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	The enterotoxin can be detected in fecal samples from human
food-poisoning cases, and bacteria are readily cultured from
clinical samples.


THERAPY
                     [(b)(l)sec 3.4(b)(2)]
       . Humans with enteritis necroticans have been
treated with antitoxin with some success.

  The organism itself is sensitive to penicillin, and,
consequently, this is the current drug of choice. Recent data
indicate that clindamycin or rifampin may suppress toxin
production, and provide superior results in animal models.

PROPHYLAXIS. [(b)(1)sec 3.4(b)(2)]
perfringens intoxication. Toxoids are being used to prevent
enteritis necroticans in humans, and veterinary toxoids are in
wide use.



PLAGUE

CLINICAL SYNDROME.

Plague is a zoonotic disease caused by Yersinia pestis, a
gram negative, non-spore forming, bacillus. Under natural
conditions, humans become infested through skin inoculation
flea bite or direct animal contact), and only rarely via
aerosol. A biological warfare attack with plague bacilli could
be delivered via contaminated vectors (fleas) or, more likely,
via aerosol. The clinical picture seen would depend upon the
route of delivery.

Clinical Features. The incubation period ranges from 2 to
10 days. Three primary syndromes are described: bubonic,
primary septicemic, and pneumonic. In bubonic plague, onset is
acute and often fulminant, with high fever, systemic signs and
symptoms, and exquisitely tender lymph node or nodes. The
hallmark of bubonic plague, the bubo, represents a

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