MEDICAL PROTECTION FOR THE EXPEDITIONARY FORCE IN THE EVENT OF USING BIOLOGICAL AGENTS

The ADM/CBRN military or terrorist attack is most likely to be enforced on the force deployed in the theaters of operations (TO), as peace making troops, peace keeping troops, etc. For the medical protection of the expeditionary forces deployed in external theaters of operations (T.O.), when using biological agents, we conducted a documentary study on the prophylaxis and specific treatment for the medical force protection, when using biological agents, by updating and improving the medical protection countermeasures against BWA, by anti-infective prophylaxis (antibacterial and antiviral) pre-exposure, post-exposure and anti-infective etiology and support of the vital fuctions treatment

Clostridium difficile – emergent hospital flora

Clostridium difficile (C. difficile) is a Gram-positive sporogenous bacillus strictly anaerobic, which in the last decade has became the most important anaerobic bacterium in nosocomial human pathology. Cl.dificile is the etiological agent of more than 20% of diarrhea postantibiotics, over 95% of pseudomembranous colitis and the first cause of nosocomial infectious diarrhea in adults. Although this bacterium usually colonizes the intestine of vertebrates (the normal microbiota), the toxinogenic strains (tcdA and tcdB) are pathogenic in the digestive tract. Given the excessive use of antibiotics and the increased spores resistance, it is possible an environment contamination, with strains which may already be resistant to antibiotics. The main causes of this infection are decreased resistance to antibiotic-induced colonization, contamination with a pathogenic strain of Cl.difficile, secretion of A and/or B toxins and deficient immune response. Due to the increasing worldwide incidence of infections with C. difficile on one hand and to the discovery of new ways of transmitting the infection according with some studies regarding the genetic diversity of bacterium strains on the other hand, a new approach is necessary for C. difficile related topics.

A new global threat for the public safety: Zika virus

Zika virus, the etiological agent of Zika fever, is transmitted by mosquitoes and has been affecting the South American continent starting with 2015. It was reported in several European countries, carried by the people who returned from Latin America, as reported by the health authorities in those countries. Today, according to the World Health Organization (WHO), the virus suspected to cause serious birth defects in the fetus has also been confirmed in 21 of the 55 countries of South America, but also in other states from Europe and North America. Zika virus is a single stranded positive sense RNA virus belonging to Flavivirus genus (family Flaviviridae) and was first identified in 1947 in Uganda rainforest Zika. The increased number of cases of microcephaly, in children from northern Brazil, suggested a connection with Zika virus, but it has not yet been proven. Also, the virus can be transmitted sexually and through blood or blood products. Diagnosis of the infection is made using Polymerase Chain Reaction (PCR). So far, there is no specific antiviral treatment or vaccine against the infection with Zika virus. The best form of prevention is to avoid mosquito bites. WHO has estimated that the spread of Zika virus, transmitted through mosquito bite, is “a global public health emergency”. The priority is to protect pregnant women and to control the mosquitoes

General considerations regarding the infections with the Escherichia coli pathogen

Escherichia coli is the species of the genus Escherichia with the greatest epidemiological impact. Escherichia coli infections are found mainly in places with poor hygiene; the infants with ages between 1 and 3 years old are included in the category with the highest risk. It is a "fecal-oral" transmission mechanism as a result of consumption of contaminated food or water, or by "dirty hands". The foods most commonly implicated in the transmission of the infection are unpasteurized milk and milk products, beef, especially the one insufficiently cooked, unpasteurized fruit juice, lettuce and insufficiently washed vegetables. The disease has been reported worldwide, being described numerous episodes of infection with Escherichia coli that caused multiple illnesses and deaths. Escherichia coli has three types of antigens: antigen "O" (somatic), antigen "H" (flagella) and antigen "K" (capsular). Clinical manifestations are present in the form of non-specific diarrhea, a dysentery form of enteritis, choleriform enteritis, hemorrhagic colitis and hemolytic uremic syndrome (HUS). The Escherichia coli infection diagnosis is made by identifying the etiologic agent and/or by highlighting the VTI toxin in the feces. The treatment consists in precautionary antibiotherapy, hydrodynamics and electrolyte rebalancing, blood transfusions and dialysis, if in the case of renal failure. The prevention of infections with Escherichia coli is achieved by personal hygiene, food hygiene and work hygiene

Capabilities for identification and confirmation of bacterial biological agents

Military Medical Service is able for detection, identification and confirmation of biological agents; it is part of medical protection against CBRN weapons. We are specialized capabilities for in vitro tests, under construction, the maximum containment laboratory designed for work with Risk Group Microorganisms. An efficient primary containment system must be in place, consisting of one or a combination of the following: Class III safety cabinet laboratory, passage of two doors, suit laboratory, controlled access, controlled air system. Negative pressure in the facility, supply and exhaust air must be HEPA-filtered, decontamination of effluents, sterilization of waste and materials, airlock entry ports for specimens, materials and animals must be provided etc. Complementary is an Animal facility for in vivo tests. This is suitable for work with animals that are deliberately inoculated with microorganisms in Risk Group

Modern medicine has a new technology: therapeutic electroporation

Electroporation is considered a new start-up in the treatment of various tumors; currently, researches are being conducted in order to develop this technology with medical applications. The technique consists in the significant increase in the electrical conductivity and permeability of the plasma membrane of cells resulting from the application of an external electric field. It is routinely used in molecular biology to transform bacteria, yeast, protoplasts and is performed using the electroporators. Currently, the process seems to be a real solution that enables a targeted drug to act with maximum efficiency on cells and tissues requiring treatment, resulting in obtaining a good therapeutic effect without major side effects. Therefore, pharmaceutical companies are trying to demonstrate through preclinical studies the potential efficacy of this technology, succeeding in recent years to achieve important steps in this direction