Children Most Vulnerable in Biological Warfare

At the recent annual meeting of the Pediatric Academic Societies, Dr. Ralph Feigin, Baylor College of Medicine president and surgeon in chief at Texas Children’s Hospital, said that children are at particular risk when exposed to biological weapons, which makes the role of the pediatrician critical as the first line of defense.

"It is the family pediatrician and subspecialists in pediatric infectious diseases who are most likely to be called on to make that initial, all-important diagnosis," Dr. Feigin said. "Pediatricians must be able to quickly spot it, refer it and report it to public health authorities."

Although the effects of bioterrorism weapons such as anthrax and smallpox are the same for children as for adults, children are particularly susceptible to the agents because of their size and stage of development.

"The severity of the effect depends on the stage of life," he said. "Young children, just like the elderly, are more likely to suffer severe effects."

Children carry this extra vulnerability, Dr. Feigin said, because they have a rapid respiratory rate, a higher skin-to-mass ratio, more permeable skin and less fluid reserve.

"Public health authorities are not recommending large-scale vaccination currently for smallpox, but the vaccine is available if needed," he said. "Treatment guidelines also are in place for possible anthrax exposure, in which antibiotics are administered in appropriate doses for children to prevent disease."

Using biological agents as weapons has a long history in the world, Dr. Feigin said, and a host of weapons are available in addition to anthrax and smallpox.

"Pediatricians must put special emphasis on their role as the family’s primary resource in health matters, preparing themselves for bioterrorism by learning how to spot the effects of biological agents and how to quickly contact the appropriate public heath agencies," Dr. Feigin said. "With children, the time available for treatment is much narrower than with adults."

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©2006 Texas Medical Center

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