Staphylococcal Enterotoxin B

Aka: Staphylococcal Enterotoxin B, SEB

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II. Pathophysiology

  1. Mechanism
    1. SEB is one of several staphylococcal enterotoxins
      1. Coagulase positive staphylococci
  2. Transmission
    1. Foodborne Illness
      1. Church picnic or community events
      2. Could contaminate small volume water supply
    2. Aerosolized Biological warfare agent
      1. Incapacitating Agent
        1. Low mortality
        2. Can render >80% exposed incapacitated x1-2 weeks
  3. Symptom Onset
    1. Occurs 3-12 hours after aerosol exposure

III. Symptoms and Signs

  1. General
    1. Symptoms occur in >80% of exposed clinically ill
    2. Fever to 103 to 105 F for 2-5 days
    3. Chills
    4. Headache
    5. Myalgia
    6. Conjunctival injection
    7. Higher exposure may lead to Septic Shock, death
  2. Aerosolized exposure (Biological Weapon)
    1. Nonproductive cough for up to 4 weeks
    2. Retrosternal Chest Pain
    3. Shortness of Breath
  3. Ingestion exposure (Foodborne Illness)
    1. Nausea or Vomiting
    2. Diarrhea

IV. Radiology: Chest XRay

  1. Normal except in severe cases

V. Differential Diagnosis

  1. Respiratory pathogens
    1. Influenza
    2. Adenovirus
    3. Mycoplasma
  2. Foodborne Illness
  3. Other aerosolized toxins
    1. Pulmonary Anthrax
    2. TularemiaPneumonia
    3. Pneumonic Plague
    4. Q Fever

VI. Prevention

  1. Protective mask
  2. No human Vaccine

VII. Course

  1. Generally low mortality
  2. Clinical illness persists 1-2 weeks

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