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BIOTERRORISM
DISEASES
/ aGENTS:
A Visual Guide for US Air Force Public Health
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Contents:
Anthrax (Bacillus anthracis)

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Description:
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This illustration depicts Bacillus anthracis taken
from the peritoneum using a Hiss capsule stain.
Anthrax is diagnosed by isolating B. anthracis from the blood, skin
lesions, or respiratory secretions, or by measuring specific antibodies in
the blood of persons suspected of having been infected.
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Content Provider:
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
free of any copyright restrictions. As a matter of courtesy we request that
the content provider be credited and notified in any public or private usage
of this image.
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Botulism (Clostridium botulinum)

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Description:
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A photomicrograph of Clostridium botulinum bacteria.
This is a photomicrograph of Clostridium botulinum stained with
Gentian violet. The bacterium C. botulinum produces a nerve toxin,
which causes the rare, but serious paralytic illness Botulism.
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Content Provider:
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Brucellosis (Brucella Species)

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Description:
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A photomicrograph of the bacterium Brucella
melitensis, initially named Micrococcus melitensis.
This is a photomicrograph of Brucella melitensis, the cause of
Brucellosis. Symptoms are similar to flu and may also include severe
infections of the central nervous systems, and the lining of the heart, or
endocardium.
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Content Providers(s):
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CDC
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Cholera (Vibrio cholerae)

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Description:
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This Gram-stain depicts flagellated Vibrio comma
bacteria, a strain of V. cholerae; the cause of Asiatic cholera.
A person may get cholera by drinking water or eating food contaminated
with the cholera bacterium, therefore, inadequate sewerage treatment can
facilitate the spread of the disease during epidemics.
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Content Providers:
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
free of any copyright restrictions. As a matter of courtesy we request that
the content provider be credited and notified in any public or private usage
of this image.
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Cryptosporidiosis
(Cryptosporidium Species)

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Description:
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This micrograph of a direct fecal smear is stained to
detect Cryptosporidium sp., an intracellular protozoan parasite.
Using a modified cold Kinyoun acid-fast staining technique, and under an
oil immersion lens the Cryptosporidium sp. oocysts, which are acid-fast
stain red, and the yeast cells, which are not acid-fast stain green.
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Content Provider:
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Eastern Equine Encephalitis

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Description:
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This colorized transmission electron micrograph (TEM)
depicts a salivary gland that had been extracted from a mosquito, which was
infected by the Eastern equine encephalitis (EEE) virus, which has been colorized
red; magnified 83,900x.
The Eastern equine encephalitis (EEE) virus is a member of the family Togaviridae,
and genus Alphavirus. EEE is a mosquito-borne viral disease. As the
name suggests, it occurs in the eastern half of the US. Due to the high case
fatality rate, it is regarded as one of the more serious mosquito-borne
diseases in the United States. This virus is transmitted to humans through
the bite of an infected mosquito. The main transmission cycle is between
birds and mosquitoes. Several species of mosquitoes can become infected with
the EEE virus. The most important mosquito in maintaining the enzootic
(animal-based, in this case bird-mosquito-bird) transmission cycle is Culiseta
melanura. Horses can become infected with, and die from EEE virus
infection.
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Content Providers:
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CDC/ Fred Murphy; Sylvia Whitfield
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Copyright Restrictions:
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of this image.
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Ebola Hemorrhagic Fever
(Ebola Virus)

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Description:
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Ebola virus antigen in skin
Immunohistochemical demonstration of Ebola virus antigen in skin. Histopathology.
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Content Providers(s):
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CDC/Dr. Sherif R. Zaki
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Copyright Restrictions:
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None - This image is in the public domain and thus
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content provider be credited and notified in any public or private usage of
this image.
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Escherichia coli O157:H7 Infection

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Description:
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After 24 hours, this inoculated MacConkey agar culture
plate cultivated colonial growth of Gram-negative Escherichia coli
bacteria.
Normally, E. coli serves a useful function in the body by
suppressing the growth of harmful bacterial species, and by synthesizing
appreciable amounts of vitamins. A minority of E. coli strains are
capable of causing human illness by several different mechanisms. E. coli
serotype O157:H7 is a rare variety of E. coli that produces large
quantities of one or more related, potent toxins that cause severe damage to
the lining of the intestine. These toxins [verotoxin (VT), shiga-like toxin]
are closely related, or identical to the toxin produced by Shigella
dysenteriae.
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Content Provider:
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CDC
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Copyright Restrictions:
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the content provider be credited and notified in any public or private usage
of this image.
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Epsilon toxin poisoning
(Clostridium
perfringens)

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Description:
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This photomicrograph reveals Clostridium perfringens
grown in Schaedler’s broth using Gram-stain.
Clostridium perfringens is a spore-forming, heat-resistant
bacterium that can cause food-borne disease. The spores persist in the
environment, and often contaminate raw food materials. These bacteria are
found in mammalian feces, and soil.
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Content Providers:
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CDC/Don Stalons
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Copyright Restrictions:
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None - This image is in the public domain and thus
free of any copyright restrictions. As a matter of courtesy we request that
the content provider be credited and notified in any public or private usage
of this image.
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Glanders (Burkholderia mallei)

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Description:
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Burkholderia pseudomallei grown on sheep blood agar
for 72 hours.
Burkholderia pseudomallei is a Gram-negative aerobic bacteria, and
is the causative agent of melioidosis. The organism's colonial morphology
changes somewhat as the incubation is extended.
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Content Providers:
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CDC/Courtesy of Larry Stauffer, Oregon State Public Health
Laboratory
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Hantavirus Pulmonary Syndrome - HPS (Hantavirus)

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Description:
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This micrograph depicts an atypical enlarged lymphocyte
found in the blood smear from a HPS patient.
Hematologic findings are important in HPS. The large atypical lymphocyte
shown here is an example of one of the laboratory findings, which when
combined with a bandemia. and dropping platelet count is characteristic of
HPS.
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Content Provider:
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CDC
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Copyright Restrictions:
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the content provider be credited and notified in any public or private usage
of this image.
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Lassa Hemorrhagic Fever
(Lassa Virus)

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Description:
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This transmission electron micrograph (TEM) depicted numbers
of Lassa virus virions adjacent to some cell debris. The virus, a member of
the virus family Arenaviridae, is a single-stranded RNA virus, and is
zoonotic, or animal-borne that can be transmitted to humans.
There are a number of ways in which the virus may be transmitted, or
spread, to humans. The Mastomys rodents shed the virus in urine and
droppings. Therefore, the virus can be transmitted through direct contact
with these materials, through touching objects or eating food contaminated
with these materials, or through cuts or sores. Because Mastomys
rodents often live in and around homes and scavenge on human food remains or
poorly stored food, transmission of this sort is common. Contact with the
virus also may occur when a person inhales tiny particles in the air
contaminated with rodent excretions. This is called aerosol or airborne
transmission. Finally, because Mastomys rodents are sometimes consumed
as a food source, infection may occur via direct contact when they are caught
and prepared for food.
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Content Providers:
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CDC/ C. S. Goldsmith, P. Rollin, M. Bowen
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Marburg Hemorrhagic Fever (Marburg Virus)

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Description:
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This transmission electron micrograph (TEM),
photographed at the Centers for Disease Control in Atlanta, Georgia,
confirmed the suspicion that the 1975 Rhodesian (now Zimbabwean) hemorrhagic
fever patient had indeed acquired the Marburg virus while traveling through
that country.
Note that in this particular section, the cylindrical Marburg virions were
sectioned in various planes, which is why some are seen as longitudinal
sections, i.e., lengthwise, while others are seen cut in a transaxial plane,
i.e., cross-sectioned, and look circular.
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Content Providers:
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CDC/ Dr. J. Lyle Conrad
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of this image.
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Melioidosis
(Burkholderia
pseudomallei)

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Description:
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Burkholderia pseudomallei grown on sheep blood
agar for 48 hours.
Burkholderia pseudomallei is a Gram-negative aerobic bacteria, and
is the causative agent of melioidosis. The organism's colonial morphology
changes somewhat as the incubation is extended.
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Content Providers:
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CDC/Courtesy of Larry Stauffer, Oregon State Public Health
Laboratory
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None - This image is in the public domain and thus
free of any copyright restrictions. As a matter of courtesy we request that
the content provider be credited and notified in any public or private usage
of this image.
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Plague (Yersinia pestis)

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Description:
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This photomicrograph depicts the histopathologic changes
in lung tissue in a case of fatal human plague pneumonia; Mag. 160X.
Note the moderate suppurative pneumonia including the presence of many
polymorphonuclear leukocytes (PMN), capillary engorgement, and intraalveolar
debris, all indicative of an acute infection. H&E stain was used to
process this slide.
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Content Providers:
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CDC/Dr. Marshal Fox
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Psittacosis
(Chlamydia psittaci)

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Description:
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This DFA-stained micrograph showed the presence of Chlamydia
psittaci bacteria in mouse brain tissue; Mag. 400X.
Direct Fluorescent Antibody (DFA) employs a fluorescently labeled, antigen
specific antibody, which attaches itself to the cell membrane bound antigen
on the Chlamydia psittaci bacteria, and fluoresces under ultraviolet
light microscopy.
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Content Providers:
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CDC/ Dr. Vester Lewis
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Q fever (Coxiella burnetii)

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Description:
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Coxiella burnetii is a species of
intracellular, pathogenic bacteria, and is the causative agent of Q fever. The
genus Coxiella is morphologically similar to the rickettsia, but with
a variety of genetic and physiological differences. C. burnetii are
small Gram negative bacteria with two growth phases, as well as a spore form
which lies idle in soil. It can survive standard disinfectants, and is
resistant to many other environmental changes.
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Content Providers:
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Rocky Mountain Laboratories, NIAID, NIH
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Ricin Poisoning
(Ricin toxin)

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Description:
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Ricin is a potent toxin that has
potential to be used as an agent of biological warfare and as a weapon of mass
destruction (WMD). Ricin is widely available, easily produced, and derived
from the beans of the castor plant (Ricinus communis). Ricin
can be extracted from castor beans and is known to have an average lethal
dose in humans of 0.2 milligrams (1/5,000th of a gram), though some sources
give higher figures. The 2007 Guinness World Records Book considers
ricin the world's most potent plant toxin.
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Content Providers(s):
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USDA
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Salmonellosis
(Salmonella Species)

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Description:
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This photograph depicts the colonial growth pattern
displayed by Salmonella typhimurium bacteria cultured on a Hektoen
enteric (HE) agar medium; S. typhimurium colonies grown on HE agar are
blue-green in color, for this organism is a lactose non-fermenter, but it
does produce hydrogen sulfide, (H2S), therefore there can be
black-colored deposits present.
HE agar is the medium designed for the isolation and recovery of fecal
bacteria belonging to the family, Enterbacteriaceae.S. typhimurium
causes 25% of the 1.4 million Salmonellosis infections a year in the United
States. Most persons infected with Salmonella sp. develop diarrhea,
fever, and abdominal cramps 12 - 72 hours after infection. The illness
usually lasts 4 - 7 days, and most people recover without treatment. However,
in some cases, the diarrhea may be so severe that the patient needs to be
hospitalized.
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Content Providers(s):
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Shigellosis
(Shigella Species)

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Description:
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This photograph depicts the colonial morphology
displayed by Gram-negative Shigella boydii bacteria on a blood agar
plate (BAP).
Four species from the genus Shigella, S. boydii, S.
dysenteriae, S. flexneri, and S. sonnei, are the etiologic agents
of the bacterial infection, shigellosis. Most who are infected with Shigella
spp. develop diarrhea, which is often bloody, fever, and stomach cramps
starting a day or two after they are exposed to the bacterium. Shigellosis
usually resolves in 5 to 7 days.
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Content Providers(s):
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CDC
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Copyright Restrictions:
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
of this image.
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Smallpox
(Variola Major)

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Description:
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Close-up of smallpox pustules found on the thigh of a
patient during the sixth day of the rash.
The smallpox lesions, or pustules, will eventually form scabs that will
fall off leaving marks on the skin. The patient is contagious to others until
all of the scabs have fallen off.
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Content Providers:
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CDC/Dr. Paul B. Dean
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Tularemia
(Francisella
tularensis)

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Description:
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Francisella tularensis, Colonization on Cysteine
Heart Agar after 72 hours.
F. tularensis, Colony Characteristics when grown on Cysteine Heart
Agar, colonies 2-4 mm, smooth, entire, greenish-white, butyrous with
opalescent sheen at 48-72hrs.
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Content Providers:
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CDC/ Courtesy of Larry Stauffer, Oregon State Public
Health Laboratory
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None - This image is in the public domain and thus
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the content provider be credited and notified in any public or private usage
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Typhus Fever
(Rickettsia
prowazekii)

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Description:
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This Gram-negative, intracellular bacteria is quite small
and, in addition, it is responsible for causing the disease typhus, which is
called classic, European, or epidemic typhus. This bacteria that attacks only
humans is spread by the body louse, or occasionally the head louse, and it is
usually worst in areas of crowding, poverty, or bad sanitation. The bacteria,
which has a short generation time of about ten hours, is first picked up by
the louse from a human blood that it consumed. The bacteria enter the
digestive system of the louse, and they begin to replicate, which allows the
louse to spread the disease to other humans. The bacteria enters the body
through the feces or the vomit of the louse, or if a crushed louse is able to
get into the skin. Eventually the bacteria in the digestive system of the
louse becomes so numerous, that in about ten days the louse itself dies.
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Content Providers:
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CDC
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Copyright Restrictions:
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the content provider be credited and notified in any public or private usage
of this image.
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Venezuelan Equine Encephalitis

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Description:
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This photomicrograph of mouse brain tissue after dying of
Venezuelan Encephalitis reveals neural necrosis and edema.
First recognized in the 1930s, Venezuelan Encephalitis has been
responsible for numerous outbreaks of febrile illnesses and encephalitis
involving thousands of humans and hundreds of thousands of equines, primarily
in tropical America.
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Content Providers:
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CDC/Dr. F. A. Murphy
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Copyright Restrictions:
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Western Equine Encephalitis

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Description:
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The virus that causes western equine encephalitis has a
complex life cycle involving birds and a specific type of mosquito,
Culex tarsalis, that is common in farming areas and around
irrigated fields. Humans, horses, and other mammals are not an important part
of the life cycle of the virus. In rare cases, however, people who live in or
visit an area where the virus lives can be infected by the bite of an
infected mosquito. Horses are common in these regions and can also be
infected. After infection, the virus invades the central nervous system,
including the spinal cord and brain.
Infection can cause a range of illnesses, from no symptoms to fatal
disease. People with mild illness often have only a headache and sometimes
fever. People with more severe disease can have sudden high fever, headache,
drowsiness, irritability, nausea, and vomiting, followed by confusion,
weakness, and coma. Young infants often suffer seizures.
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Content Providers:
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CDC/Dr. F. A. Murphy
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Copyright Restrictions:
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Culex tarsalis

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Description:
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This photograph depicted a close-up view of a Culex
tarsalis mosquito as it was about to begin feeding, after having landed
on the skin of what will become its human host. Note the light-colored band
wrapped around its dark-scaled proboscis (A), and the multiple similarly
light-colored bands wrapped around its distal appendages, i.e., the tibia and
femur, of its forelegs and middle pair of legs (B), identifying this as C.
tarsalis.
Other identifying characteristics include the presence of two silver dots
on its dorsal scutum, however, in this particular image, only one of the two
bilateral silver scutal marks is visible (C), and a blunted distal
abdominal tip, which is not visible in this view. The epidemiologic
importance of C. tarsalis lies in its ability to spread Western Equine
Encephalitis (WEE), St. Louis Encephalitis (SLE), and California
Encephalitis, and is currently the main vector of West Nile virus in the
Western United States.
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Content Provider:
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CDC
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Copyright Restrictions:
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