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or intoxication by ingestion. Assurance that food and water
supplies are free from contamination should be provided by
appropriate preventive-medicine authorities in the event of
an attack.

Dermal: Intact skin provides an excellent barrier for
many but not all biological agents. Mucous membranes and
abraded, or otherwise damaged, integument can, however,
allow for passage of some bacteria and toxins, and should be
protected in the event of an attack.

Physical Protection: The most effective and singularly most
important prophylaxis in defense against biological warfare
agents is physical protection. Preventing exposure of the
respiratory tract and mucous membranes (to include
conjunctivae) to infectious and/or toxic aerosols through use
of a full-face respirator will prevent exposure, and should,
theoretically, obviate the need for additional measures.
Chemical protective masks effectively filter biological hazards.

Decontamination Protection of Health Care Personnel: Any
dermal exposure should be treated by soap and water
decontamination. This can follow any needed use of chemical
decontaminants but should be prompt. Secondary contamination
from clothing, etc. of exposed soldiers to medical care
personnel may be important, particularly from those individuals
exposed near the dissemination source where large particle
deposition may occur. Since it will be difficult to
distinguish those soldiers exposed near the source from those
contaminated some distance away, proper physical protection of
health care providers or other persons handling exposed
personnel should be maintained until decontamination is
complete. This applies to chemical exposure as well. Clinical
laboratory samples for toxin-exposed subjects can be dealt with
routinely. Patients showing signs of pneumonic plaque
generally should be considered hazardous, as some will disperse
plague bacilli by aerosol. Anthrax could present a risk from
open lesions or blood which could result in cutaneous anthrax.
Anthrax does not pose a threat of aerosol dissemination from -
blood or during autopsy procedures, but sporulation of bacilli
exposed to air theoretically could occur, with subsequent
inhalation. On the other hand, plague and tularemia bacilli
may be dangerous, since, under some circumstances, they are
known to cause aerosol infections. Therefore, postmortem
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