues?
These are the 12 principal tip-offs that could indicate that a biological attack has taken place in the community.
What are the Timelines?
This is a visual representation of the typical course of each disease with the timing of its particular manifestations over a period of time. There is a Timeline for each disease.
What are Infection Control Precautions?
This is a synopsis of the four categories of infection control precautions that should be instituted when faced with a particular biological attack. Each disease is correlated with a specific set of precautions (viz. Standard, Airborne, Droplet, and Contact).
What about the Victim Discharge Instructions?
There are two templates, one for patients who are discharged with therapy and another for those who are discharged without therapy. It must be understood that in a major assault, most victims, real or otherwise, will not be admitted into the hospital. These instructions will tell the victim what to do, whom to contact, and what signs/ symptoms to watch out for. These templates can be photocopied and disseminated and used for victim tracking. To date, nothing like this has been developed.
What is the Cross Reference?
Patients will not be arriving after a covert assault with the diagnosis taped to their foreheads. The Cross Reference allows the responder to catalog the presenting signs and symptoms and match them to the most likely biological agent.
How many references have been used to develop Bio-Terry?
Over 50.
Why was Bio-Terry developed as a manual in a three-ring binder?
Biological terrorism in this country is a new phenomenon. The theory and practice associated with its recognition and management will be a constantly evolving process. Therefore, by its very nature, a hardbound textbook will be out of date by the time it is finally published. Publishing Bio-Terry in a three-ring binder allows alterations to be made and mailed out without having to re-do the entire copy. All one has to do is to remove the outdated material and substitute the new page or pages. In addition, plans are now being made to add other features to the manual (e.g. other disease such as Glanders and the use of biological agents throughout history).
With the development of all these nuclear-biological-chemical response teams in the country is Bio-Terry really needed?
First of all, these teams will not be sent out unless someone in the community recognizes that an assault has occurred and authorization is given to dispatch a respose team. Bio-Terry will improve the ability to recognize a covert assault. Secondly, even though it has been planned that these teams will be able to respond in a matter of hours, there is no guarantee that will occur. Disruptions in communications and in transportation may increase that response time from hours to days. Bio-Terry can serve as one way to manage the crisis, to buy time, until the cavalry arrives.
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