DPT 8.0
Biological Agent Detection
•Many biological agents can be identified by standard hospital laboratory techniques •Standard laboratory procedures may require 12 to 48 hours to yield results •Treatment should be based on index of suspicion; should not await test results
BIOLOGICAL AGENT DETECTION

Detection and identification of biological warfare agents in the hospital environment could, in some cases, be accomplished using standard laboratory microbiology or serology techniques.  The use of cultures, microscopy, immunofluorescence assays, and Gram’s and other staining procedures (and in some cases, virus isolation techniques) can help identify the causative organisms for anthrax, plague, smallpox and some viral hemorrhagic fevers. Enzyme-linked immunosorbent assays (ELISA) are capable of identifying botulinum, ricin, and other toxins.

Unfortunately, performing cultures and other procedures on some biological agents is extremely risky, and the generation of secondary aerosols could easily lead to casualties among laboratory personnel.  Some biological agents are so infective that even warfare research laboratories have handled them only under extremely sophisticated biological safety conditions.  In addition, analysis techniques that are readily available are rarely rapid procedures, and even tests which can be accomplished in-house may not yield results for 12 to 48 hours.  Some specialized laboratories can perform extremely accurate and sensitive testing, such as the DNA-based polymerase chain reaction (PCR), but results of these tests could be significantly delayed.

Like nerve agent patients, the initial treatment for biological agent victims will very likely be based on their condition at presentation and in the hours that follow, and on an index of suspicion that a biological incident has occurred.  Withholding specific antibiotics or other definitive treatment pending laboratory confirmation of the causative organism could sharply decrease the chances of successful recovery from infection by some agents.