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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> > <a href="." class="crumb_link">Pediatric Terrorism and Disaster Preparedness</a> > Table 4.1</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Pediatric Terrorism and Disaster Preparedness </span></td>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
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<h3>Table 4.1. Early Clinical Signs and Symptoms After Exposure to Selected Bioterrorist Agents</h3>
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<table border="1" cellspacing="0" cellpadding="2" width="90%">
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<tr valign="top">
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<th scope="col" width="40%">Clinical Signs and Symptoms<sup><a href="#notea">a</a></sup></th>
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<th scope="col" width="60%">Agent or Disease</th>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2">Respiratory</td>
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</tr>
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<tr valign="top">
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<td scope="row">Influenza-like illness ± atypical pneumonia</td>
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<td><p>Tularemia.<br />
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Brucellosis.<br />
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Q fever.<br />
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Venezuelan equine encephalomyelitis.<br />
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Eastern equine encephalomyelitis.<br />
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Western equine encephalomyelitis.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Influenza-like illness with cough and respiratory distress</td>
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<td><p>Inhalational anthrax.<br />
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Pneumonic plague.<br />
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Inhalational tularemia.<br />
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Ricin.<br />
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Aerosol exposure to <em>Staphylococcal enterotoxin B.</em><br />
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Hantavirus.</p>
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</td>
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</tr>
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<tr valign="top">
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<td scope="row">Exudative pharyngitis and cervical lymphadenopathy</td>
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<td>Oropharyngeal tularemia</td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Neurologic</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Flaccid paralysis</td>
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<td>Botulism</td>
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</tr>
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<tr valign="top">
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<td scope="row">Encephalitis</td>
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<td><p>Venezuelan equine encephalomyelitis.<br />
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Eastern equine encephalomyelitis.<br />
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Western equine encephalomyelitis.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Meningitis</td>
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<td><p>Inhalational anthrax.<br />
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Septicemic and pneumonic plague.<br />
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Venezuelan equine encephalomyelitis.<br />
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Eastern equine encephalomyelitis.<br />
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Western equine encephalomyelitis.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Gastrointestinal</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Diarrhea</td>
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<td><p><em>Salmonella</em> species.<br />
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<em>Shigella dysenteriae</em>.<br />
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<em>Escherichia coli</em> O157:H7.<br />
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<em>Vibrio cholerae</em>.<br />
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<em>Cryptosporidium parvum</em>.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Vomiting, abdominal pain, bloody diarrhea, hematemesis</td>
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<td>Gastrointestinal (GI) anthrax</td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Dermatologic</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Vesicular rash<sup><a href="#noteb">b</a></sup> associated with fever, headache, malaise </td>
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<td>Smallpox</td>
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</tr>
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<tr valign="top">
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<td scope="row">Painless ulceration progressing to black eschar</td>
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<td>Cutaneous anthrax</td>
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</tr>
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<tr valign="top">
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<td scope="row">Ulcer plus painful regional lymphadenopathy and influenza-like illness </td>
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<td>Ulceroglandular tularemia</td>
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</tr>
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<tr valign="top">
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<td scope="row">Petechiae<sup><a href="#noteb">b</a></sup> with fever, myalgia, prostration</td>
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<td>Viral hemorrhagic fever</td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Cardiovascular</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Shock after respiratory distress</td>
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<td><p>Inhalational anthrax.<br />
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Ricin.<br />
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Viral hemorrhagic fever.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Hematologic</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Thrombocytopenia</td>
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<td><p>Brucellosis.<br />
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Viral hemorrhagic fever.<br />
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Hantavirus.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Neutropenia</td>
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<td><p>Viral hemorrhagic fever.<br />
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Venezuelan equine encephalomyelitis.<br />
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Eastern equine encephalomyelitis.<br />
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Western equine encephalomyelitis.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Hemorrhage</td>
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<td>Viral hemorrhagic fever</td>
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</tr>
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<tr valign="top">
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<td scope="row">Disseminated vascular coagulation</td>
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<td>Viral hemorrhagic fever</td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Renal</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura</td>
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<td><p><em>Escherichia coli</em> O157:H7 and other shiga toxin-producing <em>E. coli</em>.<br />
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<em>Shigella dysenteriae</em>.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row">Oliguria, renal failure</td>
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<td><p>Viral hemorrhagic fever.<br />
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Hantavirus.</p></td>
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</tr>
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<tr valign="top">
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<td scope="row" colspan="2"><strong>Other</strong></td>
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</tr>
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<tr valign="top">
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<td scope="row">Painful lymphadenopathy</td>
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<td>Bubonic plague</td>
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</tr>
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<tr valign="top">
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<td scope="row">Purulent conjunctivitis with preauricular or cervical lymphadenopathy</td>
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<td>Oculoglandular tularemia</td>
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</tr>
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</table>
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<20><><EFBFBD><EFBFBD><EFBFBD>
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<p class="size2"><a id="notea" name="notea"></a><sup>a</sup> Based on route of exposure; likely to make someone seek medical attention; other manifestations (e.g., fever, headache, vomiting, diarrhea) possible and common early on in many illnesses.<br />
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<a id="noteb" name="noteb"></a><sup>b</sup> Rashes of diseases that cause petechiae or vesicular skin lesions may start as macular or papular lesions.</p>
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<p class="size2"><a href="pedchap4.htm#Tab4.1">Return to Document</a></p>
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<p> </p>
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