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- David Abed - Overworked Doctor
- Salvador Benavides - Doctor Aristeo Caruso
- Myles Bullock - Kevon Winters
- Dahlia DaCosta - Dahlia
- Moe Irvin - Chief Thomas Wheeler
- Jay Linzy - Carl Kevork
- Chiara Maya - Doctor Emily Hicks
- Mario Perez - Ramon
- Kim Rhodes - Assistant Director Linda Barnes
- Isaiah Russell-Bailey - Young Kevon Winters
- Cile Turner-Borman - Edna
- Regina Williams - Tanesa Winters
- Gregory Zarian - Walter Trudeau
- Emily Prentiss: "My wound is geography. It is also my anchorage, my port of call." – Pat Conroy
- Jennifer Jareau: "All of us labor in webs spun long before we were born." – William Faulkner
- The title of the episode has three distinct meanings:
- In literary terms, it refers to an unpleasant or unhealthy smell.
- In Greek mythology, a miasma is described as "a contagious power that has an independent life of its own and, until it is purged by the sacrificial death of the wrongdoer, society would be chronically infected by catastrophe."
- In medical terms, it refers to a debunked medical theory that diseases such as cholera, chlamydia and the Black Death or plague were caused by bad scents in the air. The theory was ultimately discarded by the scientific community in 1880.