RESUMEN
The concept of containment care for patients with highly hazardous infectious diseases originated in conjunction with the development of sophisticated biosafety level 4 laboratories at the US Army Medical Research Institute of Infectious Diseases in the late 1960s. Over time, the original containment facility served as a model for the development of other facilities in the United States at government and academic centers. The Ebola outbreak of 2014-2015 brought the issue of containment care into the mainstream and led to the development of such capabilities at strategic points around the country. We describe the original concepts behind development of such facilities, how the concept and acceptance has evolved over time, and how the guidelines for managing patients infected with viral hemorrhagic fevers have evolved as new information has been learned about protecting medical care providers from highly hazardous infectious pathogens.
Asunto(s)
Enfermedades Transmisibles/epidemiología , Contención de Riesgos Biológicos , Brotes de Enfermedades , Fiebre Hemorrágica Ebola/epidemiología , Fiebres Hemorrágicas Virales/epidemiología , Animales , Control de Enfermedades Transmisibles , Enfermedades Transmisibles/virología , Fiebre Hemorrágica Ebola/prevención & control , Fiebre Hemorrágica Ebola/virología , Fiebres Hemorrágicas Virales/prevención & control , Fiebres Hemorrágicas Virales/virología , Humanos , Laboratorios , Cuarentena , Estados Unidos/epidemiologíaRESUMEN
Differentiating between illness caused by community-acquired respiratory pathogens versus infection by biothreat agents is a challenge. This review highlights respiratory and clinical features of category A and B potential biothreat agents that have respiratory features as their primary presenting signs and symptoms. Recent world events make such a reminder that the possibility of rare diseases and unlikely events can occur timely for clinicians, policymakers, and public health authorities. Despite some distinguishing features, nothing can replace good clinical acumen and a strong index of suspicion in the diagnosis of uncommon infectious diseases.