Staphylococcal Enterotoxin B (SEB)
Purpose
To recommend procedures for handling potential
biological threats of Staphylococcal Enterotoxin B exposure.
Staphylococcus Enterotoxin B is a fever producing
exotoxin produced by the bacteria Staphylococcus aureus. The toxin is what
causes the disease. An exotoxin is a toxin formed inside the cell and then
excreted out of the cell where the toxin is released into the environment.
Transmission
1. Ingestion
2. Inhalation
3. Person to Person: transmission
does not occur
Incubation Period
1—6 hours
Signs & Symptoms
1.
Ingestion: headache, nausea, vomiting, diarrhea, myalgia, fever
(103-104 degrees) and chills.
2.
Inhalation: headache,
nausea, vomiting, diarrhea, myalgia, fever (103-104 degrees) and chills with
ingestion to cough, dyspnea, chest pain, pulmonary edema and septic shock with
inhaled. Duration of illness may last 2-4 weeks.
Diagnosis:
1. Clinical suspicion is based on large
numbers of cases of acute onset of a febrile,
respiratory syndrome
without radiograph abnormalities presenting simultaneously.
2. Acute and convalescent serum for
antibody (Elisa) to Staphylococcus enterotoxin.
3.
Diagnosis is made via nasal swab, serum and or urine.
a.
For ingestion, isolation of enterotoxin from stool.
Treatment
1. Supportive care is the mainstay
2. Mechanical
ventilation may be needed for severe cases
Prophylaxis
Post exposure prophylaxis for SEB is not currently
available.
Control Measures and Decontamination
1.
Standard Precautions for patient care, patient-care
equipment, and the environment.
2.
Private Rooms are
not necessary for patients.
3.
Decontamination at the scene of a bioterrorist event would
be more complex and requires direction from Health Department or CDC.
Decontamination:
Standard Precautions
Notification
Internal: At hospital
notify________________________________
External: All suspected cases of Staff Enterotoxin B should
be reported immediately to the Local Health Departments who will then contact
the State Health Department and/or
CDC.
Lab
Due to potential risks associated with handling
infectious materials, laboratory testing should be the minimum necessary for diagnostic
evaluation and patient care. Laboratory specimens should be placed in plastic
bags that are sealed, and then transported in clearly labeled, durable,
leak-proof containers directly to the specimen handling area of the laboratory.
Care should be taken not to contaminate the external surfaces of the container.
Lab personnel should be notified of what they are handling. Bio-Safety Level 2
should be used for handling specimens.
|
SEB |
2
red-top or gold-top tubes (for Ab/Ab Elisa serology) |
Urine |
Stool/vomitus |
ID
Consult |
Note on
requisition |
|
Inhalation |
Yes |
Yes |
No |
Yes |
R/O SEB |
|
Ingestion |
No |
No |
Yes |
Yes |
R/O SEB |
References
APIC Guidelines: Pg. 124-1-10
U. S. Army Biological Chemical Command (SBCCOM)
Note: These are guidelines
that have been developed with data available as of 5/9/02.
Initially Prepared by
The Akron Regional Hospital
Association
Emergency Preparedness
Subcommittee
August 20, 2002