The only requirement is that they must be stable enough to survive transport and dissemination. The toxicity of biological agents is not the same for everyone; each individual does not react exactly the same way to the same amount of an agent. Some are more resistive than others because of race, sex, age, or other factors. The dose is the quantity of a biological agent received by the subject. The penetration of agents by various routes need not be accompanied by irritation or damage to the absorbent surface. There are often unique signs and identifying symptoms depending on entry route (inhalation, ingestion, or dermal).

a. Biological agents dispersed by spray often enter the body through the respiratory tract (inhalation injury). The agent may be absorbed by any part of the respiratory tract from the mucosa of the nose and mouth to the alveoli of the lungs.

b. Liquid droplets and (less commonly) solids may be absorbed from the surface of the skin, digestive tract, and mucous membranes. Agents penetrating the skin may form temporary reservoirs under the skin.

c. Contaminated food and water can produce casualties when ingested.

Table A-11. Types and Characteristics of Some Biological Agents

ENTRANCE
TYPE OF AGENTSTABILITYINCUBATION TIMEAEROSOLNONAEROSOL
ANTHRAXHIGHHOURS TO 7 DAYSINHALATION SKIN, MOUTH
BOTULINUM TOXINHIGH24 TO 36 HOURSINHALATIONMOUTH, WOUND
BRUCELLOSISHIGH IN WET ENVIRONMENT1 TO 4 WEEKSINHALATIONMOUTH, SKIN, EYES
CHOLERAMODERATEHOURS TO 5 DAYSMOUTH
PLAGUE (PNEUMONIC)LOW2 TO 4 DAYSINHALATION
PLAGUE (BUBONIC)MODERATE2 TO 10 DAYSBITE OF VECTOR
RICINHIGH<36 HOURSINHALATIONMOUTH
SMALLPOXHIGH7 TO 17 DAYSINHALATIONLESION CONTACT
STAPHYLOCOCCAL ENTEROTOXIN BHIGH1 TO 6 HOURSINHALATIONMOUTH
TRICHOTHECENE MYCOTOXINHIGHMINUTES TO HOURSINHALATIONMOUTH, SKIN
TULAREMIALOW2 TO 10 DAYSINHALATIONMOUTH, SKIN, BITE OF VECTOR
VENEZUELAN EQUINE ENCEPHALITISMODERATE1 TO 6 DAYSINHALATIONBITE OF VECTORS
VIRAL HEMORRHAGIC FEVERSLOWDAYS TO MONTHSINHALATIONBITE OF VECTORS

A-10. Management of Biological Warfare Patients

a. Management. Management of patients suffering from the effects of BW agents may include the need for isolation. Barrier nursing for patients suspected of suffering from exposure to BW agents will reduce the possibility of spreading the disease to health care providers and other patients. Specimens must be collected and submitted to the designated supporting laboratory for identification. For details on hospital infection control aspects of managing BW casualties, see FM 8-284.