![bar chart of subsyndrome severity of hematopoietic, gastrointestinal, and neurovascular subsyndromes](RemmMockup_files/barchart2.gif)
![bar chart legend](RemmMockup_files/barchartlegend.bmp) |
Vomiting
- Onset: 1-2 hours after exposure
- Percent of victims who vomit at this dose: 70-90%
Diarrhea
- None in some patients, mild in others at the higher end of the dose range.
Headache
Level of consciousness
Body temperature
- Increased
- Onset: 1-3 hours after exposure
- Percent of victims with fever at this dose: 10-80%
Medical response
- Observation in general hospital, especially for those at higher end of this dose range
- Treatment in specialized hospital as needed and feasible
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Duration
- From end of prodrome through day 18-28
Epilation
- Moderate hair loss, beginning on day 15 or later
Medical response
- Hospitalization recommended if feasible
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Onset
- 18-28 days after prodrome
Duration
Possible clinical effects
- Anorexia
- Fever
- Malaise, weakness
- Bleeding, infection
- Epilation
- Diarrhea: none to mild at lower end of dose range; more severe with increased exposure dose
Medical response
- Appropriate supportive care
Lethality
- Rare in the lower end of this dose range
- Up to 50% may die at higher end of this dose range at 6-8 weeks.
- Aggressive supportive care will salvage many patients at the high end of this dose range.
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Recovery
- Depends on GI and bone marrow recovery
- All victims require surveillance for late effects
- Psychological support helpful
Time to recovery
Death
- Potentially avoidable with appropriate supportive care unless severe complications develop
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