plague: medical management and countermeasure development

8/10/2019 PLAGUE: Medical Management and Countermeasure Development.

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Dmitri Popov, PhD, Advanced MedicalTechnology and Systems Inc. , Canada.

[email protected]

Maliev Slava, Professor, VladicaucasianResearch Center of Russian Academy ofScience.

[email protected]


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Key Words:

ROS Reactive Oxygen Species.

Neutrophils.

Macrophages.

Innate Immunity.

Adaptive Iimmunity.

Na Cl O Sodium Hypochlorite.


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ROS Reactive Oxygen Species.

Reactive oxygen species(ROS) are chemically

reactive molecules containing oxygen.Examples include oxygenionsand peroxides.ROS are formed as a natural byproduct of thenormal metabolism of oxygenand haveimportant roles in cellsignalingand homeostasis.
http://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Ionhttp://en.wikipedia.org/wiki/Peroxidehttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Cell_signalinghttp://en.wikipedia.org/wiki/Cell_signalinghttp://en.wikipedia.org/wiki/Homeostasishttp://en.wikipedia.org/wiki/Homeostasishttp://en.wikipedia.org/wiki/Cell_signalinghttp://en.wikipedia.org/wiki/Cell_signalinghttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Peroxidehttp://en.wikipedia.org/wiki/Ionhttp://en.wikipedia.org/wiki/Oxygen


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Treatment of acute severe deadly infectionsdiseases (Plague, Ebola, SARS Severe AcuteRespiratory Syndrome , MERS Middle East

Respiratory Syndrome) with I/V solutionswith Reactive Oxygen Species ( SodiumHypochlorite).


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Plague is primarily a disease of rodents andtheir fleas, which can infect humans. It istransmitted between rodents by rodent fleas,

and can be transmitted to people when infectedrodent fleas bite them.

As with many primarily zoo-notic diseases,plague is a very severe disease in people, with

case fatality rates of 50-60% if left untreated.[WHO ]


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Objective: Biological Weapon remain most dangerous threat in

the world. Bioterrorismis terrorisminvolving the intentional

release or dissemination ofbiological agents. Theseagents are bacteria,viruses, or toxins, and may be in anaturally occurring ora human-modified form. For theuse of this method in warfare, seebiological warfare.

The Working Group on Civilian Biodefense hasdeveloped consensus based

recommendations for measures to be taken by medicaland public health professionals following the use ofplague as a biological weapon against a civilianpopulation.
http://en.wikipedia.org/wiki/Terrorismhttp://en.wikipedia.org/wiki/Biological_agenthttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Biological_agenthttp://en.wikipedia.org/wiki/Toxinhttp://en.wikipedia.org/wiki/Biological_agenthttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Toxinhttp://en.wikipedia.org/wiki/Warhttp://en.wikipedia.org/wiki/Biological_warfarehttp://en.wikipedia.org/wiki/Warhttp://en.wikipedia.org/wiki/Biological_warfarehttp://en.wikipedia.org/wiki/Biological_warfarehttp://en.wikipedia.org/wiki/Biological_warfarehttp://en.wikipedia.org/wiki/Biological_warfarehttp://en.wikipedia.org/wiki/Warhttp://en.wikipedia.org/wiki/Toxinhttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Biological_agenthttp://en.wikipedia.org/wiki/Terrorism


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A biological weapon is usefulto terroristsmainly as a method of creatingmass panic and disruption to a state or a

country.http://en.wikipedia.org/wiki/Bioterrorism
http://en.wikipedia.org/wiki/Terroristshttp://en.wikipedia.org/wiki/Bioterrorismhttp://en.wikipedia.org/wiki/Bioterrorismhttp://en.wikipedia.org/wiki/Terrorists


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Under current United States law, bio-agentswhichhave been declared by the U.S. Department of Healthand HumanServicesor the U.S. Department ofAgricultureto have the "potential to pose a severethreat to public health and safety" are officially defined

as "select agents". The CDC categorizes these agents (A,B or C) and administers the Select Agent Program,which regulates the laboratories which may possess,use, or transfer select agents within the United States.As with US attempts to categorize harmful recreational

drugs, designer viruses are not yet categorized andavian H5N1 has been shown to achieve high mortalityand human-communication in a laboratory setting.

http://en.wikipedia.org/wiki/Bioterrorism#Category_A
http://en.wikipedia.org/wiki/United_States_lawhttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/Select_agentshttp://en.wikipedia.org/wiki/Select_agentshttp://en.wikipedia.org/wiki/Select_Agent_Programhttp://en.wikipedia.org/wiki/Select_Agent_Programhttp://en.wikipedia.org/wiki/Select_Agent_Programhttp://en.wikipedia.org/wiki/Select_agentshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/Bio-agentshttp://en.wikipedia.org/wiki/Bio-agentshttp://en.wikipedia.org/wiki/Bio-agentshttp://en.wikipedia.org/wiki/United_States_law


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Bubonic plague.Plague is a disease caused bythe Yersinia pestisbacterium. Rodents are the normalhost of plague, and the disease is transmitted tohumansby fleabites and occasionally by aerosolin theform of pneumonic plague. The disease has a history of

use in biological warfare dating back many centuries,and is considered a threat due to its ease of culture andability to remain in circulation among local rodents fora long period of time. The weaponized threat comesmainly in the form of pneumonic plague (infection by

inhalation).

It was the disease that caused the BlackDeathin Medieval Europe. http://en.wikipedia.org/wiki/Bioterrorism#Category

_A
http://en.wikipedia.org/wiki/Bubonic_plaguehttp://en.wikipedia.org/wiki/Yersinia_pestishttp://en.wikipedia.org/wiki/Fleahttp://en.wikipedia.org/wiki/Aerosolhttp://en.wikipedia.org/wiki/Pneumonic_plaguehttp://en.wikipedia.org/wiki/Pneumonic_plaguehttp://en.wikipedia.org/wiki/Pneumonic_plaguehttp://en.wikipedia.org/wiki/Aerosolhttp://en.wikipedia.org/wiki/Pneumonic_plaguehttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Pneumonic_plaguehttp://en.wikipedia.org/wiki/Aerosolhttp://en.wikipedia.org/wiki/Fleahttp://en.wikipedia.org/wiki/Yersinia_pestishttp://en.wikipedia.org/wiki/Yersinia_pestishttp://en.wikipedia.org/wiki/Yersinia_pestishttp://en.wikipedia.org/wiki/Bubonic_plague


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Category A

These high-priority agents pose a risk tonational security, can be easily transmitted and

disseminated, result in high mortality, havepotential major public health impact, maycause public panic, or require special action forpublic health preparedness.

http://en.wikipedia.org/wiki/Bioterrorism#Category_A


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An aerosolized plague weapon could cause fever,cough, chest pain,

and hemoptysis with signs consistent with severepneumonia 1 to 6 days after exposure.

Rapid evolution of disease would occur in the 2 to 4days after symptom onset and would lead to septic shock with high mortality

without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or

the tetracycline or fluoroquinolone classes of antimicrobials would be advised. JAMA. 2000;283:2281-2290 www.jama.com http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Plague Following Use of a Biological Weapon The epidemiology of plague following its use as a biological

weapon would differ substantially from that of naturallyoccurring infection.

Intentional dissemination of plague would most probably occur

via an aerosol of Y pestis, a mechanism that has been shown toproduce disease in nonhuman primates. A pneumonic plague outbreak would result with symptoms

initially resembling those of other severe respiratory illnesses. The size of the outbreak would depend on factors including the

quantity of biological agent used, characteristics of the strain,environmental conditions, and methods of aerosolization.

Symptoms would begin to occur 1 to 6 days following exposure,and people would die quickly following onset of symptoms.

http://www.bt.cdc.gov/agent/plague/consensus.pdf


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The bacteria migrate through cutaneo-lymphatics toregional lymph nodes where they are phagocytosedbut resist destruction.

They rapidly multiply causing destruction and

necrosis of lymph node architecture with subsequentbacteremia, septicemia, and endotoxemia can leadquickly to shock, disseminated intravascularcoagulation, and coma.

Mandell GL, Bennett JE, Dolin R, eds.

Principles and Practice of Infectious Diseases.NewYork, NY: Churchill

Livingstone; 1995:2070-2078http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Patients typically develop symptoms of bubonic plague 2 to 8 days after being bitten by an infected flea. There is sudden onset of fever, chills, and weakness

and the development of an acutely swollen tender lymph node, or bubo, up to 1 day later.

Campbell GL, Dennis DT. Plague and other Yersinia infections. In: Fauci AS, Braunwald E, Isselbacher

KJ, et al, eds. Harrisons Principles of Internal Medicine. New York, NY: McGraw-Hill; 1998: 975-

983http://www.bt.cdc.gov/agent/plague/consensus.pdf


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The bubo most typically

develops in the groin, axilla, or cervical

Region and is often so painful

that it prevents patients from moving the affected area of the body. Buboes

are 1 to 10 cm in diameter, and the overlying

skin is erythematous.

Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases.NewYork, NY: Churchill

Livingstone; 1995:2070-2078


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Septicemic plague may lead to disseminated

intravascular coagulation, necrosis of

small vessels, and purpuric skin lesions.

Gangrene of regions such as the digits andnose may also occur

in advanced disease, a process believed

responsible for the name black death in thesecond plague pandemic.


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Secondary pneumonic plague develops

in a minority of patients with bubonic or primarysepticemic plague. This process, termed secondarypneumonic plague, develops via hematogenous

spread of plague bacilli to the lungs. Patients

commonly have symptoms of severebronchopneumonia, chest pain, dyspnea, cough,and hemoptysis.

Mandell GL, Bennett JE, Dolin R, eds. Principles andPractice of Infectious Diseases.NewYork, NY: Churchill

Livingstone; 1995:2070-2078


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Plague Following Use of a Biological Weapon The pathogenesis and clinical manifestations of plague

following a biological attack would be notably different thannaturally occurring plague. Inhaled aerosolized Y pestisbacilli would cause primary pneumonic plague. The time

from exposure to aerosolized plague bacilli untildevelopment of first symptoms in humans and nonhumanprimates has been found to be 1 to 6 days and most often, 2

to 4 days. The first sign of illness would be expected to be fever with

cough and dyspnea, sometimes with the productionof bloody, watery, or less commonly, purulent sputum.http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Prominent gastrointestinal symptoms, includingnausea, vomiting, abdominal pain, and diarrhea,might be present. The ensuing clinical findings ofprimary pneumonic plague are similar to those ofany severe rapidly progressive pneumonia and arequite similar to those of secondary pneumonic

plague. Clinical-pathological features may help

distinguish primary from secondary pneumonicplague.http://www.bt.cdc.gov/agent/plague/consensus.pdf


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In contrast to secondary pneumonic plague,

features of primary pneumonic plague

would include absence of buboes (except,

rarely, cervical buboes) and, on

pathologic examination, pulmonary disease

with areas of profound lobular exudation

and bacillary aggregation.http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Laboratory studies may reveal leukocytosis

with toxic granulations, coagulationabnormalities, aminotransferase elevations,azotemia, and other evidence of multiorgan

failure. All are nonspecific findings associated withsepsis and systemic inflammatory responsesyndrome. The time from respiratory exposure todeath in humans is reported to have been between

2 to 6 days in epidemics during the pre-antibioticera, with a mean of 2 to 4 days in most epidemics.http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Diagnosis of Pneumonic Plague Infection FollowingUse of a Biological Weapon

Epidemiology and symptoms

Sudden appearance of many persons with fever,

cough, shortness of breath, hemoptysis, and chest pain Gastrointestinal symptoms common (eg, nausea,

vomiting, abdominal pain, and diarrhea)

Patients have fulminant course and high mortality

Clinical signs: Tachypnea, dyspnea, and cyanosis Pneumonic consolidation on chest examination

http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Sepsis, shock, and organ failure Infrequent presence of cervical bubo (Purpuric skin lesions and necrotic digits only in advanced

disease) Laboratory studies Sputum, blood, or lymph node aspirate

Gram-negative bacilli with bipolar (safety pin) staining on Wright,Giemsa, or Wayson stain Rapid diagnostic tests available only at some health departments,

the Centers for Disease Control and Prevention, and military laboratories Pulmonary infiltrates or consolidation on chest radiograph Pathology Lobular exudation, bacillary aggregation, and areas of

necrosis in pulmonary Parenchyma http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Working Group Recommendations for Treatment of Patients WithPneumonic

Plague in the Contained and Mass Casualty Settings and for Post-exposure Prophylaxis*

Patient Category Recommended Therapy Contained Casualty Setting

Adults Preferred choices Streptomycin, 1 g IM twice daily Gentamicin, 5 mg/kg IM or IV once daily or 2 mg/kg loading dose

followed by 1.7 mg/kg IM or IV 3 times daily Alternative choices

Doxycycline, 100 mg IV twice daily or 200 mg IV once daily Ciprofloxacin, 400 mg IV twice daily Chloramphenicol, 25 mg/kg IV 4 times daily http://www.bt.cdc.gov/agent/plague/consensus.pdf


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Mass Casualty Setting and PostexposureProphylaxis.

Adults Preferred choices

Doxycycline, 100 mg orally twice daily Ciprofloxacin, 500 mg orally twice daily

Alternative choice

Chloramphenicol, 25 mg/kg orally 4 times

daily http://www.bt.cdc.gov/agent/plague/consen

sus.pdf


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Plague BIOLOGICAL WEAPON.

Can be resistant to any form of antibiotics.


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Plague treatment with Na Cl O. : ,

, , , , -

. Method of treatment with Sodium hypochlorite

currently in use in medical practice for treatmentof different forms of Viral Infections - Viralhepatitis; human immunodeficiency virus(HIV)

is a lentivirus (a subgroup of retrovirus) thatcauses the acquired immunodeficiency syndrome(AIDS); different forms of herpes.

Can we use this method for Plague treatment?
https://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWwhttps://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWwhttps://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWwhttps://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWwhttps://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWwhttps://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&sqi=2&ved=0CB0QFjAA&url=http://en.wikipedia.org/wiki/Viral_hepatitis&ei=z8FPVJysKISVyATFv4HYBg&usg=AFQjCNES_oJiMH-aHUkooYpfiJlqQViOqA&sig2=eQbmeqSsjTw_Bdbwcxc4mg&bvm=bv.77880786,d.aWw


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Dilute bleach baths have been used for decadesto treat moderate to severe eczemain humans,

but it has not been clear why they work.According to work published by researchers at

the Stanford University School of MedicineinNovember 2013, a very dilute (0.005%) solutionof sodium hypochlorite in water was successfulin treating skin damage with

an inflammatorycomponent causedby radiation therapy, excess sun exposure oraging in laboratory mice.
http://en.wikipedia.org/wiki/Eczemahttp://en.wikipedia.org/wiki/Stanford_University_School_of_Medicinehttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Radiation_therapyhttp://en.wikipedia.org/wiki/Laboratory_micehttp://en.wikipedia.org/wiki/Laboratory_micehttp://en.wikipedia.org/wiki/Radiation_therapyhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Stanford_University_School_of_Medicinehttp://en.wikipedia.org/wiki/Eczema


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Sodium hypochlorite solution for intravenousinfusions was produced by electrolysis with devicefor electrochemical method of elaboration from

NaCl isotonic (0,89%) solution. 200400 ml of 002 %-0,03% sodium hypochlorite

solution usually administered drop-by-drop intoan the median cubital vein(or median basilic

vein) is a superficial veinof the upper limbvein atthe rate of 30-40 drops per minute. A course oftreatment included 20 procedures 1-3 proceduresevery 24 hours (depended on severity of diseases).
http://en.wikipedia.org/wiki/Superficial_veinhttp://en.wikipedia.org/wiki/Upper_limbhttp://en.wikipedia.org/wiki/Upper_limbhttp://en.wikipedia.org/wiki/Superficial_vein


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Plague: Treatment with Na Cl O, IV, endo-lymphatic.

( N 418

13.04.91). Approved by National Pharmaceutical

Department. Ministry of Public Health. Russia.


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Advantages& disadvantages.

1. Sodium hypochloriteis a chemical

compoundwith the formulaNa Cl O - wellknown disinectant preparation and used fordestruction of viruses and bacteria on externalsurfaces.

2. Sodium hypochlorite is a Disinfectant.

3. http://en.wikipedia.org/wiki/Disinfectant
http://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_formulahttp://en.wikipedia.org/wiki/Chemical_formulahttp://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_compound


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Advantages& disadvantages.

Approved by National PharmaceuticalDepartment. Ministry of Public Health. Russia.

Method can be used for medical managementfor millions acutely and severe ill people inshort time.

Method already used in clinical conditions fortreatment patients with viral hepatitis andintoxication with chemical and biologicaltoxins.


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Disinfectantsare antimicrobial agentsthat are applied to non-livingobjects to destroy microorganismsthat are living on the objects.

Disinfection does not necessarily kill all microorganisms, especiallyresistant bacterial spores; it is less effective than sterilization, which is anextreme physical and/or chemical process that kills all types of life.

Disinfectants are different from other antimicrobial agents suchas antibiotics, which destroy microorganisms within the body,and antiseptics, which destroy microorganisms on living tissue.Disinfectants are also different from biocidesthe latter are intended todestroy all forms of life, not just microorganisms. Disinfectants work bydestroying the cell wall of microbes or interfering with the metabolism.

Bacterial endosporesare most resistant to disinfectants, but some virusesand bacteria also possess some tolerance.

Disinfectants are frequently used in hospitals, dental surgeries, kitchens,and bathrooms to kill infectious organisms.

http://en.wikipedia.org/wiki/Disinfectant#Oxidizing_agents
http://en.wikipedia.org/wiki/Microorganismshttp://en.wikipedia.org/wiki/Antimicrobialhttp://en.wikipedia.org/wiki/Microorganismshttp://en.wikipedia.org/wiki/Endosporehttp://en.wikipedia.org/wiki/Sterilization_(microbiology)http://en.wikipedia.org/wiki/Endosporehttp://en.wikipedia.org/wiki/Sterilization_(microbiology)http://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Biocidehttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Biocidehttp://en.wikipedia.org/wiki/Endosporehttp://en.wikipedia.org/wiki/Endosporehttp://en.wikipedia.org/wiki/Biocidehttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Antiseptichttp://en.wikipedia.org/wiki/Antibiotichttp://en.wikipedia.org/wiki/Sterilization_(microbiology)http://en.wikipedia.org/wiki/Endosporehttp://en.wikipedia.org/wiki/Microorganismshttp://en.wikipedia.org/wiki/Antimicrobial


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Oxidizing agentsact by oxidizing the cellmembrane of microorganisms, which results ina loss of structure and leads to cell lysisand

death. A large number of disinfectants operatein this way. Chlorineand oxygenare strongoxidizers.

http://en.wikipedia.org/wiki/Disinfectant#O

xidizing_agents
http://en.wikipedia.org/wiki/Redoxhttp://en.wikipedia.org/wiki/Lysishttp://en.wikipedia.org/wiki/Chlorinehttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Oxygenhttp://en.wikipedia.org/wiki/Chlorinehttp://en.wikipedia.org/wiki/Lysishttp://en.wikipedia.org/wiki/Redox


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Sodium hypochloriteis very commonly used. Commonhousehold bleachis a sodium hypochlorite solutionand is used in the home to disinfect different surfaces.In more dilute form, it is used in swimming pools, andin still more dilute form, it is used in drinking water.

When pools and drinking water are said to bechlorinated, it is actually sodium hypochlorite or arelated compoundnot pure chlorinethat is beingused. Chlorine partly reacts with proteinaceous liquidssuch as blood to form non-oxidizing N-chlorocompounds, and thus higher concentrations must beused if disinfecting surfaces after blood spills.

In more diluted and ionized form can be used for I/Vadministration and treatment for deadly, severe formof viral or bacterial infection.
http://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Bleachhttp://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Bleachhttp://en.wikipedia.org/wiki/Bleachhttp://en.wikipedia.org/wiki/Sodium_hypochlorite


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Electrolyzed wateror "Anolyte" is an oxidizing,acidic hypochlorite solution madeby electrolysisof sodium chlorideinto sodium

hypochloriteand hypochlorous acid. Anolytehas an oxidation-reduction potential of +600 to+1200 mV and a typical pH range of 3.58.5,but the most potent solution is produced at a

controlled pH 5.06.3 where the predominantoxychlorine species is hypochlorous acid.
http://en.wikipedia.org/wiki/Electrolyzed_waterhttp://en.wikipedia.org/wiki/Electrolysishttp://en.wikipedia.org/wiki/Sodium_chloridehttp://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Sodium_hypochloritehttp://en.wikipedia.org/wiki/Sodium_chloridehttp://en.wikipedia.org/wiki/Electrolysishttp://en.wikipedia.org/wiki/Electrolyzed_water


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A method of treating acute generalized Plaguecomprising performing medical treatment ,wherein the treatment consists in IV or endo-

lymphatic administration of an aqueoussolution of sodium hypochlorite.


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Sodium hypochloriteis a chemicalcompoundwith the formulaNaClO.It is composed of

a sodiumcation(Na+) and a hypochloriteanion(ClO); it mayalso be viewed as thesodium saltof hypochlorous acid.
http://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_formulahttp://en.wikipedia.org/wiki/Sodiumhttp://en.wikipedia.org/wiki/Cationhttp://en.wikipedia.org/wiki/Hypochloritehttp://en.wikipedia.org/wiki/Anionhttp://en.wikipedia.org/wiki/Salt_(chemistry)http://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Hypochlorous_acidhttp://en.wikipedia.org/wiki/Salt_(chemistry)http://en.wikipedia.org/wiki/Anionhttp://en.wikipedia.org/wiki/Hypochloritehttp://en.wikipedia.org/wiki/Cationhttp://en.wikipedia.org/wiki/Sodiumhttp://en.wikipedia.org/wiki/Chemical_formulahttp://en.wikipedia.org/wiki/Chemical_compoundhttp://en.wikipedia.org/wiki/Chemical_compound


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A new effective method of countermeasureagainst biological weapons, antiviral treatmentof acute and chronic viral hepatitis B and C and

against other viral diseases was used inmedical practice in hospitals.Research show this method as effective methodagainst severe viral infections, warfare, and

outbreak infections, Biological warfare,methicillin-resistant staphylococcus aureus.


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Equipment: Mobile and Industrial.

Cost effective, Simple, Effective Therapy.

http://iadt.siemens.ru/assets/files/news/OS

EC.pdf http://www.niitop.ru/site.aspx?IID=2139510

&SECTIONID=2074568
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http://carakurt.narod.ru/hipohlorit_Na.htm

http://www.naclo.ru/opublikovannyie-stati/type/2/126/

http://www.naclo.ru/en/ http://www.dissercat.com/content/gipokhlor

it-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pecheni

http://irbis.ismu.baikal.ru/smg/2008-6/18.pdf
http://carakurt.narod.ru/hipohlorit_Na.htmhttp://www.naclo.ru/opublikovannyie-stati/type/2/126/http://www.naclo.ru/opublikovannyie-stati/type/2/126/http://www.naclo.ru/en/http://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://irbis.ismu.baikal.ru/smg/2008-6/18.pdfhttp://irbis.ismu.baikal.ru/smg/2008-6/18.pdfhttp://irbis.ismu.baikal.ru/smg/2008-6/18.pdfhttp://irbis.ismu.baikal.ru/smg/2008-6/18.pdfhttp://irbis.ismu.baikal.ru/smg/2008-6/18.pdfhttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.dissercat.com/content/gipokhlorit-natriya-v-lechenii-bolnykh-khronicheskimi-diffuznymi-zabolevaniyami-pechenihttp://www.naclo.ru/en/http://www.naclo.ru/opublikovannyie-stati/type/2/126/http://www.naclo.ru/opublikovannyie-stati/type/2/126/http://www.naclo.ru/opublikovannyie-stati/type/2/126/http://carakurt.narod.ru/hipohlorit_Na.htm


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http://www.ikar.udm.ru/sb/sb36-2.htm

http://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-

kompleksnom-lechenii-oslozhnenii-ostrogo-pa http://bankpatentov.ru/node/349358

http://www.findpatent.ru/patent/208/2089194.html
http://www.ikar.udm.ru/sb/sb36-2.htmhttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://bankpatentov.ru/node/349358http://www.findpatent.ru/patent/208/2089194.htmlhttp://www.findpatent.ru/patent/208/2089194.htmlhttp://www.findpatent.ru/patent/208/2089194.htmlhttp://www.findpatent.ru/patent/208/2089194.htmlhttp://bankpatentov.ru/node/349358http://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.dissercat.com/content/primenenie-gipokhlorita-natriya-i-sandostatina-v-kompleksnom-lechenii-oslozhnenii-ostrogo-pahttp://www.ikar.udm.ru/sb/sb36-2.htmhttp://www.ikar.udm.ru/sb/sb36-2.htmhttp://www.ikar.udm.ru/sb/sb36-2.htm


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Many Thanks to Thomas V. Inglesby, MD David T. Dennis, MD, MPH Donald A. Henderson, MD, MPH John G. Bartlett, MD Michael S. Ascher, MD Edward Eitzen, MD, MPH Anne D. Fine, MD Arthur M. Friedlander, MD Jerome Hauer, MPH John F. Koerner, MPH, CIH Marcelle Layton, MD Joseph McDade, PhD Michael T. Osterholm, PhD, MPH Tara OToole, MD, MPH Gerald Parker, PhD, DVM Trish M. Perl, MD, MSc Philip K. Russell, MD Monica Schoch-Spana, PhD

Kevin Tonat, DrPH, MPH for the Working Group on Civilian Biodefense http://www.bt.cdc.gov/agent/plague/consensus.pdf And many others.
http://www.bt.cdc.gov/agent/plague/consensus.pdfhttp://www.bt.cdc.gov/agent/plague/consensus.pdf

plague: medical management and countermeasure development

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