Nebraska DHHS Emergency Preparedness

Emergency Contact Information

Healthcare providers should be alert to the illness patterns and diagnostic clues that might signal an outbreak due to the intentional release of a chemical or biological agent.

If you become aware of any disease patterns that may signal a potential
biological or chemical event (see below), please call:
(402) 471-1983

Look for the following clinical and epidemiological clues that could suggest a possible terrorism event or public health emergency:

  • Suspected or confirmed communicable diseases that are not locally endemic ( e.g., anthrax, plague, tularemia, smallpox, or viral hemorrhagic fever)
  • Any unusual age distributions or clustering for a rare or common disease ( e.g., an increase in what appears to be a chickenpox-like illness among adult patients)
  • Any sudden increase of illness in previously healthy individuals
  • Any unusual increase or clustering in patients presenting with clinical symptoms that suggest an infectious disease outbreak
  • Any sudden increases in the following non-specific syndromes:
    • Respiratory illness with fever
    • Gastrointestinal illness
    • Encephalitis or meningitis
    • Neuromuscular illness (e.g., botulism)
    • Fever with rash
    • Bleeding disorders
    • Simultaneous disease outbreaks in human and animal populations
    • Any unusual temporal and/or geographic clustering of illness (e.g., persons who attended the same public event or religious gathering)

Some infections caused by biological agents present with distinctive signs that can provide valuable diagnostic clues. In previously healthy persons presenting with a febrile illness, the following signs and symptoms are highly suggestive of infection with certain biological agents:

Diagnostic Sign Disease
Widened mediastinum: Inhalational anthrax
Gram negative pneumonia with hemoptysis: Pneumonic plague
Vesicular/pustular rash starting on face and hands, with all lesions at the same stage of development: Smallpox

Most of the illnesses caused by pathogens likely to be used as biological weapons ( e.g., anthrax, plague and smallpox), would present initially as non-specific influenza-like illnesses. Therefore, an unusual pattern of respiratory or influenza-like illness (e.g., occurring out of season or large numbers of previously healthy patients presenting simultaneously) should prompt clinicians to alert the Department of Health and Human Services. These disease patterns might represent an early start to the influenza season, the introduction of a new pandemic strain, or could be the initial warning of a bioterrorist event.