Index

691

INDEX

A

Aberdeen Proving Ground, Maryland, 398, 409–410See also Edgewood Arsenal, Maryland

ABGSee Arterial blood gases (ABG)

Abortionseptic, in brucellosis, 516

Abrin, 610, 632Abrus precatorius , 610, 632AC

See Hydrogen cyanide (AC)Acetaminophen, 627Acetylcholine (ACh), 132–134, 136, 159, 647Acetylcholinesterase (AChE), 131–132, 134, 182–184Acetylene tetrachloride, 34Acid hydrolysis, 355Action potential, 133Activated charcoal, 217, 362–363, 366, 370, 373, 670Adamsite

See DM (diphenylaminearsine)Additives, 122Adenine arabinoside (Ara-A), 553Adenosine triphosphate (ATP), 275, 383, 431S-Adenosylhomocysteine hydrolase inhibitors, 552Adenoviridae, 575, 683Adrenaline, 132Adrenergic nervous system, 132Adsorbent materials, 354, 363–364, 370Advanced trauma management (ATM), 326–327Aedes albopictus, 563, 566, 568Aedes dorsalis, 567Aeromedical Isolation Team (AIT), 432, 434Aeromonas, 609Aerosol

definition, 248detection, 383, 448LCt50 calculation, 606LD50 calculation, 606particle size, for biological agents, 440

Aerosolization, 121of biological agents, 440–442of toxins, 605–608, 612See also Inhalational injury; specific agent

Aerosol vulnerability testing, 429AERP system

See Aircrew Eye/Respiratory Protection (AERP) systemAfghanistan, 3, 67–68, 102, 104, 656–658, 665Aflatoxins, 656, 662African swine fever, 459African viral hemorrhagic fever, 434Agent Orange, 105, 297, 419Agent Purple, 51Agent X

See Botulinum toxinsAging, of organophosphoryl–cholinesterase bond, 162, 182–

183, 230AHF

See Argentine hemorrhagic fever (AHF)Airborne toxic material

definitions, 248See also Aerosol; Inhalational injury; specific material

Aircraft masks, 74Aircrew Eye/Respiratory Protection (AERP) system, 369–370Aircrew personal protective equipment, 368–370

Aircrew uniform, integrated battlefield (AUIB), 373Air delivery

history, 28, 31, 34–35, 49–50See also Aerosol; Inhalational injury; specific agent

Airplane smoke tanks, 31AIT

See Aeromedical Isolation Team (AIT)Alarms, 377–383

biological agent, 431history, 23, 53, 60–62, 66–67LOPAIR, E33 Area Scanning, 53M8A1 Automatic Chemical Agent, 380–381M21 Remote Sensing Chemical Agent (RSCAAL), 381Portable Automatic Chemical Agent, 60–62See also Detection

Alastrim, 543Alexander, Stewart, 103Algal toxins, 457, 609, 617Alimentary toxic aleukia (ATA), 659, 667Alkaline hydrolysis, 355Allergic contact sensitivity, 238–239, 249, 314, 316–317α-Naphthylthiourea (ANTU), 638Alphaviruses, 562

antigenic classification, 564–565structure and replication, 569–570See also Viral encephalitides; specific virus

Alphavirus virion, 569Ambergard XE-555 Resin, 353Ambulance exchange points, 331AMEDD

See U.S. Army Medical Department (AMEDD)American Civil War, 11, 13, 88, 416, 540American Cyanamid Company, 38American Type Culture Collection (ATCC), 463, 646American University, 94Amherst, Sir Jeffery, 416Aminoglycosides, 518Aminopyridines, 6512-Amino thiazoline 4-carboxylic acid, 276Amphetamines, 292Amyl nitrite, 280Angola, 69Anguidine

See 4,15-Diacetoxyscripenol (DAS)Animals

that harbor disease, 487–488, 514, 524, 527–528transgenic research involving, 683vaccines for, 434, 460, 464, 568, 576, 578weapons directed against, 12, 16, 34–35, 37, 51, 60, 428–

429, 459–460See also specific agent or animal

Animal venom toxins, 610, 650Anthrax, 5, 467–475

in animals, 468–469clinical manifestations, 471–472cutaneous, 471–473delivery, 442, 446diagnosis, 473epidemiology, 469gastrointestinal, 472–473history, 10, 16, 32, 42–44, 50, 68, 417–418, 420, 427, 431–432,

459, 468, 645inhalational, 469, 471–473lethality, 443–444, 456occupational exposure, 468–469, 474

Medical Aspects of Chemical and Biological Warfare

692

oropharyngeal, 472–473pathogenesis, 469–471prophylaxis, 473–475recent use, 4, 420–421, 452–453, 462, 464, 468spore stability after production, 441treatment, 473vaccination, 73, 462, 468, 473–475See also Bacillus anthracis

Anthraxin, 473Antianimal weapons, 459–460

history, 12, 16, 34–35, 37, 51, 60, 428–429See also specific agent or animal

Antibioticsfor anthrax, 473for brucellosis, 518cream/ointment, 214for plague, 497–498for Q fever, 531resistance, 681–682for tularemia, 507See also specific antibiotic

Anticholinergics, 294–302See also specific agent

Anticonvulsants, 154–155, 165, 187, 191, 279See also specific drug

Antidote kits, 73Antidotes

anticholinergic, 298–302cyanide, 279–282Lewisite, 102, 218, 220nerve agent, 158–159, 329self-administration, 329–331See also specific antidote

Antigensdetection, 383, 517viral, 541–542

Antihistamines, 627See also specific drug

Antimaterial agents, 459, 461Anti-O-polysaccharide antibody, 517Antiplant balloon bomb, 51–52Antiplant weapons, 460–461

history, 44, 51–52, 60, 427–429, 431See also Defoliants; specific agent or plant

Antiricin antibody, 638–639Antitoxins, 434, 632Antitussives, 628Antiviral drugs, 434, 598–599

See also specific drugANTU

See α-Naphthylthiourea (ANTU)Anxiety reactions

differential diagnosis, 297–298Apodemus agrarious , 594Ara-A

See Adenine arabinoside (Ara-A)Arab–Israeli Six-Day War (1967), 57, 65Arab–Israeli War of 1973, 3Ara-C

See Cytosine arabinoside (Ara-C)Arenaviridae, 575, 592–593Argentine hemorrhagic fever (AHF), 592–593, 595–596, 599Armstrong, George E., 428Arrhythmias, 156, 165–166, 239, 253, 277Arsenicals, 42, 198

See also specific agentArtane

See Trihexyphenidyl

Arterial blood gases (ABG), 252Arthur, Stanley, 73Artificial ventilation

See Ventilatory supportArtillery shells, 120Ascorbic acid, 671ASC Whetlerite charcoal, 363Ash, Charles A., 13Aspartate aminotransferase (AST), 596Aspergillus fumigatus, 429Asphyxiation, 249Aspirin, 597, 627Assassinations

using biological weapons, 420–421, 446, 645ASZ impregnated charcoal, 363–364ATA

See Alimentary toxic aleukia (ATA)ATCC

See American Type Culture Collection (ATCC)Atelectasis, 252Ativan

See LorazepamATM

See Advanced trauma management (ATM)ATP

See Adenosine triphosphate (ATP)AtroPen, 155, 159–160, 169Atropine sulfate, 159–162

administered in absence of nerve agent intoxication, 160cardiovascular effects, 156, 160, 165contraindications, 167decrease in sweating caused by, 160for dermal exposure, 161–162dosage and administration, 160–161, 169and endurance time in protective gear, 394history, 47, 54, 60, 131, 291ID50, 295as incapacitating agent, 294–295, 299for inhalational exposure, 161injectors, 54, 73, 155, 159–161, 169LD50, 295for nausea and vomiting, 168and nerve agent cardiovascular effects, 156and nerve agent–induced seizures, 154–155and nerve agent pretreatments, 184–187, 191pulmonary effects, 148–149, 158topical ocular administration, 147, 166–167, 215

Attack measuresfor medical support, 328

AUIBSee Aircrew uniform, integrated battlefield (AUIB)

Aum Shinrikyo, 4, 75, 113, 118, 131, 169, 274, 342, 438, 463, 678Aura virus, 566Australia, 460Autoclaving, 358Autoinjectors, 54, 73, 155, 159–161, 163–165, 169, 252, 341Autoinoculation

and vaccinia vaccination, 548–549Automatic Chemical Agent Alarm

M8A1, 380–381Automatic G-Agent Field Alarm, 53Automatic G-Agent Fixed Installation Alarm, 53Autonomic nervous system

effects of cyanides on, 277Aviator’s masks, 74Avipoxvirus, 542Azidothymidine (AZT), 639Azithromycin, 531

Index

693

B

Bacillus anthracis , 383, 439, 468–469, 474See also Anthrax

Bacillus globigii, 43, 60, 429Bacillus subtilis, 428Bacitracin, 214Bacteria

possible biological warfare agents, 439See also Biological agents; specific agent

Bacterial toxins, 609, 647See also specific toxin

Bacterium tularenseSee Francisella tularensis

Badoglio, Pietro, 34Baker, Newton D., 25BAL

See British anti-Lewisite (BAL)Baldwin Report, 427–428“8-Ball,” 428Bang, B., 514Barbiturates, 293, 302Bari mustard disaster (Italy), 40, 103–104, 200Barmah Forest virus, 565Barrier nursing procedures, 432–433, 598Barton, Samuel, 13Base-ejection devices, 120–121Battalion aid station (BAS), 327, 329, 331, 335Battledress overgarment (BDO), 371, 373Battledress uniform (BDU), 373, 669Battlefield health service support, 326–328Bedbugs, 487Bell, Sir Charles, 105Belladonna, 289–290, 294–295, 297–299Benactyzine, 159, 187Benenson, Abram S., 428Benzilate, 295Benzodiazepines, 302Berlin Blockade, 47Berthollet, Claude Louis, 10β-Propiolactone (BPL), 597Bhopal disaster (India), 119Bicuculline, 154–155BIDS

See Biological Integrated Detection System (BIDS)BIGEYE bomb, 65–66, 71Binary weapons programs, 65–66, 70–72, 75, 104Biological agents

aerosolization, 440–442availability or ease of production, 438–439, 457, 678containment precautions, 430, 432–434decontamination, 357–358defense against, 1–6, 425–435, 438, 443–446, 677–684delivery systems, 121, 420–421, 429, 438–442, 446, 457, 656,

658–659detection, 74, 377, 382–384, 431, 447–449differential diagnosis, 438, 448–449dispersal, 5dual use, 679ease of dissemination, 440, 457enhanced pathogenicity, 680–681epidemiological surveillance, 448field testing in U.S., 429genetic recombination, 681ideal, requirements for, 438–441incapacitation caused by, 292, 431, 439–440incubation periods, 439infectivity, 680–681

inhalational injury, 440introduction to, 4–6laboratory testing, 448–449lethality, 439–440, 444nonmilitary sources, 5–6, 10nonreplicating, 4–5occupational exposure, 398–399, 402–408, 432, 434patient isolation procedures, 432–433protective equipment against, 431, 447–448replicating, 4–5risk of transmission to medical staff, 356stability after production, 441susceptibility and nonsusceptibility, 441vaccines, 60–61, 73, 434, 441, 460, 462, 681–683virulence, 681See also specific agent

Biological bombs, 32–33, 44, 51–52, 59, 441–442, 444Biological defense equipment, 431Biological Defense Research Program, 434–435Biological Integrated Detection System (BIDS), 74, 377, 382–

384, 448Biological warfare

attempts to control, 13, 419–420, 678–679Cold War, 50–52, 55, 58–60, 420–422, 426, 430, 656definition, 10early proposals and usage, 12, 88, 416–417history, 9–75, 87–105, 415–422indications of possible attack, 448–449and military healthcare provider, 6, 445, 447, 683–684pre–World War I, 10–13, 88–90psychological factors, 4451920s, 28–291930s, 31–331960s, 58–60, 104–1051970s, 64, 67–68, 104–105, 420–4211990s, 74–75, 104–105, 420–422strategic and tactical concerns, 445–446, 456–458threat, 451–464, 683–684unconventional/clandestine use, 442, 446–447, 458World War I, 16, 21–22, 90–97, 417, 446, 459, 540World War II, 36–37, 42–44, 103–104, 417–419, 426–427, 446,

483–485, 540, 632, 644–645Biological Warfare Convention, 64, 67Biological weapons

advantages and disadvantages, 442–445, 456–459, 684demilitarization, 431–432, 525, 564nations with capability for use, 679nonhuman targets of attack, 434, 459–461versus nuclear and chemical weapons, 458–459proliferation, 456–459, 678use, 437–449

Biological Weapons Anti-Terrorism Act, 75, 633Biological Weapons Convention, 419–420, 422

compliance, 432, 435, 455, 458, 462–463, 679and Soviet biological warfare program, 4, 452–453, 455–456Third Review Conference, 453and toxin definition, 604, 608Trilateral Agreement, 455and U.S. biological warfare program, 426

Biopreparat, 454Biosafety levels, 430, 432–434, 597Biotechnology, 678–683

and nerve agent pretreatments, 192–193Birds

viral encephalitides carried by, 567, 573Blackburn, Luke, 12Black Death, 481–482, 487, 495Blackford, William W., 11

Medical Aspects of Chemical and Biological Warfare

694

Black Plague, 416Black vinyl overboot (BVO), 374Bleach

See Hypochlorite solutionBleaching powder, 22–23, 33–34, 54Bleeding

in viral hemorrhagic fevers, 597Blood–brain barrier permeability

and nerve agent pretreatments, 187, 191Blood cell counts, 497, 506, 530, 635Blood cholinesterases, 132, 136–139Blue-X, 3BN 52021, 670Boer War, 11Bolivian hemorrhagic fever, 593, 595–596, 599Bombs

biological, 32–33, 44, 51–52, 59, 441–442, 444chemical, 28, 40, 49–50, 59, 65–66, 71See also specific type of bomb

Bone disease, 215–217, 517Boots

protective, 373–375Botulinum toxins, 5, 643–652

and assassination of Reinhard Heydrich, 645crystalline, 644decontamination, 616detection, 383dual use, 457genetics, 647history, 32, 43, 417, 421, 427, 644–645lethality, 608mechanism of action, 609–611, 647–649military significance, 644recent use, 462–463relation to other bacterial toxins, 647serology, 646stages of toxicity, 648versus tetanus toxin, 646treatment, 611vaccination, 73, 462, 644, 651

Botulism, 646clinical manifestations, 649–650diagnosis, 650differential diagnosis, 574, 613–614infant, 644, 646inhalational, 647, 649–650pathogenesis, 647–649treatment, 616, 651–652wound, 644

Bouquet, Henry, 12Boynton, E. C., 11BPL

See β-Propiolactone (BPL)Bradley, Tom, 461Bradycardia, 156–157Brain lesions

nerve agent–induced, 154–155, 187Brazil

hemorrhagic fever outbreak, 593Breathing difficulties

with mask use, 365, 403nerve agent–induced, 145, 147–149, 158, 167–168, 170and toxic inhalational injury, 255See also Ventilatory support

The Breeders, 461Brefeldin-A, 639Brevetoxins, 609Bristol-Myers Squibb Oncology Division, 237

British anti-Lewisite (BAL), 102, 218, 220, 261British anti-Lewisite (BAL) Eye Ointment, 42British smoke grenade, 262Bromine, 273Bronchiectasis, 211–212, 215, 238Bronchitis, 211, 238, 253, 257Bronchoconstriction, 148–149, 158Bronchodilators, 253, 257Bronchospasm, 250, 253, 257Brown, Frederic, 93, 96Bruce, David, 10, 514Brucella, 383, 514–515

See also BrucellosisBrucella abortus, 514, 516, 518Brucella canis, 514–515, 517–518Brucella endocarditis, 517–518Brucella melitensis, 514–518Brucella neotomae, 514Brucella ovis, 514Brucella suis, 51, 429, 514–515, 517Brucellosis, 5, 513–519

clinical manifestations, 516–517diagnosis, 517–518differential diagnosis, 574epidemiology, 515history, 10, 43–44, 417, 427, 429–430, 514lethality, 444pathogenesis, 515–516prophylaxis, 518treatment, 518See also Brucella

Bubo aspiration, 495Bubonic plague, 480, 486, 491–492, 497BuChE

See Butyrocholinesterase (BuChE)Buddy-aid, 155, 159, 161, 165, 166

and chemical workers, 407, 409–410Bulk-release munitions, 120–121Bullene, Egbert F., 48, 50Bunyaviridae, 575, 592–594Burnet, MacFarlane, 525Burns

CS-induced, 313mustard, 98–100, 202, 205–208, 214, 238, 342–343thermal, 343

Burroughs Wellcome Co., 214, 552Bush, George, 72, 74, 117, 455, 462Butyl rubber aprons, 329, 332Butyl rubber gloves, 356–357Butyl rubber masks, 364–365, 369–370Butyl rubber overgarments, 370Butyrocholinesterase (BuChE), 132, 136–139, 192, 301Butyrophenones, 293Butyrylcholine, 132, 134BVO

See Black vinyl overboot (BVO)BZ (3-Quinuclidinyl benzilate), 5, 119, 159, 294–296

anticholinergic delirium produced by, 296chemical structure, 295clinical pharmacology, 295–296delivery systems, 121history, 5, 57–59, 291ID50, 295MED50, 296treatment, 298–302

C

CA (bromobenzylcyanide), 320

Index

695

Caffeine, 292CAI

See Chemical (Surety Material) Accident or Incident (CAI)CAIRA

See Chemical Accident or Incident Response and Assis-tance (CAIRA)

Calabar bean, 130, 298Calamine, 670Calcium ethylenediaminetetraacetic acid (CaEDTA), 261Calcium hypochlorite

See Hypochlorite solutionCalomys colosus, 592CAM

See Chemical Agent Monitor (CAM)Cambodia

See KampucheaCamp Detrick

See Fort Detrick, MarylandCamphor, 670Camp Terry, Plum Island, New York, 460Canada, 32, 427Canister mask arrangement, 364, 366–369Cannabinoids, 297–298Canvas Trench Fan, 22–23Capripoxvirus, 542Capsaicin, 316Carbamates, 130, 132, 134, 183–184

See also specific agentCarbamoylation, 184Carbaryl

See SevinCarbon tetrachloride, 199, 201, 310Carbonyl chloride

See Phosgene (CG)Carcinogenesis

and mustard exposure, 217, 237–238Cardiovascular effects

of brucellosis, 517–518of cyanides, 277of mustard, 217of nerve agents, 145, 155–157, 165–166, 169of Q fever, 528of riot control agents, 315, 321of staphylococcal enterotoxin B, 626of toxic inhalational injury, 252–253of viral hemorrhagic fevers, 596

Carus, W. Seth, 458Cassava, 273–274Castor beans, 610, 632–633, 635Castor oil, 610, 632, 636Casualty arrival point, 331–332Casualty decontamination, 329, 331–335, 340–341, 352, 386–

387, 408–410Casualty Decontamination Center (CDC), 329Casualty-receiving area, 331–335Cats, 487–488Cat scratch disease, 495–496Cattle, 417, 459–460, 548Cavanaugh, Dan C., 483CB Pressurized Pod, 67CBPS

See Chemical and Biological Protected Shelter (CBPS)C-CHF

See Crimean-Congo hemorrhagic fever (C-CHF)CCST

See Chemical Casualty Site Team (CCST)CD

See Cluster of differentiation (CD)

CDAESee Chemical defense aircrew ensemble (CDAE)

CDCSee Casualty Decontamination Center (CDC); Centers for

Disease Control and Prevention (CDC)cDNA

See Complementary DNA (cDNA)CDTF

See Chemical Decontamination Training Facility (CDTF)Cefazolin, 473Ceftriaxone, 497Centers for Disease Control and Prevention (CDC), 540, 551–

552, 596, 626, 651Central Intelligence Agency (CIA), 428, 454, 456–457, 461–462Central nervous system effects

of brucellosis, 517of cyanides, 277of mustard, 212, 239of nerve agents, 145, 149–155, 170, 233–234of Q fever, 529–530in toxic inhalational injury, 254of viral encephalitides, 571–574, 576

Centro Chemico Militaire, 29Cephalosporium, 656Cephalothin, 473Cerebrospinal fluid (CSF) examination, 576CF

See Complement fixation (CF)CG

See Phosgene (CG)Chad, 69CHAMP

See Chemically Hardened Air-Management Plant(CHAMP)

Chancroid, 495–496CHASE (Operation Cut Holes and Sink ’Em), 62–64CHATH

See Chemically Hardened Air Transportable Hospital(CHATH)

ChESee Cholinesterase (ChE)

Chemical accident/incident response and assistance, 409–411Chemical (Surety Material) Accident of Incident (CAI), 409Chemical Accident or Incident Response and Assistance

(CAIRA), 409–411Chemical agent monitor (CAM), 70, 378–379

decontamination certification with, 355–357and medical management, 332, 335

Chemical agents, 4–6, 10, 18–19, 22–24, 27, 29–31, 34–35, 37–39, 41, 52–53, 57, 62–63, 66–69, 72–74, 118–119

defense against, 1–6, 677–684definition, 398demilitarization, 115, 117, 411–412detection, 377–381deterrents to use, 6dispersal, 5incapacitation caused by, 292lethality, 607nonmilitary uses, 5–6, 115–116, 679nonpersistent, 5, 122–123offensive use, 112–117persistent, 5, 122–123, 157physical properties, 122–123release, See Delivery systems; specific systemreview of effects, 341–344storage, 411–412volatility, 122–123See also specific agent

Medical Aspects of Chemical and Biological Warfare

696

Chemical and Biological Protected Shelter (CBPS), 385Chemical bombs, 28, 40, 49–50, 59, 65–66, 71Chemical casualties

advising agencies for treatment, 398with combined injuries, 340, 347–348decontamination, 329, 331–335, 340–341, 352diagnosis, 112, 124field management, 325–336first aid for, 329–332medical management, 124–125, 329World War I, 6, 24, 91–92, 100–101, 200, 205

Chemical Casualty Site Team (CCST), 410Chemical Corps

biological warfare programs, 430creation of, 45post–World War II programs, 46–471950s programs, 47–551960s programs, 55, 57–621970s programs, 64–681980s programs, 68–72See also Chemical Warfare Service (CWS)

Chemical decontamination methods, 158, 354–355, 357–358,363

Chemical Decontamination Training Facility (CDTF), 71Chemical defense aircrew ensemble (CDAE), 373Chemical defense equipment, 124

aircrew, 368–370and chemical warfare capability, 113Cold War, 52–53, 60–62, 67, 69–70developmental, 375early, 12–13ground crew, 365–368individual, 363–377joint service use, 362, 375and medical personnel, 329, 331–332, 334, 338, 340–341post–World War II, 471920s, 27–28, 101–1021930s, 33–34, 101–1021960s, 60–621980s, 69–701990s, 74World War I, 15–18, 22, 91–94, 363–364, 393World War II, 37, 40–43, 103, 365, 394See also Collective protection; Masks; Mission-oriented

protective posture (MOPP); specific itemChemically Hardened Air-Management Plant (CHAMP), 385Chemically Hardened Air Transportable Hospital (CHATH),

385Chemically protected deployable medical system (CP

DEPMEDS), 384Chemical Personnel Reliability Program (CPRP), 399–402

baseline data for future exposures, 404periodic medical examinations, 404–406preplacement examination, 403–404, 406screening/evaluation, 399–404termination examination, 405

Chemical protective footwear cover (CPFC), 374Chemical protective glove set, 374–375Chemical protective overgarment (CPOG), 373Chemical rockets, 40, 58–59, 62, 71Chemicals in War (Prentiss), 123Chemical Stockpile Emergency Preparedness Program

(CSEPP), 409Chemical Surety Inspection (CSI)

documentation, 400–402Chemical surety material

definition, 399, 402

Chemical surety missioncivil–military relations and, 408–411definition, 398duty positions, 399–402healthcare and, 397–412

Chemical threatdefinition, 112and enemy capability, 113–114

Chemical warfareattempts to control, 13, 115, 117, 411–412, 678–679capability for, 113–117definition, 10early proposals and usage, 11–12, 88future, 125–126history, 9–75, 87–105and military healthcare provider, 6, 111–126, 328–335, 683–

684pre–World War I, 10–13, 88–901920s, 25–29, 101–1021930s, 29–36, 101–1021950s, 47–55, 104–1051960s, 55–64, 104–1051970s, 64–68, 104–1051980s, 68–72, 104–1051990s, 72–75, 104–105training, 48, 55–56, 71–72, 94, 124World War I, 13–25, 90–97, 290World War II, 36–47, 103–104, 125, 131, 200, 290

Chemical Warfare in Southeast Asia and Afghanistan (Haig), 68Chemical Warfare Review Commission, 70Chemical Warfare School, 26, 29, 35, 48, 71Chemical Warfare Service (CWS)

biological warfare programs, 426, 428, 632creation of, 18–19, 95permanent establishment of, 25–27post–World War II demobilization, 451920s programs, 27–291930s programs, 29–31World War I programs, 19–22World War II programs, 37–44See also Chemical Corps

“Chemical warfare threshold,” 117Chemical weapons

nations with capability for use, 114, 116, 679versus nuclear and biological weapons, 458–459proliferation, 114–118reduction or elimination, 115, 117, 411–412tactical and strategic use, 120–125versus toxin weapons, 605, 607

Chemical Weapons Convention, 75, 115, 117, 679Chemical workers

health education for, 407–410health surveillance for, 402–405

Chest radiographyand inhalational injury, 252, 259–261, 264and pneumonic plague, 494and Q fever, 530and tularemia, 506

Chickenpoxversus smallpox, 546

Chikungunya virus, 562, 578Chile, 463China

biological warfare program, 461–462Japanese invasion of, 35–36, 200, 218, 417–418, 485

Chipmunks, 487–488Chlamydia trachomatis, 496

Index

697

Chloramphenicol, 473, 497, 507Chloride of lime

See Hypochlorite solutionChlorine (Cl), 118, 255–257

clinical effects, 256history, 5, 11, 14–15, 27, 88–93, 95, 119, 248long-term health effects, 257physical properties, 255–256treatment, 256–257

1-ChloroacetophenoneSee CN (1-Chloroacetophenone)

2-Chlorobenzaldehyde, 315Chlorobenzene, 201o-Chlorobenzylidene malononitrile

See CS (o-Chlorobenzylidene malononitrile)Chloroform, 11Chloroform–methanol extraction (CMR vaccine), 532Chloropicrin (PS), 10, 12, 19, 27, 201Chlorosulfonic acid

See Sulfur trioxide–chlorosulfonic acid (FS smoke)Chlorpromazine, 280, 302Cholecalciferol, 498Cholera, 10, 12, 16, 33, 37, 42, 417–419, 462Cholinergic nervous system, 132–134Cholinesterase (ChE), 130–139, 159Cholinesterase (ChE) inhibitors, 130–142, 164, 236

See also Nerve agents; Organophosphorus compounds;specific agent

Chromium, hexavalent (CrVI), 363Chronic pulmonary disease, 237–238Churchill, Winston, 14, 125, 418, 427CIA

See Central Intelligence Agency (CIA)Cigarettes

Teflon-contaminated, 265–266Cigarette smoke

cyanide content, 273Cigarette smoking

and toxic inhalational injury, 250Cimex lectularius, 487Ciprofloxacin, 473Civil defense program

and biological warfare, 434–435, 446World War II, 41

Civil disturbancesriot control agent use during, 309–310, 313

Civilian resourcestraining, 409–410

Civil–military relationsand biological defense program, 434–435and chemical surety mission, 408–411

CKSee Cyanogen chloride (CK)

Clean Air Act, 412Clean treatment area, 331, 333, 335Cleghorn, G., 514Clethrionomys glareolus, 594Clindamycin, 473Clinton, William, 455Clostridium botulinum, 644, 646–647

See also Botulinum toxins; BotulismClostridium difficile, 463Clostridium perfringens, 421Clostridium tetani, 644, 646–647

See also Tetanus toxinClothing decontamination, 358, 408Cluster of differentiation (CD), 542, 622

CMRSee Chloroform–methanol extraction (CMR vaccine)

CN (1-Chloroacetophenone), 27, 119, 292, 309–310, 316–321Cobalt salts, 281Cocaine, 292Coccidioides immitis, 429Coccidioidomycosis, 429, 431Cochrane, Thomas, 88Codeine, 628Cold War, 47–64

binary weapons programs, 65–66, 70–71biological warfare programs, 50–52, 55, 58–60, 420–422,

426, 430, 656detection developments, 53–54, 60–62, 66–67, 70nerve agent production and development, 49offensive chemical agent developments, 49–50, 57–59protective device developments, 52–53, 60–62, 67, 69–70Soviet threat, 54–55

Collective protection, 384–386developmental, 386history, 33, 42, 60, 67, 70medical systems, 384–385for military vehicles, 67preattack measures, 328

Collective protection equipment (CPE)M28, 384

Colorado beetles, 418Combat lifesaver, 327, 339Combat medic, 327, 339Combat Service Mask, 41Combat Support Hospital (CSH), 328Combat vehicle filtration protection system, 368Combat Vehicle Mask, 70, 74Combined injuries, 340, 347–348

See also WoundsComboPen, 155, 163–165Committee on Biological Warfare, 427Complementary DNA (cDNA), 569Complement fixation (CF), 531, 573Compound W

See Ricin toxinConjunctivitis, 98–99, 208, 210, 214–215, 238, 314Contact lenses

and protective masks, 402–403Containment precautions, 430, 432–434Contamination

of medical equipment and facilities, 124–125, 157, 353, 357wound, 124, 347–348, 356

Continental United States (CONUS), 326, 328Convention on Prohibition of Bacteriological and Toxin

WeaponsSee Biological Weapons Convention

Convulsions, 154–155, 158, 165, 187, 239Copper oxide, 363Coquilletdia, 566Corneal damage, 210, 238, 317Corticosteroids, 598Corynebacterium diphtheriae, 647Cotton lung disease, 659Cough suppressants, 628Counterterrorism, 75Cowpox, 548Cows, 417, 459–460, 548Cox, Herald, 525Coxiella burnetii, 430, 524–526, 528–529

See also Q feverCoyotes, 488

Medical Aspects of Chemical and Biological Warfare

698

CP DEPMEDSSee Chemically protected deployable medical system (CP

DEPMEDS)CPE

See Collective protection equipment (CPE)CPFC

See Chemical protective footwear cover (CPFC)CPOG

See Chemical protective overgarment (CPOG)C protein, 570CPRP

See Chemical Personnel Reliability Program (CPRP)CR (dibenz(b,f)-1:4-oxazepine), 319–320Crackles, 251, 343–344Crick, Francis, 679Crimean-Congo hemorrhagic fever (C-CHF), 439, 593–596,

599Crimean War, 11, 13, 88Crimes Involving Poisons, 463CRM-197, 648Cross-neutralization tests, 573–574Crotocin, 665CS (o-Chlorobenzylidene malononitrile), 119, 292, 310–316

cardiovascular effects, 315, 321chemical structure, 310clinical effects, 310–316delivery systems, 121dermatological effects, 312–314, 320–321future use, 321gastrointestinal effects, 314–315history, 5, 310, 313metabolic effects, 315mutagenic effects, 315–316nations with capability for use, 114ocular effects, 314, 321physical characteristics, 310properties, 309pulmonary effects, 311–312, 321severe medical complications from, 317–318tolerance to exposure, 310–311

CSEPPSee Chemical Stockpile Emergency Preparedness Program

(CSEPP)CSF examination

See Cerebrospinal fluid (CSF) examinationCSH

See Combat Support Hospital (CSH)CSI

See Chemical Surety Inspection (CSI)Ct

definition, 142, 202, 249–250Cuba, 657Cui-xing-ning, 191Culex taeniopus, 567Culex tarsalis, 563–564, 566Culiseta melanura , 563, 566, 573Cunningham, Roy, 461Curare, 647CWS

See Chemical Warfare Service (CWS)Cyanate, 276Cyanides, 118–119, 271–282

antidotes, 279–282biochemical basis for poisoning, 274–276and combined injuries, 348, 355and CS-caused deaths, 315decontamination, 279detection, 380

food poisoning with, 463food sources, 273–274history, 5, 119, 273–274, 447laboratory findings, 278military uses, 273nonmilitary uses, 273–274pharmacokinetics and pharmacodynamics, 276poisoning presentation and management, 277–279, 342properties, 272prophylactic drugs, 281–282toxicity, 276triage considerations, 342, 344–347and wound decontamination, 355–356See also specific agent

Cyanogen bromide, 273Cyanogen chloride (CK), 118, 272–282

detection, 380history, 10, 16, 38, 40, 273–274properties, 272toxicity, 276

Cyanohydrin-forming drugs, 282Cyanomethemoglobin (CNMetHb), 275, 280Cyclohexyl alcohol, 185Cyclopentolate, 146Cyclophosphamide, 528Cynomys species, 487Cyprus, 524Cystathionase, 275Cytochrome oxidase, 274, 280Cytokines, 681Cytolysins, 609Cytosine arabinoside (Ara-C), 553Cytoxan, 237

D

DA (diphenylchlorarsine), 319Dakin’s solution

See Hypochlorite solutionDalden Corp., 374DANC

See Decontaminating Agent, Non-Corrosive (DANC)DAS

See 4,15-Diacetoxyscripenol (DAS)Davaine, Casimir-Joseph, 10da Vinci, Leonardo, 11–12Davis, Gordon, 525Davy, Humphry, 10DC (diphenylcyanoarsine), 319DDT

See Dichlorodiphenyltrichloroethane (DDT)Dead-space ventilation, 364Decontaminable litter, 389Decontaminating Agent, Non-Corrosive (DANC), 34, 62Decontaminating Apparatus, 62, 70Decontaminating Solution 2 (DS2), 62, 374, 388Decontamination, 351–358, 362

biological agents, 357–358casualty, 329, 331–335, 340–341, 352, 386–387, 408–410certification, 355chemical methods, 158, 354–355, 357–358, 363clothing, 358, 408definition, 352, 357equipment, 124–125, 353, 357, 387–388eyes, 352–353history, 22–24, 33–34, 42, 47, 54, 62, 70, 97–98importance, 157, 329and inhalational injury, 252

Index

699

methods, 354–355nerve agents, 47, 157–158, 168–169, 354–355, 387by oxidative chlorination, 354–355personal (self-), 157, 329–330, 352personnel, 352, 386–387personnel requirements for, 335physical methods, 354, 358, 363–364, 370skin, 157–158, 333, 335, 352–353, 356, 386–387, 408, 669–670spot, 333, 341, 353surgical instruments, 357time required for, 333, 335, 341toxins, 616, 660, 669–670training, 352, 387, 408vapor, 352, 356wounds, 352, 355–357, 387See also specific agent or method

Decontamination apparatus/systems, 62, 70, 97–98, 388Decontamination area, 332–333, 335, 409Decontamination equipment, 386–389Decontamination Kit, Individual Equipment (DKIE)

M295, 387–388Decontamination kits, 158, 335, 353–354, 387–388Deer mice, 487–488DEET (diethyltoluamide), 191Defense Research Establishment, Ottawa, Canada, 658Defoliants, 119

history, 44, 51, 56, 60, 62, 104, 419, 428Dehydration

and protective clothing use, 370–371, 406–407Deliriants, 294

See also specific agentDelirium

anticholinergic-induced, 296, 298–301Delivery systems, 120–122

biological agents, 121, 420–421, 429, 438–442, 446, 457, 656,658–659

and chemical warfare capability, 114, 116and choice of agent, 123history, 27, 31, 36–37, 39–40, 51–52, 58–59vapor, 121–122weather conditions and, 122–123, 125See also specific system

de Mussis, Gabriel, 416Demustardizing Apparatus, Commercial Type, 33Dendrochium toxicum, 659Dengue hemorrhagic fever, 593–596, 598–599Deoxynivalenol (DON), 659–661, 668Deoxyribonucleic acid (DNA), 515, 660–662, 679

alkylation, 203, 239complementary, 569

Deoxyribonucleic acid (DNA) viruses, 540–541Deoxyribonucleoproteids, 541Deoxyverrucarol (DOVE)–protein conjugate, 671Department of Defense Appropriation Authorization Act, 66–

67Department of Defense Biological and Chemical Defense

Planning Board, 430Depressants, 293

See also specific agentDermal effects

of anthrax, 471–473of Lewisite, 219of mustard, 201–202, 205–210, 214, 217, 238–239, 342–343of nerve agents, 143–145, 161–162, 167of phosgene oxime, 221of plague, 494–495of riot control agents, 312–314, 316–317, 320–321of smallpox, 543–545, 548–550

of trichothecene mycotoxins, 658, 665–666, 670of tularemia, 505of viral hemorrhagic fevers, 595–596

Derrick, Edward, 525Deseret Test Center, Fort Douglas, Utah, 430Detection, 124, 362, 377–383, 683

aerosol, 383, 448biological agent, 74, 377, 382–384, 431, 447–449chemical agent, 377–381Cold War, 53–54, 60–62, 66–67, 70developmental, 381integrated mobile systems, 381–383and medical management, 329point, 377–380post–World War II, 46preattack measures, 3281960s, 60–621970s, 66–671980s, 701990s, 74standoff, 53–54, 74, 380–381, 447–448toxins, 613World War I, 23World War II, 42See also specific detector

Detection paperM8 Chemical Agent, 335, 355, 357, 377–379M9 Chemical Agent, 378

Detector crayon, 42Detector kits, 42, 46

M256A1 Chemical Agent, 379–380Detector paint, 42, 46Detector paper, 42, 46, 66–67, 70Detoxification, 352Dexamethasone, 670Dextromethorphan, 628DFA staining

See Direct fluorescent antibody (DFA) stainingDFP

See Diisopropyl fluorophosphate (DFP)4,15-Diacetoxyscripenol (DAS), 660–661, 666Diamanus montanus, 487Dianisidine chlorosulfate, 14Diaphragm masks, 33Diarrhea, 212, 216, 314–315Diatomaceous earth, 353Diazepam, 154–155, 165–169, 191, 279, 347Dibucaine numbers, 137DIC

See Disseminated intravascular coagulation (DIC)Dichlorodiphenyltrichloroethane (DDT), 483Dichloroformoxime

See Phosgene oxime (CX)2,4-Dichlorophenoxyacetic acid (VKA), 44Dicobalt edetate, 279, 281DIDS, 275Dihydrocodeinone, 628Diisopropyl fluorophosphate (DFP), 132, 152–153, 233, 301Dilger, Anton, 16Dilger, Carl, 16Dimefox, 138Dimercaprol

See British anti-Lewisite (BAL)Dimethylaminopheno (DMAP), 2754-Dimethylaminophenol (4-DMAP), 279–281Dinitropheno (DNP), 275Diphenhydramine, 627, 670Diphenylaminearsine

Medical Aspects of Chemical and Biological Warfare

700

See DM (diphenylaminearsine)Diphosgene (DP), 16, 118–119Diphtheria toxin, 609, 647–648Direct fluorescent antibody (DFA) staining, 495–496DISCOM

See Division Support Command (DISCOM)Disinfection

definition, 357Disney, Walt, 41, 103Disseminated intravascular coagulation (DIC), 595–597Distilled mustard agent (HD), 38–39, 198–200Ditran, 298Diuretics, 253, 259–260Division Support Command (DISCOM), 327DKIE

See Decontamination Kit, Individual Equipment (DKIE)DM (diphenylaminearsine), 27, 119, 292, 309, 3194-DMAP

See 4-Dimethylaminophenol (4-DMAP)DNA

See Deoxyribonucleic acid (DNA)DON

See Deoxynivalenol (DON)Dopamine, 132, 598Doughty, John W., 11, 14, 88–89Doxycycline, 473, 497–498, 518DR1 emulsion, 33Drinking tubes, 60, 366–370Drones

for agent delivery, 59Dry heat decontamination, 358Dryvax, 551DS2

See Decontaminating Solution 2 (DS2)D-Stoff

See Phosgene (CG)Dugout blanket, 22Dugway Proving Ground, Utah, 427, 429, 432, 457Dugway sheep-kill incident, 62, 432Du Pont Advanced Fiber Systems, 373, 638Du Pont Company, 33, 38Du Pont Multi-Source Products, 302Du Pont Polymers, 264, 617, 638Dusts

definition, 248Dutch Powder, 353Dyer, Rolla, 525Dynamite, 89Dysentery, 12, 42, 417–418Dyspnea

nerve agent–induced, 145, 147–149, 158, 167–168, 170in toxic inhalational injury, 252, 255–256, 258–261, 265

E

EACSee Echelon Above Corps (EAC)

Eastern equine encephalitis (EEE), 570–574, 576–579Eastern equine encephalitis (EEE) virus, 562–564

PE-6 strain vaccine, 579Eastern equine encephalitis (EEE) virus complex, 564–566Ebola hemorrhagic fever, 432, 434–435, 439, 593–596Ebola viruses, 594Ebola–Zaire strain, 594ECG

See Electrocardiography (ECG)Echelon Above Corps (EAC), 328Echelons of care

definition, 326I: Unit Level, 326–327, 340II: Division Level, 327–328III: Corps Level, 328IV: Echelon Above Corps (EAC), 328V: Continental United States (CONUS), 328treatment emphasis at, 327

EcstasySee 3,4-Methylenedioxymethylamphetamine (MDMA)

Eczema vaccinatum, 549–550ED50

See Effective dose (ED50)Edema toxin, 470Edgewood Arsenal, Maryland, 19, 26, 30, 38–39, 49, 93, 101,

434, 460, 658EEE

See Eastern equine encephalitis (EEE)EEG

See Electroencephalography (EEG)Effective dose (ED50), 622Eglin Air Force Base, Florida, 429Egypt, 56, 104, 200, 418–419, 657Ehrlich, Paul, 632Electrocardiography (ECG), 156, 165–166Electroencephalography (EEG), 153, 235–236Electron transport system (ETS), 275ELISAs

See Enzyme-linked immunosorbent assays (ELISAs)Ember, L. R., 657Emergency medical treatment (EMT) station, 331–335Emetics

See Nausea-producing agents; specific agent ; Vomitingagents

Emetine, 671Encephalitis

equine, 562–579lethality, 444postvaccinial, 549–550

Encephalomyelitisnonviral causes, 576viral causes, 575

Encephalomyelitis virusesSee Viral encephalitides; specific virus

Endocarditisbrucella, 517–518Q fever, 528, 530

Endocrine systemeffects of cyanides on, 277

Endothelial-derived relaxing factor (EDRF), 275Enterocolitis, 625–626Entry point, 331–332Environmental concerns

with sea dumping, 62–64Environmental conditions

and agent delivery, 122–123Environmental samples

for toxin exposure diagnosis, 614, 617, 627, 668Enzootics

definition, 480genetic drift, 567–568and plague, 487and viral encephalitides, 564, 567–568, 572

Enzyme-linked immunosorbent assays (ELISAs)in biological agent diagnosis, 448–449in toxin exposure diagnosis, 617See also specific agent diagnosis

Epileptogenic substances, 292Epinephrine

Index

701

See AdrenalineEpiphytotics, 460Epizootics

definition, 480genetic drift, 567–568and plague, 487, 491and viral encephalitides, 564, 567–568, 571–572

Epoxide group, 656Equine encephalitis, 562–579Equipment decontamination, 124–125, 353, 357, 387–388Erythema multiforme, 549Erythrocyte cholinesterase (RBC-ChE), 132, 136–137

baseline and periodic measurements, 404–405inhibition, 138–139as nerve agent pretreatment, 192

Erythromycin, 473, 507, 531Escherichia coli, 609, 633, 682Eserine

See PhysostigmineEthiopia, 34–35, 102, 200Ethyl bromoacetate, 12–13, 308Ethylenediaminetetraacetic acid (EDTA)

cobalt salt, 279, 281Ethyl iodoacetate, 13Evacuation categories, 340Evans, A. C., 514Executive Order 11850, 308Exertion

and mask use, 365and toxic inhalational injury, 254–255

Explosive-release devices, 120–122Export controls

and chemical manufacturing, 116–117Eye decontamination, 352–353Eye irrigation

for mustard injuries, 98Eye pain, 147, 166–167, 215Eyes

protection from toxins, 612See also under Ocular

F

Faceblank, 364Fasciculations, 149, 168–170FDA

See Food and Drug Administration (FDA)FDECU

See Field deployable environmental control unit (FDECU)Feather bombs, 51Federal Emergency Management Agency (FEMA), 411–412Federal Security Agency, 426FH

See Field Hospital (FH)Field deployable environmental control unit (FDECU), 385Field Hospital (FH), 328Field management

of chemical casualties, 325–336Field manuals

for chemical surety inspection, 400Field Masks, 74Field medical card (FMC), 333, 335Field mouse, 592, 594Fildes, Paul, 645Filoviridae, 592–594Filter mask layer, 364–368, 370Finlay, Carlos, 10First aid

for chemical casualties, 329–332Fiske, Norman E., 34–35Fitness evaluations

for Chemical Personnel Reliability Program, 402–403Flaccid paralysis, 149Flame warfare agents, 90, 119Flannel hoods, 91Flaviviridae, 575, 592–594Flavonoids, 671Fleas

as bacterial agent vector, 33, 380, 482–489, 498Flechettes, 439–440, 442Flettner rotor, 441–442FLOT

See Forward line of troops (FLOT)Flour

decontamination with, 353–354Fluoroquinolones, 507, 531FM

See Titanium tetrachloride (FM)FMC

See Field medical card (FMC)Food and Drug Administration (FDA), 188, 463Food Machinery and Chemical Company, 49Food poisoning, 463, 622, 644, 646, 649, 659Food supply contamination, 442, 446–447, 459, 469Foot-and-mouth disease, 51, 460Ford, Gerald R., 64, 308Foreign material

in wounds, 356Formulation, 1222-Formyl-1-methylpyridinium chloride

See 2-Pralidoxime chloride (2-PAM Cl)Fort Detrick, Maryland, 43–44, 426–432, 434, 460, 616, 623–

624, 651Fort Morgan virus, 566Forward line of troops (FLOT), 326Forward Support Medical Company (FSMC), 329Foster, John S., 431Fourier Transform Infrared (FTIR) spectrometer, 380Fowl pest, 460Fox, Leon A., 31–32, 426FOX Nuclear, Biological, Chemical Reconnaissance System

(NBCRS), 74, 377, 381–383France

biological warfare programs, 32chemical warfare programs, 114

See also World War I; World War IIFrancis, Edward, 504Francisella tularensis , 383, 429, 504, 506–507

See also TularemiaFreeze drying, 440–441French and Indian War, 416Fries, Amos A., 18, 25–26, 28, 95FSMC

See Forward Support Medical Company (FSMC)FS smoke

See Sulfur trioxide-chlorosulfonic acid (FS smoke)FTIR spectrometer

See Fourier Transform Infrared (FTIR) spectrometerFugu toxin

See TetrodotoxinFuller, J.F.C., 35Fuller’s earth, 353Fumes

definition, 248Fumonisins, 656Fungal toxins, 609–610, 656

Medical Aspects of Chemical and Biological Warfare

702

See also specific toxinFusarenon-X

See MonoacetylnivalenolFusarium, 656, 658–659, 668Fusarium nivale, 659Fusarium semitectum var semitectum, 658

G

GASee Tabun (GA)

D-Galactose, 639γ-Aminobutyric acid (GABA), 132Gangliosides, 648Gases

airway distribution, 248–249definition, 248historical war, 255–260See also specific gas

“Gas Fright,” 95, 97, 343, 393Gas gangrene, 417Gas–liquid chromatography (GLC), 668–669Gas mask phobia, 393–395Gastrointestinal disturbances

anthrax-induced, 472–473CS-induced, 314–315mustard-induced, 212, 216nerve agent–induced, 145, 168staphylococcal enterotoxin–induced, 622–627See also Diarrhea; Nausea; Vomiting

Gas Warfare Service, 95See also Chemical Warfare Service (CWS); Chemical Corps

Gates, Robert, 456–457GB

See Sarin (GB)GD

See Soman (GD)Gel diffusion test, 546General Hospital (GH), 328General Ordnance Equipment Corp., 310Genetic engineering, 452, 454, 680Genetic recombination, 681Genetic weaponry, 682Geneva Protocol

history, 29, 34, 57, 64, 67, 69, 290, 427and riot control agents, 308, 321and status of chemical proliferation, 114, 679

Genitourinary tract infection, 517Gentamicin, 473, 497, 507Germany

biological warfare programs, 16, 32, 36–37, 418, 426, 459,644

chemical warfare programs, 5, 14–15, 89, 130–131post–World War II weapons disposal, 46viral hemorrhagic fever outbreak, 594See also World War I; World War II

GF, 119, 130–131, 230aging half-time, 183decontamination, 354Iraqi production, 185–186and pyridostigmine pretreatment, 185–186

GHSee General Hospital (GH)

Gilchrist, Harry L., 93, 96–98Glanders, 10, 16, 427, 431, 459GLC

See Gas–liquid chromatography (GLC)Gloves

protective, 373–375rubber/surgical, 356–357

Glucocorticosteroids, 670Glucose-6-phosphate, 203Glutathione (GSH), 203–204Glycolates, 295–296, 298

See also specific agentGlycoprotein synthesis, 570Goats, 528Goebbels, Joseph, 418Gorbachev, Mikhail, 453, 455Grains

moldy, 659See also Antiplant weapons; specific grain

Greek fire, 88Green cross

See Phosgene (CG)Green vinyl overboot (GVO), 374Grenades

hydrocyanic acid, 40–42smoke, 262tear gas, 90

Ground crew personal protective equipment, 365–368Ground squirrels, 487–488, 504Gruinard Island, Scotland, 418, 441GSH

See Glutathione (GSH)Guanarito virus, 593Guanine, 239Guarnieri bodies, 546Gulf War syndrome, xvi, 73, 105, 190, 191, 195, 297GVO

See Green vinyl overboot (GVO)

H

HSee Impure mustard agent (H)

Haber, Fritz, 14, 25, 89–91Haber’s law, 276Ha bomb, 33Haemophilus ducreyi, 496Haffkine, Waldemar M. W., 498Hague Convention of 1899, 89–90Hague Peace Conferences, 13Haig, Alexander M., 68Haloperidol, 293Hantaan virus, 593–594, 599Hantavirus disease, 594, 598Hantaviruses, 593–596Hantavirus pulmonary syndrome (HPS), 594–595Harassing agents

See Riot control agents; specific agentHarmine, 293Hart, B. H. Liddell, 35Haslett, Lewis P., 13HC

See Hexachloroethane (HC); Zinc oxide (HC)HD

See Distilled mustard agent (HD)Healthcare

and biological warfare, 445, 447, 683–684and chemical surety mission, 397–412and chemical warfare, 111–126, 328–335, 683–684

Health educationfor chemical workers, 407–408

Health service support (HSS), 326–328Heart block

Index

703

atrial–ventricular (A–V), 156Heart rate

effects of CS on, 315effects of cyanides on, 277effects of nerve agents on, 156–157in toxic inhalational injury, 253

Heat categoriesand work/rest cycles, 329–330, 371, 403, 405

Heat stressand protective gear, 125, 329–330, 367, 370–371, 394, 403,

405–407Helminthosporium oryzae van Brede de Haan, 460Hemagglutination assays, 497, 507, 517–518, 531Hemagglutination-inhibition (HI) tests, 566, 573Hemodialysis, 217Hemolysins, 609Hemopoietic changes

mustard-induced, 215–217Hemorrhagic fevers

See also Viral hemorrhagic fevers; specific virusHemorrhagic fever with renal syndrome (HFRS), 593–595,

597, 599Hemorrhagic meningitis, 471Henbane, 294HEPA filters

See High-efficiency particulate air (HEPA) filtersHeparin, 217, 597Hepatitis, 517Hepatitis A virus, 418Herbicides, 460Herpesviridae, 575Hexachloroethane (HC), 27, 260Hexamethamine tetramine, 260Hexamethyltetramine, 363Hexose monophosphate shunt, 203Heydrich, Reinhard, assassination of, 645HFRS

See Hemorrhagic fever with renal syndrome (HFRS)High-efficiency particulate air (HEPA) filters, 430, 432, 434Highlands J (HJ) virus, 566–567, 574High-mobility, multipurpose, wheeled vehicle (HMMWV),

382–385High-performance liquid chromatography–mass spectrometry

(HPLC-MS), 669Hill, Edwin, 427Hinsch, Frederick, 16HI tests

See Hemagglutination-inhibition (HI) testsHitler, Adolph, 103HJ virus

See Highlands J (HJ) virusHL, 119HMMWV

See High-mobility, multipurpose, wheeled vehicle(HMMWV)

Hmong, 3, 67–68, 656–658HN-1/HN-2/HN-3

See Nitrogen mustardHoffman, Theodore A., 12–13Hog cholera, 460Homatropine, 147, 166–167, 215Honest John rocket, 59Hoods

M6A2, 366Hoplopsyllus anomalus, 487Horses

biological warfare involving, 417, 459encephalitis viruses, 562–579

protective equipment for, 31, 91vaccination, 568, 576, 578

HospitalsChemically Hardened Air Transportable (CHATH), 385combat support, 328Echelon V (CONUS and ZOI), 328field, 328general, 328mobile surgical, 328personnel needs, 331

Hotlinein casualty-receiving area, 331–333, 335, 340, 410

HPLC-MSSee High-performance liquid chromatography–mass

spectrometry (HPLC-MS)HPS

See Hantavirus pulmonary syndrome (HPS)HS

See Mustard (HS)HSS

See Health service support (HSS)HTH solution

See Hypochlorite solutionHT-2 toxin, 660–661, 664, 666Hughes, M. L., 514HUGO

See Human Genome Organization (HUGO)Human Genome Organization (HUGO), 682Human Genome Project, 682Human immune globulin preparations, 434Human immunodeficiency virus (HIV) infection, 550, 552Humoral immunity, 505, 528, 542, 551, 683Hun Stoffe (Germany stuff)

See Mustard (HS)Hussein, Saddam, 72–74, 113, 416, 421, 679Hussein Kamal Hussein, 421Hydrocodone, 628Hydrogen cyanide (AC), 118, 272–282

detection, 380history, 10, 16, 37–38, 40–42, 104, 273–274physical properties, 122–123properties, 272toxicity, 141, 276

Hydrolysis, 121, 354–355, 387Hydroxamine, 162Hydroxide

dilute, 158Hydroxocobalamin (vitamin B12a), 279, 281Hyoscine

See ScopolamineHyoscyamine

See Atropine sulfateHyoscyamus falezlez, 290Hypertension

pralidoxime chloride–induced, 163–164, 170Hypochlorite solution, 352–358, 387, 408

contraindications, 314, 353, 356, 358for nerve agent decontamination, 158, 341preparation, 358for riot control agent decontamination, 314spot decontamination with, 333, 335for toxin decontamination, 616, 660, 669for vesicant decontamination, 214World War I use, 22–23

“Hypo helmet,” 363Hypotension, 170, 598Hypoxia

and inhalational injury, 252, 257

Medical Aspects of Chemical and Biological Warfare

704

I

Ibogaine, 293ICAM

See Improved Chemical agent monitor (ICAM)ICN Pharmaceuticals, 132Idoxuridine, 550IFA staining

See Indirect fluorescent antibody (IFA) stainingIg

See Immunoglobulin (Ig)I. G. Farbenindustrie, 130IL-6

See Interleukin-6 (IL-6)IMA

See Installation Medical Authority (IMA)Imipenem, 473Immune response, 681, 683

to brucellosis, 515–516to Q fever, 528to smallpox, 542, 551to staphylococcal enterotoxins, 622–623to tularemia, 505to viral encephalitides, 573, 576–577

Immunization, 681–683against anthrax, 473–474against botulinum toxins, 651against plague, 498against Q fever, 531–532against smallpox, 540, 546–551against staphylococcal enterotoxin B, 628against toxins, 615, 618–619against trichothecene mycotoxins, 671against viral encephalitides, 564, 576–579against viral hemorrhagic fevers, 599See also Vaccines

Immunoglobulin (Ig), 434, 516Immunology, 632, 681–683Immunotoxins, 632Imperial Chemicals, Ltd., 49Improved Chemical agent monitor (ICAM), 378–379Impure mustard agent (H), 199–200Incapacitating agents, 118–119, 287–302

biological, 292, 431, 439–440chemical, 292and combined injuries, 348delivery systems, 121differential diagnosis, 297–298historical precedents, 52, 57, 289–290ideal, criteria for, 288–289medical management, 298–302nonchemical, 291–292toxin, 608, 622triage considerations, 344, 346use, 289–291See also specific agent

Incapacitationdefinition, 288possible approaches to, 291–294

Incinerationof surplus chemical weapons, 72, 411–412

Indirect fluorescent antibody (IFA) staining, 531Individual Equipment Decontamination Kit, 70Indoles, 297–298, 302Industrial accidents, 119Industrial hygienist, 399, 402Infant botulism, 644, 646

Influenza viruses, 680–681Information-Telegraph Agency of Russia–Telegraph Agency

of Soviet Union (ITAR-TASS), 455Inhalational injury, 123, 247–267

biological agents, 440clinical effects, 249, 253and condition of exposed tissues, 250evaluation, 250–252exertion and, 254–255and intensity of exposure, 249–250laboratory measurements, 251–252nerve agent–induced, 139–144, 157, 161, 167patient history, 250–251physical aspects, 248–249, 251physiology, 249–250pulmonary effects, 253, 256, 258–259, 265–266, 343therapeutic considerations, 252–253, 255See also specific agent

Injectorsatropine, 54, 73, 155, 159–161, 169diazepam, 1652-pralidoxime chloride (2-PAM Cl), 73, 155, 163, 169

Insecticidesand plague prevention, 498See also Organophosphorus compounds; Carbamates;

specific agentInsects

as bacterial agent vectors, 33, 50See also specific insect or agent

Installation Medical Authority (IMA), 402–404, 406–407, 409Installation Response Force (IRF), 410Institute of Especially Pure Biopreparations, 454–455Integrated mobile systems, 381–383Interferon-alpha (IFN-α), 599Interferon-gamma (IFN-γ), 505, 516, 599Interleukin-6 (IL-6), 471Intermediate syndrome, 232–233International Declaration Concerning the Laws and Customs

of War, 13Iran

biological warfare program, 679Iran–Iraq War, 68–69, 321, 362

chemical casualties death rate, 6cyanide use during, 273mustard use during, 3–4, 104, 114, 116–117, 157, 198, 200–

201, 205, 214–216, 230, 237–239nerve agent use during, 104, 114, 116–117, 122–123, 230,

290Iraq

biological warfare program, 421–422, 462–463, 657, 679chemical warfare capability, 114–115, 117, 185–186

Iraqi Kurds, 4, 69, 74, 104, 273, 679IRF

See Installation Response Force (IRF)Irrigation solutions, 353, 357Irritants

See Riot control agents; specific agentIshii, Shiro, 32–33, 483Isolation procedures, 432–433, 497, 547, 598Isolators Ltd., 432Israel, 190, 608Italian–Ethiopian War, 34–35, 102, 200ITAR-TASS

See Information-Telegraph Agency of Russia–TelegraphAgency of Soviet Union (ITAR-TASS)

Ivanovskii Institute (Moscow), 562

Index

705

J

JACADSSee Johnston Atoll Chemical Agent Destruction System

(JACADS)Japan

biological warfare programs, 32, 36–37, 417–418, 426–427,446, 483–485, 540

chemical warfare programs, 37Imperial Unit 100, 418Imperial Unit 731, 417–418, 427, 483, 540invasion of China, 35–36, 200, 218, 417–418, 485sarin incidents in, 4, 75, 113, 118, 131, 169, 274, 342, 438,

463, 678Jenner, Edward, 548Jerks, 149, 158, 168–169Jimson weed, 294Johnston Atoll, 64, 72, 411Johnston Atoll Chemical Agent Destruction System

(JACADS), 72, 411Joint disease, 517Joint Service Lightweight Integrated Suit Technology

(JSLIST), 375–376Aviation Overgarment (AVOG), 375–376Duty Uniform (DU), 375–376Improved Chemical and Biological Protective Glove

(ICBPG), 376–377Multipurpose Overboot (MULO), 377Overgarment (OG), 375–376Vapor-Protective, Flame-Resistant Undergarment

(VPFRU), 375–377Joint United States/United Kingdom/Russia Trilateral

Statement on Biological Weapons, 4Junin virus, 592–593, 599

K

K-agents, 52Kampuchea, 3, 67–68, 421, 656, 666Kawasaki disease, 623, 628Kelocyanor, 281Keratitis

vaccinia, 550Keratopathy

delayed, 238α-Ketoglutaric acid, 282Kevlar, 373, 638Khmer Rouge, 656, 666Kitchener, Field Marshal Lord, 13Koch, Robert, 10, 468, 470Kops Tissot Monro (KTM) mask, 22, 28, 92Korea, North, 461–462, 679Korean hemorrhagic fever, 594Korean War, 47–48, 104, 394, 418–419, 429, 485, 594Kostov, Vladimir, 420–421Kuhn, Richard, 131Kuntsevich, Anatoly, 453, 455Kyasanur Forest disease, 593–594

L

LSee Lewisite (L)

LACSee Operation Large Area Coverage (LAC)

Lacrimators, 292, 308See also specific agent

Lactic acidosis, 279Laetrile, 274

Lane, Benjamin I., 13Laos, 3, 67–68, 421, 656–658, 665Laser detection systems, 380Lassa fever, 592–593, 595, 598–599Lassa virus, 592LCt50, 142, 183, 606LD50, 142, 183, 606LDS

See Lightweight Decontamination System (LDS)Le 100

See Tabun (GA)League of Nations, 28–29, 34Lederle Laboratories, 191Legionella, 525Legionnaire’s disease, 434Leporipoxvirus, 542Lethal factor, 470Leukocytosis, 635Leukopenia, 215–217, 667Lewis, W. Lee, 19Lewisite (L), 118–119, 218–220

antidote, 102, 218, 220biochemical mechanisms of injury, 218chemical structure, 218clinical effects, 218–219delivery systems, 121dermatological effects, 219detection, 42, 380–381differential diagnosis, 200, 212, 219–220history, 19, 36–38, 40, 46, 102, 198laboratory tests, 220long-term health effects, 217, 220military use, 218mixed with mustard, 201, 218nations with capability for use, 114, 116ocular effects, 219pharmacology, 199physical properties, 122–123, 218pulmonary effects, 219toxicity, 218treatment, 220vapor, 218–219

Lewisite shock, 219Libya, 4, 69, 74, 321, 524Lice, 487Light reduction, 145–146Light sources, high intensity

incapacitation by means of, 291–292Lightweight Decontamination System (LDS)

M17, 388Eli Lilly and Company, 280Lilly Cyanide Antidote Kit, 280–281Limitation of Arms Conference, 29Line source

for aerosol delivery, 441–442Lipid peroxidation, 204Lipopolysaccharide (LPS), 504, 515, 526, 528Liston, W. G., 486Litter

decontaminable, 389Litter decontamination station, 332–333, 410Litter-patient airlock

in chemical shelter, 385Little John rocket, 59Livens projector, 20–21, 31, 91Live vaccine strain (LVS), 507Loco weed, 294Loffler, F., 10

Medical Aspects of Chemical and Biological Warfare

706

LOPAIR ( long-path infra red) alarm, 53–54Lorazepam, 302LOST

See Mustard (HS)Lott, Joseph, 11LPS

See Lipopolysaccharide (LPS)LVS

See Live vaccine strain (LVS)Lymphogranuloma venereum, 495–496Lymphoid changes, 471, 495, 505–506, 571, 625D-Lysergic acid diethylamide (LSD), 52, 293, 302

M

MacArthur, Douglas, 29Mace

See CN (1-Chloroacetophenone)Machupo virus, 593Macrocyclics, 660Macromolecules, 192Macrophages, 515–516, 528Mafenide acetate, 214Magnesium sulfate, 670Mahan, Alfred T., 13Major, John, 455Major histocompatibility complex (MHC), 505, 622–623Malaria, 32, 418, 596–597Malathion, 132, 138Malononitrile, 315Manchuria, 418, 427, 483, 594Mandrake root, 289Manning, Van H., 17Marboran

See MethisazoneMarburg hemorrhagic fever, 439, 593–596Marburg virus, 594–595March, Peyton C., 25Marijuana intoxication, 298Marine toxins, 609

See also specific toxinMARK I kits, 252

atropine therapy, 161–162and combined injuries, 347Persian Gulf War use, 73, 155pralidoxime chloride therapy, 164–170self-administration, 329–330, 341

Markov, Georgi, 420–421, 632Marmots, 481–482, 488Marshall, John D., 483Marston, J. A., 514MASH

See Mobile Army Surgical Hospital (MASH)Mask-Only Command, 371–372Masks, 123, 362–370

Chemical–Biological: Aircraft, M43, 369Chemical–Biological: Aircrew MBU-19/P, 369–370Chemical–Biological: Field, M40, 363–364, 366–368Chemical–Biological: Field, M42, 368Chemical–Biological: Field, M17A2, 363, 366–367Chemical–Biological: MCU-2/P, 368Cold War, 53–54, 105and contact lenses, 402–403design, 364–365developmental, 370discipline in use, 94, 124, 393drinking tubes in, 60, 366–370early, 12–13

function testing, 365–366, 403for horses, 31, 91microphones in, 364, 366, 368–370M45 protective, 365M1 Service, 28, 33M2 Service, 40and nerve agent exposure, 157post–World War II, 46–47psychological effects of wearing, 393–395quality assurance concerns, 941920s, 28, 1011930s, 33, 1011960s, 60, 1051980s, 69–701990s, 74and toxin protection, 612, 669training, 393–395winterization kits, 366work of breathing added by use of, 365World War I, 15–18, 22, 91–94, 363–364, 393World War II, 37, 40–41, 43, 103, 365, 394

Mask-to-mouth resuscitator, 54Mass casualty biological (toxin) weapon (MCBW), 605–606,

611Mass hysteria, 124Mass spectrometry (MS), 669Mastomys natilensis , 592MAT

See Medical Augmentation Team (MAT)Material

biological agents directed against, 459, 461M256A1 ticket, 355Maximum credible event (MCE), 409Mayan, Thayer, 89Mayaro virus, 562MCAT

See Medical Chemical Advisory Team (MCAT)McAuliffe, Anthony C., 47McBride, Lewis M., 27MCBW

See Mass Casualty Biological (Toxin) Weapon (MCBW)McCarthy, Richard D., 431McCoy, G. W., 504MCE

See Maximum credible event (MCE)McNamara, Robert S., 55McNeill Consumer Products Co., 274MD

See Methyldifluorarsine (MD)MDMA

See 3,4-Methylenedioxymethylamphetamine (MDMA)Meade, John, 34–35MED50, 295–296MEDCEN

See Medical Center (MEDCEN)MEDDAC

See Medical Department Activity (MEDDAC)Mediastinitis, 471–473Medical Aspects of Chemical Warfare (Vedder), 102Medical assistance

procedures for requesting, 407–408Medical Augmentation Team (MAT), 410Medical Biological Defense Research Program, 615Medical care

levels of, 410safe environment for, 71, 124–125

Medical Center (MEDCEN), 398Medical Chemical Advisory Team (MCAT), 411

Index

707

Medical Collective Protection Systems, 384–385Medical defense

history, 87–105Medical Department Activity (MEDDAC), 398Medical directives

for chemical surety inspection, 401Medical Management of Chemical Casualties Course, 398, 409Medical Management of Chemical Casualties Handbook , 401Medical record card, 333, 335Medical Reengineering Initiative (MRI), 328Medical research

on human volunteers, 52, 60–61Medical Response Team (MRT), 410Medical support

in biological warfare environment, 445, 447, 683–684in chemical warfare environment, 111–126, 328–335, 683–

684Medical surveillance

for chemical workers, 402–405definition, 402

Medical treatment facility (MTF), 328, 409casualty-receiving area, 331–335contamination, 124–125, 353, 357

Mediterranean fruit fly, 461Melanoconion, 564, 567Melioidosis, 431Membrane-damaging toxins

mechanism of action, 609, 611See also specific toxin

Memorandum on Gas Poisoning in Warfare with Notes on itsPathology and Treatment (U.S. Army War College), 23–24

Memorandums of Agreement (MOAs), 401, 408–409, 411Meningitic plague, 491, 494Meningitis

anthrax-induced, 471–473hemorrhagic, 471

Meningococcal infection, 417Meningoencephalitic syndrome, 574Meningoencephalitis, 517Menthol, 670Mercaptopyruvate sulfurtransferase, 2753-Mercaptopyruvate sulfurtransferase, 276Merck, George W., 43, 426–427Merck Company, 43, 198Mescaline, 52Metabolic disturbances, 277, 315Metals

contamination with biological agents, 459, 461Methanesulfonate salt of pralidoxime (P2S), 163Methemoglobin, 275, 280Methemoglobin-forming drugs, 280–282

See also specific drugMethisazone, 552Methyldifluorarsine (MD), 273,4-Methylenedioxymethylamphetamine (MDMA), 293Methylisocyanate, 119Methylthiazolidine-4-carboxylate, 670Metoclopramide, 670Metrazole, 292Mevinphos, 138Meyer, Karl F., 498Meyer, Victor, 10, 198MHC

See Major histocompatibility complex (MHC)Mice, 487–488, 592, 594Michigan Department of Public Health, 473Mickey Mouse gas mask, 41, 103Microcystin, 609, 611, 616–617

Microphonesin masks, 364, 366, 368–370

Microwave bombardmentincapacitation by means of, 291

Midazolam, 154, 191Middelburg virus, 565Militarily significant weapon

definition, 604Military healthcare providers

biological warfare threat and, 6, 445, 447, 683–684chemical warfare threat and, 6, 111–126, 328–335, 683–684detection capability, 124safety from chemical contamination, 125, 157

Military installationsplague on, 483–484

Military medical facilitiescontamination, 124–125, 157, 353, 357

Military occupation specialty (MOS), 327Military vehicles

collective protection for, 67Mines, 31, 52, 58, 123Minnesota Multiphasic Personality Inventory (MMPI), 311Minnesota Patriots Council, 463–464Miosis

nerve agent–induced, 144–147, 166–168, 170Missile-control vans

collective protection for, 67Missiles, 120, 446Mission-oriented protective posture (MOPP) gear, 101, 123–

125, 169–170, 362, 371exchange procedure, 331, 334and heat stress, 125, 329–330, 367, 370–371, 394, 403, 405–

407level of efficiency in, 329, 362and medical personnel, 329, 331–332, 334, 338, 340–341postattack measures, 329preattack measures, 328psychological effects of wearing, 362, 393–395removal of, 333, 335, 355, 386, 669training, 393–395

Mission-oriented protective posture (MOPP) levels, 328, 372Mist

definition, 248MK 4 suit, 123MLRS

See Multiple Launch Rocket System (MLRS) BinaryChemical Warhead

MOAsSee Memorandums of Agreement (MOAs)

Mobile Army Surgical Hospital (MASH), 328Mobile decontamination facilities

World War I, 97–98Molasses residuum, 37Molds, 656, 659Molluscipoxvirus , 542Monkeypox virus, 542, 547, 551Monoacetylnivalenol, 659Monoclonal antibodies

as nerve agent pretreatment, 192in toxin prophylaxis, 615, 651, 671, 682–683

MOPPSee Mission-oriented protective posture (MOPP)

gear,Mission-oriented protective posture (MOPP) levels

MOPP Ready, 371–372Morocco, 102Morphine, 293Mortars, 21, 27, 31, 39, 48

Medical Aspects of Chemical and Biological Warfare

708

MOSSee Military occupation specialty (MOS)

Mosquito, 418, 430as viral encephalitides vector, 562–564, 566–568, 573, 577as viral hemorrhagic fever vector, 593–594, 596as yellow fever vector, 50

Most probable event (MPE), 409–410Mouth-to-mouth ventilation, 159MRI

See Medical Reengineering Initiative (MRI)MRT

See Medical Response Team (MRT)MS

See Mass spectrometry (MS)M9 tape, 355, 357MTF

See Medical treatment facility (MTF)Mucoid plugs, 148, 158Multiple Launch Rocket System (MLRS) Binary Chemical

Warhead, 71Muscarine (mAChR), 132–133Muscular system

effects of nerve agents on, 145, 149, 232Mussolini, Benito, 34Mustard (H)

impure, 199–200Mustard (HD)

distilled, 38–39, 198–200Mustard (HS), 118–119, 198–217, 230–231

biochemical mechanisms of injury, 202–204carcinogenic effects, 217, 237–238cardiovascular effects, 217central nervous system effects, 212, 239clinical effects, 204–212, 342–343and combined injuries, 347–348, 355–356deaths related to, 205, 212decontamination, 22–24, 33–34, 54, 157–158, 213, 354–355,

387dermatological effects, 98–100, 201–202, 205–210, 214, 217,

238–239, 342–343detection, 42, 66, 378, 380–381differential diagnosis, 200, 212–213, 219–220, 343exposure categories, 213–214gastrointestinal effects, 212, 216history, 5, 10, 27, 29–31, 34–40, 46, 56–57, 62–63, 102–104,

198inhalation, 100laboratory test for, 213long-term health effects, 97–101, 217, 230, 236–239metabolism, 204military use, 200–201mixed with Lewisite, 201, 218mutagenic effects, 239nations with capability for use, 114–116neuropsychiatric effects, 239ocular effects, 202, 208–211, 214–215, 238pharmacology, 199physical properties, 122–123, 199, 201pulmonary effects, 211–212, 215–217, 237–238recent use, 3–4, 69, 198, 200–201, 205, 214–216, 230, 237–239reproductive toxicity, 239teratogenic effects, 239thickened, 356toxicity, 201–202, 276treatment, 213–217triage considerations, 342–343vapor, 201–202, 237World War I use, 16, 19–24, 95–101, 119, 198, 200–201, 205,

210, 212–214, 216, 237–238, 393and wound decontamination, 355–356

Mustard burns, 98–100, 202, 205–208, 214, 238, 342–343Mustard shell, 40Mustargen, 198Mutagenesis, 239, 315–316Mutual aid agreements

for chemical surety inspection, 401Mycotoxicosis, 659, 670Mycotoxins, 656

See also Trichothecene mycotoxins; specific toxinMyrotecium, 656Myrothecium verrucaria, 659

N

NAD+ (nicotinamide adenine dinucleotide), 203Nairovirus, 593Naloxone, 302, 670Napalm, 119NAPP (nerve agent pyridostigmine pretreatment)

See Pyridostigmine bromideNAPPS

See Nerve agent pyridostigmine pretreatment set (NAPPS)Narcan

See NaloxoneNasal effects

of nerve agents, 145, 147, 167–168, 170Nasal mucosal swabs

for toxin exposure diagnosis, 614, 617, 627, 638, 650National Academy of Science, 43, 217, 220, 426National Research Council (NRC), 17, 43, 426National Security Memoranda

on use of biological weapons, 426, 431NATO

See North Atlantic Treaty Organization (NATO)Natural killer (NK) cells, 505, 516, 528Nausea, 145, 168, 212, 216, 314–315Nausea-producing agents, 292

See also specific agent; Vomiting agentsNBC officer

See Nuclear, biological, and chemical (NBC) officerNBC-PC

See Nuclear, biological, chemical protective covers (NBC-PC)

NBCRSSee FOX Nuclear, Biological, Chemical Reconnaissance

System (NBCRS)NBC Warning and Reporting System, 448Nduma virus, 565Nebelwerfer launcher, 36Neoprene masks, 41Neosporin, 214Neostigmine, 132, 298Nernst, Walther, 14, 91Nerve agent pretreatments, 132, 134, 181–193

biotechnological, 192–193and cardiopulmonary response, 156centrally acting, 191–192and central nervous system effects, 154, 187oxime, 164and pulmonary response, 149See also Pyridostigmine; specific agent

Nerve agent pyridostigmine pretreatment set (NAPPS), 189Nerve agents, 118–119, 129–171, 230

aging, 162, 182–183, 230antidotes, 158–159, 329binary weapons, 65–66, 70–72, 75, 104

Index

709

and blood cholinesterase activity, 138–139cardiovascular effects, 145, 155–157, 165–166, 169central nervous system effects, 145, 149–155, 170, 233–234and combined injuries, 347, 355–356versus commonly used cholinesterase inhibitors, 139in contemporary U.S. munitions inventory, 131decontamination, 47, 157–158, 168–169, 354–355, 387dermal exposure, 143–145, 161–162, 167detection, 53, 66, 378, 380–381differential diagnosis, 613–614, 638effects on organs and organ systems, 144–157, 230, 341–342electrocardiographic (ECG) effects, 156, 165–166, 235–236electroencephalographic (EEG) effects, 153exposure categories, 166–170exposure routes, 142–144gastrointestinal effects, 145, 168“G” series, 130history, 5, 30, 36, 46, 49, 56–58, 62–63, 103–104, 130–131,

290inhalational injury, 139–144, 157, 161, 167intermediate syndrome caused by, 232–233long-term health effects, 153–154, 170, 230–236mechanism of action, 132–136, 230mild exposure, 167–168minimal exposure, 167moderate exposure, 168moderately severe exposure, 168–169muscular effects, 145, 149, 232nasal effects, 145, 147, 167–168, 170nations with capability for use, 114, 116neuropsychiatric effects, 145, 149–155, 233–235occupational exposure, 136, 236ocular effects, 144–147, 166–168, 170oral effects, 145versus organophosphorus compounds, 231pharmacology, 139–142physical properties, 123polyneuropathy caused by, 231–232pulmonary effects, 145, 147–149, 167–168, 170and return to duty, 170severe exposure, 169suspected exposure, 166thickened, 356toxicological studies, 236treatment, 54, 73, 154–155, 157–170, 230triage considerations, 341–342, 344–346vapor exposure, 142–144, 157, 161, 167ventilatory support, 148, 158–159, 166–169“V” series, 130and wound decontamination, 355–356See also specific agent

Neuromuscular conduction, 132–134, 647Neuropsychiatric effects

of brucellosis, 516of mustard exposure, 239of nerve agents, 145, 149–155, 233–235of Q fever, 529–530of viral encephalitides, 573–574

Neurotoxinsclostridial, 644, 647differential diagnosis, 650mechanism of action, 609–611See also specific toxin

Neutrophils, 505Newcastle disease, 460New York State Psychiatric Institute, 52Niacinamide, 203Nicotine (nAChR), 132–133, 292

Nightshade, 289, 294NIKE missile-control vans, 60“Nine Mile Agent,” 525Nitric oxide, 263Nitrites, 280–281

See also specific agentNitrogen dioxide, 263Nitrogen mustard, 198, 200, 231

history, 30, 36, 38, 46See also Mustard (HS)

Nitrogen oxides (NOX), 263–264Nitrous oxide, 263Nivalenol, 659–661Nixon, Richard M., 63–64, 431, 525NK cells

See Natural killer (NK) cellsNobel, Adolph, 89Noguchi, Hideyo, 525Noise

incapacitation by means of, 291Nomex, 373Noradrenaline (norepinephrine), 132Norfolk Supply Center, Norfolk, Virginia, 429Noriega, Manuel, 291North Atlantic Treaty Organization (NATO), 70, 74, 182, 185,

354, 368Nosecup, 364–365Nosocomial transmission

of viral hemorrhagic fevers, 592–593, 595–596NOx

See Nitrogen oxides (NOx)NRC

See National Research Council (NRC)Nuclear, biological, and chemical (NBC) officer, 362, 445Nuclear, biological, chemical protective covers (NBC-PC), 669Nuclear age, 36–47Nuclear weapons

versus chemical and biological weapons, 458–459Number Facility (NF) performance, 296Nunn, Sam, 75Nursing care

for biological agent–exposed patients, 432–433, 598

O

ObidoximeSee Toxogonin

Obscurants, 260–266See also specific agent; Smokes

Occupational exposure, 119to anthrax, 468–469, 474and chemical surety mission, 398–399, 402–408to Q fever, 524, 532to ricin toxin, 636and U.S. biological warfare program, 398–399, 432, 434

Ochratoxins, 656Ocular effects

of cyanides, 277of Lewisite, 219of mustard, 202, 208–211, 214–215, 238of nerve agents, 144–147, 166–168, 170of phosgene oxime, 221of riot control agents, 314, 317, 321of trichothecene mycotoxins, 665–666

Ocular vaccinia, 549–550Oehler, Gordon, 462Off-gassing, 356Ofloxacin, 497

Medical Aspects of Chemical and Biological Warfare

710

Okinawa accident, 63–64Olfactory assault

incapacitation by means of, 292Olfactory nervous system

viral encephalitides infection through, 571–572Oligonucleotide primers, 627Omsk hemorrhagic fever, 593–594O’nyong-nyong virus, 562Open reading frame, 541Operation Cut Holes and Sink ‘Em (CHASE), 62–64Operation Davy Jones Locker, 46Operation Desert Shield, Operation Desert Storm

See Persian Gulf WarOperation Geranium, 46Operation Just Cause, 291Operation Large Area Coverage (LAC), 52Operation Red Hat, 64Operation Solid Shield 87, 71Operation Steel Box, 72OPIDN

See Organophosphorus ester–induced delayed neurotoxic-ity (OPIDN)

Opioids, 293, 302Opisochrostis hirsutus, 487Optical remote sensing (ORS), 380Oral exposure

to nerve agents, 145to trichothecene mycotoxins, 665

Orenburg, 659Orf, 473Organofluoride polymers, 264–266, 638Organophosphorus compounds, 130, 132, 231, 233–234

long-term health effects, 231–236mechanism of action, 134versus nerve agents, 231treatment of exposure, 163See also Nerve agents; specific agent

Organophosphorus ester–induced delayed neurotoxicity(OPIDN), 231–232

Oropharyngeal anthrax, 472–473Oropsylla idahoensis, 487Oropsylla labis, 487ORS

See Optical remote sensing (ORS)Orthopoxvirus, 540–542Overgarments, 363, 370–377

See also Mission-oriented protective posture (MOPP) gearOxidation

decontamination by, 354–355, 387Oximes, 162–165

contraindications, 167dosage and administration, 163–164, 169mechanism of action, 162–163for pretreatment use, 164, 183and pyridostigmine pretreatment, 184–187treatment, 164–165See also 2-Pralidoxime chloride (2-PAM Cl); specific drug

Oxygen supplementation, 253, 255, 257, 266, 279Oxytetracycline, 531

P

PADPRPSee Poly(ADP-ribose) polymerase (PADPRP)

Palmer, John M., 55Palythoa tuberculosa, 609Palytoxin, 6092-PAM Cl

See Pralidoxime chloride (2-PAM Cl)p-Aminoheptanoylphenone (PAHP), 280–281p-Aminooctanoylphenone (PAOP), 281p-Aminopropiophenone (PAPP), 275, 280–281Panama, 291, 524Paramyxoviridae, 575Parapoxvirus, 542Paraquat, 638Parathion, 132, 138, 232Paratyphoid, 42Parker, Ralph, 525Partial pressure of carbon dioxide (PCO2), 253, 264Partial pressure of oxygen (PO2), 252, 278Particles

and toxic inhalational injury, 249, 260Pasechnik, Vladimir, 453–455Passive hemagglutination assays (PHAs), 497Pasteur, Louis, 468–469Pasteurella tularensis, 60Patient decontamination, 329, 331–335, 340–341, 352, 386–387,

408–410Patient flow pattern

in chemical environment, 125Patient-isolation procedures, 432–433, 497, 547, 598Patient protection, 389Patient protective wrap (PPW), 335, 389Patient transport equipment, 389PATS

See Protection Assessment Test System (PATS)PB

See Pyridostigmine bromidePCP

See Phencyclidine (PCP)PCR

See Polymerase chain reaction (PCR)PDA

See Portable Decontamination Apparatus (PDA)PDDA

See Power-Driven Decontamination Apparatus (PDDA)PEEP

See Positive end-expiratory pressure (PEEP)Pellets

biological agent delivery via, 420–421, 442Penicillin, 473Pepper spray, 316Perfluorocarbon rubber masks, 364Perfluoroethylpropylene, 264Perfluoroisobutylene (PFIB), 264–266Permethrin, 191Peromyscus species, 487Pershing, John J., 6, 18, 25, 95Pershing missile, 59Persian Gulf War

anthrax vaccination during, 474biological warfare threat during, 2, 6, 72–74, 416, 421, 438,

444–445, 462, 608, 678–679botulinum vaccination during, 651chemical warfare threat during, 2, 6, 72–74, 117, 130–131,

198, 230, 362, 394, 678–679MARK I kits issued during, 73, 155medical aftermath of, xvi, 73, 105, 190, 191, 195, 297pyridostigmine pretreatment use during, 185, 188–191Q fever cases during, 524

Personal decontamination, 157, 329–330, 352, 408Personnel decontamination, 352, 386–387Personnel decontamination kits, 386Personnel documents

for chemical surety inspection, 401–402

Index

711

Petroleum productsbiological agents directed against, 461

PFIBSee Perfluoroisobutylene (PFIB)

PGSee Staphylococcal enterotoxin B (SEB)

Pharyngeal plague, 494Pharyngitis, 506PHAs

See Passive hemagglutination assays (PHAs)P helmet, 17Phencyclidine (PCP), 293–294Phenethylamine derivatives, 302Phenethylamines, 292Phenothiazine derivatives, 627Phenoxybenzamine, 280Phentolamine, 163–164PH helmet, 91Phillips Duphar, 132Phlebovirus, 593Phosgene (CG), 118–119, 257–260

clinical effects, 258, 343–344and combined injuries, 348detection, 42history, 5, 10, 27, 29–30, 36–38, 40, 248long-term health effects, 260physical properties, 123therapy, 258–260toxicity, 276triage considerations, 343–347World War I use, 16, 19, 21, 91–93, 95, 119

Phosgene oxime (CX), 220–222biochemical mechanisms of injury, 221chemical structure, 220clinical effects, 221dermatological effects, 221differential diagnosis, 200, 219–220, 638history, 220military use, 220ocular effects, 221pharmacology, 198–199physical properties, 220–221pulmonary effects, 221treatment, 221–222

Phospholipases, 609Phosphoric acid, 262Phosphorus pentoxide, 262Phosphorus smokes, 262Phosphorus trioxide, 262Phossy jaw, 262Photochemical smog, 263Photostimulation, high intensity

incapacitation by means of, 291–292p-Hydroxylaminopropiophenone, 281Physical decontamination methods, 354, 358, 363–364, 370Physical disturbances

incapacitation by means of, 291Physical examinations

for Chemical Personnel Reliability Program, 403–406Physostigmine, 130, 132

as anticholinergic antidote, 298–302chemical structure, 184dosage and administration, 299, 302mechanism of action, 134, 299as nerve agent pretreatment, 187, 191–192side effects, 191

Picornaviridae, 575Pine Bluff Arsenal, Arkansas, 429, 431

Pioneer Chemical Co., 62Plague, 479–499

as biological warfare agent, 482–485bubonic, 480, 486, 491–492, 497clinical manifestations, 491–495cutaneous manifestations, 494–495cycles, 489diagnosis, 495–497differential diagnosis, 574epidemiology, 486–489history, 10, 16, 32–33, 37, 42, 75, 416–417, 431, 454, 462–463,

480–482incidence, 489–491laboratory confirmation, 495–497lethality, 439meningitic, 491, 494pathogenesis, 491patient isolation procedures, 497pharyngeal, 494pneumonic, 454, 489, 491, 494, 497prophylaxis, 498septicemic, 480, 491–494, 497treatment, 497on U.S. military installations, 483–484vaccination, 498See also Yersinia pestis

Plantstransgenic research involving, 683weapons directed against, 44, 51–52, 60, 427–429, 431, 460–

461See also Defoliants; specific agent or plant

Plant toxins, 610See also specific toxin

Plaque reduction neutralization (PRN) antibodies, 573Plasma carboxylesterase, 192Plasma cholinesterase

See Butyrocholinesterase (BuChE)Plasminogen activator, 491Playfair, Sir Lyon, 11, 88Pneumonia, 506, 623Pneumonic plague, 454, 489, 491, 494, 497Pneumonitis, 253Point detectors, 377–380Point source

for aerosol delivery, 442Point-source explosives, 120The Poisoner’s Handbook, 463Polish Academy of Science, 419Pollution control

and weapons disposal programs, 412Poly(ADP-ribose) polymerase (PADPRP), 203Poly- D-glutamic acid, 469Polymerase chain reaction (PCR)

in biological agent diagnosis, 448–449in toxin exposure diagnosis, 617See also specific agent diagnosis

Polymer fume fever, 264–265Polyneuropathy, 231–232Polyparaphenyleneterephthalamide

See KevlarPolytetrafluoroethylene

See TeflonPortable Decontamination Apparatus (PDA), 62, 70, 388Porter, William N., 37–38, 45Porton Down Laboratory, England, 658Positive end-expiratory pressure (PEEP), 253, 257, 259, 266Positive-pressure total body suits, 432–434Postattack measures

Medical Aspects of Chemical and Biological Warfare

712

for medical support, 328–329Postsynaptic potential, 133–134Potassium cyanide, 273Poultry, 460Powders

biological agent dispersal as, 441decontamination with, 353–354

Powell, Colin, 74Power-Driven Decontamination Apparatus (PDDA), 388Poxviruses, 540–542

See also specific virusPoxvirus virions, 541PPW

See Patient protective wrap (PPW)Prairie dogs, 487–4882-Pralidoxime chloride (2-PAM Cl), 149, 162–165

dosage and administration, 163–165, 169and endurance time in protective gear, 394injectors, 73, 155, 163, 169and nerve agent cardiovascular effects, 156and nerve agent–induced seizures, 154–155pharmacokinetics, 163and pyridostigmine pretreatment, 184–187side effects, 163–164, 170

Preattack measuresfor medical support, 328

Prentiss, Augustin M., 123Preplacement examination

for Chemical Personnel Reliability Program, 403–404, 406Presidential Decision Directive 39, 6Prison incidents

use of riot control agents during, 318PRN antibodies

See Plaque reduction neutralization (PRN) antibodiesProchlorperazine, 627Project 80, 55Project 112, 55Project CD-22, 430“Project Whitecoat,” 428Promazine, 280Promethazine, 217, 280Propranolol, 165Prostigmin

See NeostigmineProtection and Detection Sets, 54Protection Assessment Test System (PATS), 365–366Protection factor (PF), 366Protective antigen, 470Protective boots, 373–375Protective ensembles, 371–373Protective equipment, 363, 370–377

acclimatization period, 406biological, 431, 447–448factors that restrict wearing of, 402toxins, 612–613, 669See also Chemical defense equipment; Masks; Mission-

oriented protective posture (MOPP) gear; specific itemProtective gloves, 373–375Protective Ointment Kit, 42Protective ointment sets, 54Protective ratio (PR), 183, 186Protein exotoxins, 469–470Protopam Chloride

See 2-Pralidoxime chloride (2-PAM Cl)PS

See Chloropicrin (PS)P2S

See Methanesulfonate salt of pralidoxime (P2S)

PseudocholinesteraseSee Butyrocholinesterase (BuChE)

Pseudomonas , 609Psilocybin, 293Psittacosis, 43–44, 427, 431Psychedelics, 293–294

See also specific agentPsychochemical agents, 292–294

See also specific agentPsychochemical Agents project, 52Psychological effects

of wearing mission-oriented protective posture gear, 362,393–395

See also Neuropsychiatric effectsPublic hostility, 62–63Public Law 91-121, 63Public Law 91-672, 64Public Law 92-532, 64Public Law 99-145, 71–72Public Law 102-484, 72Public Law 607, 45Public water systems

biological warfare testing involving, 428–429Pulex irritans, 483, 487Pulmonary effects

of anthrax, 472of brucellosis, 517of cyanides, 277of Lewisite, 219of mustard, 211–212, 215–217, 237–238of nerve agents, 145, 147–149, 167–168, 170of phosgene oxime, 221of Q fever, 530of ricin toxicity, 636–637of riot control agents, 311–312, 315–316, 321of staphylococcal enterotoxin B, 624–627of toxic inhalational injury, 253, 256, 258–259, 265–266, 343of trichothecene mycotoxins, 666, 670of tularemia, 506

Pulmonary function tests (PFT), 252, 265Pulmonary toxicants, 118–119, 247–267

See also Inhalational injury; specific agentPungi sticks, 419Puumala virus, 594Pyridine-2-aldoxime methyl chloride

See 2-Pralidoxime chloride (2-PAM Cl)2-Pyridine aldoxime methyl chloride

See 2-Pralidoxime chloride (2-PAM Cl)Pyridostigmine, 124, 183–191, 298

blister pack, 189blood–brain barrier permeability, 187chemical structure, 184dosage and administration, 187–188, 191drug interactions, 188efficacy, 184–187FDA informed consent waiver for, 188mechanism of action, 134and nerve agent cardiovascular effects, 156and nerve agent–induced pulmonary effects, 158and nerve agent–induced seizures, 154–155, 165as nerve agent pretreatment, 134, 149, 154–156, 158, 165,

182pharmacology, 183–184precautions, 187safety, 187–188side effects, 187, 189–190wartime use, 185, 188–191

Pyridostigmine bromide, 73, 132

Index

713

Pyrogenic toxinsSee Staphylococcal enterotoxin B; specific toxin

Pyruvate dehydrogenase complex, 218

Q

QDH/SSSee Quick Doff Hood/Second Skin (QDH/SS)

Q fever, 5, 523–532acute, 529–530chronic, 528, 530clinical manifestations, 528–530diagnosis, 530–531differential diagnosis, 574in domestic animals, 528epidemiology, 526–527history, 52, 430–431, 525lethality, 444military relevance, 524–525occupational exposure, 524, 532pathogenesis, 527–528prophylaxis, 531–532treatment, 531vaccination, 430, 531–532See also Coxiella burnetii

Q fever endocarditis, 528, 530QNB

See BZ (3-Quinuclidinyl benzilate)Quarpel-treated fabric, 373Quayle, Dan, 73Quick Doff Hood/Second Skin (QDH/SS), 743-Quinuclidinyl benzilate

See BZ (3-Quinuclidinyl benzilate)

R

Rabbits, 504Radiation Detector

ANVDR2, 382Radiographic findings

in brucellosis, 517See also Chest radiography

Radioimmunoassays (RIAs), 448, 668Rales, 343, 530Rapidity of action, 123Rats, 481–482, 486–488Rattus norvegicus , 482, 487–488Rattus rattus, 482, 487RBC-ChE

See Erythrocyte cholinesterase (RBC-ChE)RDIC (resuscitation device, individual, chemical), 159, 169Reagan, Ronald, 68, 70–71Receptor-mediated endocytosis (RME), 648–649Red mold disease, 659Red phosphorus, 262Reed, Walter, 10Remote sensing capability, 53–54, 74, 380–381, 447–448Remote Sensing Chemical Agent Alarm (RSCAAL)

M21, 74, 381–382Reoviridae, 575Replicating agents, 604Reproductive toxicity

and mustard exposure, 239Resin kit

M291, 353–354, 387Respiration

depth and frequency of, and toxic inhalational injury, 250,255

Respirators

See MasksRespiratory failure, 148, 252RESPO 21, 370Resuscitation

See Ventilatory supportReturn to duty, 170, 213, 331Reverse transcriptase polymerase chain reaction (RT-PCR),

597Revolutionary War, 417RFK mask

See Richardson, Flory, and Kops (RFK) maskRH-195, 33–34Rhabdoviridae, 575Rhinorrhea, 145, 147, 167–168, 170Rhodanese, 275Rhonchi, 343–344RIAs

See Radioimmunoassays (RIAs)Ribavirin, 598–599Ribonucleic acid (RNA), 541, 569, 662

genomic, 569–570Ribonucleic acid (RNA) viruses, 592Ribosomal ribonucleic acid (rRNA) analysis, 504, 525Rice, George S., 17Rice blast disease, 60, 460–461Rice fungus, 44, 427, 460Richardson, Flory, and Kops (RFK) mask, 22Ricinis communis

See Castor beansRicin toxin, 604, 631–639

anticancer effects, 632availability or ease of production, 438cause of death, 636–637clinical manifestations and pathology, 635–637detection, 383diagnosis, 637–638history, 10, 420–421, 446, 463–464, 632–633immunization, 638–639inhalation, 636–639injection, 635lethality, 608mechanism of action, 610–611military significance, 632–633native, 632occupational exposure, 636oral intoxication, 635pathogenesis, 634sample collection, 617structure, 633toxicity, 633–634treatment, 611, 616, 638–639

Ricketts, Howard T., 10Rickettsia mooseri , 418Rickettsia prowazeki, 418Rifampin, 518, 531, 552, 616Rift Valley fever (RVF), 434, 444, 593, 595–596, 599Rift Valley fever (RVF) virus, 593, 595, 599Rinderpest, 51, 460Riot control agents, 118–119, 292, 307–322

characteristics, 308–309decontamination, 320definition, 308future use, 321history, 5, 48, 56, 62, 75, 308–310medical care, 320–321nations with capability for use, 114severe medical complications from, 317–318types, 308

Medical Aspects of Chemical and Biological Warfare

714

See also Tear agents; specific agentRipley, James W., 11RME

See Receptor-mediated endocytosis (RME)RNA

See Ribonucleic acid (RNA)Rockets

chemical, 40, 58–59, 62, 71Rock squirrels, 487Rocky Mountain Arsenal, Denver, Colorado, 460–461Rocky Mountain spotted fever, 10, 525Rodents

that harbor plague, 480–482, 486–488, 498that harbor viral encephalitides, 567that harbor viral hemorrhagic fevers, 592–594, 596See also specific rodent

Roosevelt, Franklin D., 36, 43–44, 125, 426–427Roridin A, 661Ross River virus, 562Royall, Kenneth C., 45RSCAAL

See Remote Sensing Chemical Agent Alarm (RSCAAL)Rubratoxins, 656Russia

biological warfare programs, 420, 422, 453, 455, 679chemical warfare capability, 75, 115–116, 218, 679

Russo–Japanese War, 11RVF

See Rift Valley fever (RVF)

S

Sabia virus, 593Sacroiliitis, 517Sag Paste (Salve Antigas), 22Salmonella, 12, 447, 574, 683Salt intake

and protective gear use, 407Sanders, Murray, 32San Francisco Bay

biological agent testing, 429Sarin (GB), 118–119, 130, 230

aging half-time, 162, 183and blood cholinesterase activity, 138cardiovascular effects, 156case reports, 135–136, 147decontamination, 354detection, 378–381electroencephalographic (EEG) effects, 153, 236history, 30, 36, 46, 49–50, 58–59, 63–64, 66, 103, 130–131LCt50, 141long-term health effects, 154, 232, 235–236molecular model, 140nations with capability for use, 114–115neuropsychiatric effects, 152–153, 235ocular effects, 144–147pharmacology, 141physical properties, 122–123polyneuropathy caused by, 232pulmonary effects, 148and pyridostigmine pretreatment, 184–186recent use in Japan, 4, 75, 113, 118, 131, 169, 274, 342, 438,

463, 678toxicological studies, 236treatment, 163, 165

Satratoxin, 659, 661Saxitoxin, 604, 609

availability or ease of production, 439

dual use, 457lethality, 608mechanism of action, 610treatment, 610, 616

SBRSee Small-box respirator (SBR)

Scarification, 548Schäfer method of assisted ventilation, 159Scheele, Carl, 10Schrader, Gerhard, 30, 130Schutz, W., 10Schwarzkopf, H. Norman, 73Scopolamine, 191, 294–295, 298–299

ID50, 295Scopolamine hydrochloride, 153Scopolamine methylbromide, 153SCPE

See Simplified Collective Protective Equipment (SCPE)Screening

for Chemical Personnel Reliability Program, 399–404Scrub typhus, 495SDS polyacrylamide gel electrophoresis

See Sodium dodecyl sulfate (SDS) polyacrylamide gelelectrophoresis

SEASee Staphylococcal enterotoxin A (SEA)

Sea dumpingof surplus chemical agents, 45–46, 62–64

SEBSee Staphylococcal enterotoxin B (SEB)

Secobarbital, 293Secondary inoculation

and vaccinia vaccination, 548–549Secretion precautions

with biological agent–exposed patients, 433SED

See Staphylococcal enterotoxin D (SED)SEE

See Staphylococcal enterotoxin E (SEE)Seizures, 154–155, 165, 187, 279Selassie, Haile, 34Selenium, 671Self-aid

and chemical workers, 407, 409–410Self-decontamination, 157, 329–330, 352, 408Semliki Forest virus, 565, 569Sensory stimulation

incapacitation by means of, 291Seoul virus, 594Septic abortion, 516Septicemic plague, 480, 491–494, 497Sergeant missile system, 59Serotherapy

for viral encephalitides, 577Serratia marcescens , 32, 428–429Service Response Force (SRF), 410–411Sesquiterpenoids, 660Sevin, 132Shalikashvilli, John M., 104Shanty, Frank, 53Sheep, 528Shellfish toxins, 439

See also specific toxinShelter System, 67Shepherd, Forrest, 11Sherman, W. T., 416Shigella

Index

715

See DysenteryShuffle pit, 333Sibert, William L., 19, 25, 28Silent Death (Uncle Fester), 463Silicone rubber masks, 364–366Silver nitrate solution, 320Silver sulfadiazine, 214Simplified Collective Protective Equipment (SCPE), 385–386Sindbis virus, 562, 566–567, 577Sin nombre virus, 594Skin decontamination, 157–158, 333, 335, 352–353, 356, 386–

387, 408, 669–670Skin Decontamination Kit

M291, 387M238A1, 669M258A1, 387, 669XM291, 669–670

S-LOSTSee Mustard (HS)

Small-box respirator (SBR), 18, 91, 93–94, 364, 393Smallpox, 539–553

and biological warfare, 540–541chemoprophylaxis and chemotherapy, 552–553versus chickenpox, 546clinical manifestations, 542–546complications, 543–544diagnosis, 546–547eradication, 540, 543flat-type, 543, 545hemorrhagic-type, 543, 545history, 10, 12, 416–417, 462, 540immunoprophylaxis, 548–552modified-type, 546pathogenesis, 542–546patient-isolation procedures, 547treatment, 547–553vaccination, 540, 546–551See also Variola virus; Vaccinia vaccines

SmithKline Beecham Pharmaceuticals, 302Smoke inhalation

and cyanide poisoning, 273–274, 280, 282Smokes, 118, 260–266

definition, 248See also specific agent

Smoke tankairplane, 31

Snake venom toxins, 610, 650Soap and water

decontamination with, 353–354, 357–358, 388, 616, 669–670Sodium bicarbonate, 279, 670Sodium carbonate, 408Sodium dodecyl sulfate (SDS) polyacrylamide gel electro-

phoresis, 647Sodium hypochlorite

See Hypochlorite solutionSodium nitrite, 279–280Sodium phosphate, 670Sodium thiosulfate, 217, 279, 281, 363Solanaceae, 290, 294Somalia, 525, 540Soman (GD), 118–119, 130, 230

aging half-time, 162, 183blood–brain barrier permeability, 187cardiovascular effects, 156case report, 150–151decontamination, 354detection, 381

history, 3, 103, 131LCt50, 141long-term health effects, 153–154, 232, 235molecular model, 140muscle necrosis caused by, 232nations with capability for use, 114, 116neuropsychiatric effects, 153, 235pharmacology, 141physical properties, 122polyneuropathy caused by, 232pretreatments, 183–187, 192pulmonary effects, 148–149toxicological studies, 236treatment, 165

SOPsSee Standing operating procedures (SOPs)

Southeast Asiatrichothecene mycotoxin use, 419, 421, 609, 657–658See also specific country

Soviet Institute of Microbiology and Virology, 420Soviet PKhR-RM Chemical Agent Detector Kit for Medical

and Veterinary Services, 65Soviet Union

biological warfare program, 4, 29, 55, 67–68, 418, 429, 452–455, 485, 656–658, 679

chemical warfare program, 47, 54–55, 67–68, 72, 104, 114–117, 130–131, 679

SPESee Streptococcal pyrogenic exotoxins (SPE)

SPE-ASee Streptococcal enterotoxin A (SPE-A)

SPE-CSee Streptococcal enterotoxin C (SPE-C)

Spermophilus, 487Spermophilus beechyi , 487Spermophilus lateralis , 487Spermophilus richardsoni, 487Spermophilus variegatus, 487Spondylitis, 517Spot decontamination, 333, 341, 353Spray delivery, 40, 120–121, 441–442Spray drying, 440–441Squirrels, 487–488, 504SRF

See Service Response Force (SRF)SS John Harvey, 40, 103–104, 200Stachybotryotoxicosis, 659Stachybotrys , 656Stachybotrys atra , 659Standing operating procedures (SOPs), 401, 407–408Standoff detection, 53–54, 74, 380–381, 447–448Stanton, Edwin, 88Staphylococcal enterotoxin A (SEA), 622–623Staphylococcal enterotoxin B (SEB), 621–628

clinical manifestations, 626–627detection, 383, 627diagnosis, 627differential diagnosis, 473, 613–614, 638immunotherapy, 628incapacitation caused by, 622inhalational exposure, 623–626mechanism of action, 609pathogenesis, 623–626prophylaxis, 628toxicity, 608, 622treatment, 627–628vaccines, 628

Medical Aspects of Chemical and Biological Warfare

716

Staphylococcal enterotoxin C1 (SEC1), 622Staphylococcal enterotoxin C2 (SEC2), 622Staphylococcal enterotoxin C3 (SEC3), 622Staphylococcal enterotoxin D (SED), 622–623Staphylococcal enterotoxin E (SEE), 622Staphylococcal enterotoxins, 5, 622–623

classification, 622decontamination, 616diagnosis, 613incapacitation caused by, 431mechanism of action, 609sample collection, 617treatment, 616

Staphylococcus, 609Staphylococcus aureus, 622–623, 626Status epilepticus, 155STB

See Super tropical bleach (STB)Steam heat, 358Stenhouse, John, 10, 13Sterilization

definition, 357Sternutators, 308Steroid therapy

contraindications, 597for riot control agent exposure, 320–321for toxic inhalational injury, 253, 257, 264, 266

Stimson, Henry L., 29, 43, 426Stimulants, 292–293

See also specific agentStokes mortar, 21, 27, 31Strategic Biological Standoff Detection System, 448Streptococcal adenitis, 495Streptococcal disease, 473Streptococcal enterotoxin A (SPE-A), 622–623Streptococcal enterotoxin C (SPE-C), 622–623Streptococcal pneumonia, 623Streptococcal pyrogenic exotoxins (SPE), 622–623Streptomycin, 497, 507, 518Stress testing, 254Strychnine, 292Stubbs, Marshall, 54–55Submarine mine, 52Succinylcholine, 137Sudan, 594Suipoxvirus, 542Sulfur dioxide, 13–14Sulfur donors, 281Sulfur mustard

See Mustard (HS)Sulfur trioxide-chlorosulfonic acid (FS smoke), 262–263Superantigens, 622–623Super tropical bleach (STB), 54, 388, 408Surgical gloves, 356–357Surgical instruments

decontamination, 357Surgical irrigation solutions, 353, 357Survival Technology, 155Sverdlovsk accident, 4, 68, 420, 452–453, 468Synaptotagmin, 648Systox, 138

T

T-144See Sarin (GB)

TABSee N,N’-Trimethylenebis-[pyridine-4-aldoxime bromide]

(TMB4)Tabun (GA), 118–119, 130, 230

aging half-time, 162, 183behavioral effects, 152decontamination, 354detection, 381history, 30, 36, 46, 103, 130–131LCt50, 141long-term health effects, 232molecular model, 140nations with capability for use, 114pharmacology, 141physical properties, 122polyneuropathy caused by, 232pulmonary effects, 148–149and pyridostigmine pretreatment, 184–186recent use, 69toxicological studies, 236

TacrineSee Tetrahydroaminoacridine (THA)

Tactical Biological Standoff Detection System, 448Tank Collective Protector, 53Tank masks, 53, 70, 74TAP ensemble

See Toxicological agent protective (TAP) ensembleT cells, 505, 577, 622–623, 628Tear agents, 118–119, 308

delivery systems, 121history, 11, 13, 35–36, 56, 90, 104–105See also Riot control agents; specific agent

Techne, 132Teflon, 264–266, 617, 638Temperature

and agent delivery, 122–123and protective gear use, 125, 329–330, 367, 370–371, 394,

403, 405–407TEMPER (tent, extendable, modular, personnel) system, 384TEPP

See Tetraethyl pyrophosphate (TEPP)Teratogenesis

and mustard exposure, 239Terrorism, 6, 75, 117–118, 678, 683

and biological weapons, 117–118, 422, 438, 446–447, 461,463–464, 604, 609, 611, 633, 678, 683

and toxin weapons, 604, 609, 611, 633Terrorist weapon

definition, 604Tetanus toxin, 609, 644, 646–647Tetracycline, 473, 497–498, 507, 531–532Tetraethyl pyrophosphate (TEPP), 130Tetrahydroaminoacridine (THA), 301Tetrahydrocannabinol (THC), 52, 298Tetrodotoxin, 417–418, 609–610Thermal burns, 343Thiamine, 163Thickeners, 122, 356Thin-layer chromatography (TLC), 668Thiocyanate, 276Thiodiglycol, 213Thiolcalcium hypothesis

of mustard injury, 203–204Thiosulfate reductase, 275–276Third World nations

biological weapons programs, 456–458, 461, 678–679chemical warfare capabilities, 116–117See also specific nation

ThorazineSee Chlorpromazine

Index

717

Thrassus bacchi, 487Threshold limit value (TLV), 250Tick-born encephalitis, 444Ticks

as biological agent vector, 504, 525, 528, 593–594, 596Titanium tetrachloride (FM), 27, 263TLC

See Thin-layer chromatography (TLC)TMB4

See N,N’-Trimethylenebis-[pyridine-4-aldoxime bromide](TMB4)

TNFSee Tumor necrosis factor (TNF)

TOCPSee Triorthocresyl phosphate (TOCP)

Togaviridae, 562, 575Tooele demilitarization plant (Utah), 72, 411Topical skin protectants

for chemical warfare agents, 669Torsade de pointes, 156Tourniquet test, positive, 596Towelettes

decontamination, 158Toxic Agent Training Course, 409Toxic Chemical Training for Medical Support Personnel

Course, 398Toxicological agent protective (TAP) ensemble, 404Toxic shock syndrome, 623, 626–627Toxic shock syndrome toxin-1 (TSST-1), 622–623, 627–628Toxins

aerosolized, 605–608, 612analysis and identification, 617bacterial, 609, 647bioengineered production, 682chimeric, 632countermeasures, 610–619decontamination, 616, 660, 669–670definition, 604detection, 613diagnosis, 613–614ease of production, 605–608fungal, 609–610, 656immunization, 615, 618–619incapacitation caused by, 608, 622marine, 609mechanisms of action, 608–611, 648–649physical protection, 612–613plant, 610prevention, 614–616route of exposure, 604sample collection, 616–617shellfish, 439sources, 608–610stability, 605–608toxicity, 605–608, 612treatment, 614–616venom, 610, 650water purification methods effective against, 617–618See also Biological agents; specific agent

Toxin weaponsversus chemical weapons, 605, 607defense against, 603–619populations at risk, 611–612possible, 439terminology, 604

Toxogonin, 163TPS1/TPS2

See Topical skin protectants

Tracheobronchial destruction, 100Tracheobronchial stenosis, 215–217Training

chemical warfare, 48, 55–56, 71–72, 94, 124for chemical workers, 407–410of civilian resources, 409–410decontamination, 352, 387, 408protective gear, 393–395

Training Mask, 40Tranquilizers, 293Transport equipment, 389Treaties

chemical weapons, 4, 13, 72, 75, 104–105, 113, 115, 117, 411verification of compliance, 117, 420See also specific treaty

Treaty of Versailles, 29Trench fan, 22–23Triage, 337–349

definition, 338objective, 338

Triage categories, 331, 334, 339–341, 344–347chemical intermediate, 339delayed, 340, 344–346expectant, 340, 345–347immediate, 340, 344–345minimal, 340, 345–346urgent, 339

Triage officer, 331qualifications, 338

Triage station, 331–332Trichloromethyl chloroformate

See Diphosgene (DP)Trichoderma, 656Trichotecin, 665Trichothecene mycotoxins, 655–671

acute effects, 664–666aerosolized, 658–659, 666–667, 670anticancer potential, 667chemical and physical properties, 660chronic toxicity, 667clinical manifestations, 658, 664–667decontamination, 616, 660, 669–670dermal exposure, 665–666, 670diagnosis, 667–669ease of production, 659history, 655–659lethality, 658–659mechanism of action, 611, 660–662metabolism, 662–664military significance, 655–659occurrence in nature, 659ocular exposure, 666prophylaxis, 670–671protective equipment, 669recent use, 3, 68, 419, 421respiratory exposure, 666, 670structure, 659toxicology and toxicokinetics, 660–664treatment, 611, 669–671use in Southeast Asia, 419, 421, 609, 657–660, 665–666, 668See also specific toxin

Trichothecene ring, 656Trihexyphenidyl, 191Trilateral Agreement, 455Trilon-46

See Sarin (GB)Trilon-83

See Tabun (GA)

Medical Aspects of Chemical and Biological Warfare

718

Trimethoprim/sulfamethoxazole, 498, 518, 531N,N’-Trimethylenebis-[pyridine-4-aldoxime bromide]

(TMB4), 159, 163Trinitrotoluene (TNT), 89Triorthocresyl phosphate (TOCP), 232Truman, Harry S, 64T-Shell, 14TSST-1

See Toxic shock syndrome toxin-1 (TSST-1)T-2 toxin, 608–610, 659

aerosolized, 658–659chemical and physical properties, 660clinical manifestations, 658decontamination, 670dermal exposure, 665–666diagnosis, 668ease of production, 659lethality, 658–659mechanism of action, 660–662metabolism, 662–664ocular exposure, 666prophylaxis, 671protective equipment, 669toxicity, 661treatment, 670

Tuberculosis, 495Tularemia, 5, 503–508

clinical manifestations, 505–506diagnosis, 506–507differential diagnosis, 473, 495–496epidemiology, 504history, 10–11, 427, 429, 454, 504lethality, 444pathogenesis, 504–505prophylaxis, 507treatment, 507typhoidal, 505–507ulceroglandular, 505–507vaccination, 507See also Francisella tularensis

Tumor necrosis factor (TNF), 471, 505Twitches, 149, 158, 168–169Tylenol, 274, 447Typhus, 10, 33, 37, 42, 444, 495

U

UJI bomb, 32–33Ultraviolet radiation

decontamination with, 358Umbrella gun, 420–421United Kingdom

anticrop research programs, 460–461biological warfare programs, 32, 418–419, 427, 455, 645chemical warfare divisions

See World War I; World War IIUnited Nations, 683

chemical/biological weapons reports/inspections, 63, 104–105, 419–422, 444, 458, 461

and Iraqi chemical weapons program, 69, 73–74, 114, 201,462–463, 679

Resolution 687, 462–463, 679Resolution 715, 462–463, 679Security Council, 420, 462–463, 679Yemen Civil War investigation, 56–57

United Nations Special Commission (UNSCOM), 421, 463, 679United States

animals that harbor plague in, 487–488

anticrop research programs, 460–461biological field testing in, 429biological warfare and defense programs, 425–435, 455,

645chemical warfare agencies

See Chemical Warfare Service (CWS); Chemical Corpschemical warfare policies, 29, 36, 44–45, 48, 56, 63, 72, 75,

89–90, 104–105, 112, 117nerve agent inventory, 131plague cycles in, 489Q fever epidemiology in, 527See also Continental United States (CONUS)

UNSCOMUnited Nations Special Commission (UNSCOM)

U.S. Army Chemical Research and Development Center,Edgewood, Maryland, 658

U.S. Army General Order No. 100, 13U.S. Army Medical Department (AMEDD), 328, 428U.S. Army Medical Research Institute of Chemical Defense

(USAMRICD), 410, 434U.S. Army Medical Research Institute of Infectious Diseases

(USAMRIID), 431–434, 596, 599, 616, 623, 651U.S. Army Medical Unit, 430–431

See also U.S. Army Medical Research Institute of InfectiousDiseases (USAMRIID)

U.S. Army regulations/publicationsfor chemical surety inspection, 400

U.S. Biological Warfare Committee, 43U.S. Biological Warfare Program, 59–60U.S. Biological Weapons Program, 44U.S. House of Representatives Committee on Armed Services,

114Defense Policy Panel, 456Special Inquiry Into the Chemical and Biological Threat,

461, 678–679U.S. Public Health Service, 411U.S. Senate Committee on Governmental Affairs, 114USAMRICD

See U.S. Army Medical Research Institute of ChemicalDefense (USAMRICD)

USAMRIIDSee U.S. Army Medical Research Institute of Infectious

Diseases (USAMRIID)Ustinov, D. F., 453U Thant, 57

V

Vaccine interference, 578Vaccines

for animals, 434, 460, 464, 568, 576, 578biological agent, 60–61, 73, 434, 441, 460, 462, 681–683live attenuated, 507, 683recombinant vector, 683verified clinical take, 547See also specific agent or vaccine

Vacciniageneralized, 549ocular, 549–550progressive, 549–550

Vaccinia-immune globulin (VIG), 550–552Vaccinia keratitis, 550Vaccinia necrosum, 549–550Vaccinia vaccines, 540, 548–551, 683Vancomycin, 473V antigen, 486, 491Vapor, 121–122

airway distribution, 248–249

Index

719

decontamination, 352, 356definition, 248delivery systems, 121–122Lewisite, 218–219mustard, 201–202, 237nerve agent, 142–144, 157, 161, 167off-gassing from contaminated wounds, 356

Vapor Detector Kit, 42Variable domain-β (Vβ), 622Varicella

versus variola, 546Variola major, 543–544, 547Variola minor, 543, 545, 547Variola virus, 540–542

See also SmallpoxVariolization, 548Vector Laboratories (Russia), 540Vectors

for bacterial agent dispersal, 33, 37, 50See also specific vector or agent

Vedder, Edward B., 102VEE

See Venezuelan equine encephalitis (VEE)Vegetable killer acid

See 2,4-Dichlorophenoxyacetic acid (VKA)Vegetable killer liquid (VKL), 44“Veil” respirators, 91Venezuela

hemorrhagic fever outbreak, 593Venezuelan equine encephalitis (VEE)

clinical manifestations, 572–573diagnosis, 573enzootic, 567–568, 572epizootic, 567–568, 571–572history, 44, 431, 434immunization, 576–579incapacitation caused by, 439pathogenesis, 570–572

Venezuelan equine encephalitis (VEE) virus, 5, 562–564C-84 strain vaccine, 578–579TC-83 strain vaccine, 577–578Trinidad donkey (TrD) strain, 571, 577–578

Venezuelan equine encephalitis (VEE) virus complex, 564–566Venom toxins, 610, 650

See also specific toxinVentilatory support

for cyanide poisoning, 279for first interventions, 341history, 54, 60for mustard-exposed patients, 215for nerve agent–exposed patients, 148, 158–159, 166–169for toxic inhalational injury, 252–253, 257, 259, 266for toxin exposure, 616for viral hemorrhagic fevers, 597

Ventricular fibrillation, 156Verrucarin A, 661Verticimonosporium, 656Vesicants, 118–119, 197–222

clinical differences among, 200definition, 198detection, 378, 380–381incapacitation caused by, 292pharmacology, 199triage considerations, 342–347and wound decontamination, 355See also specific agent

VHF syndrome

See Viral hemorrhagic fever (VHF) syndromeVibrio cholerae

See CholeraVickers Medical Containment Stretcher Transit Isolator, 432Victor, Joseph, 427Vietnam, North, 656–657Vietnam War

adaptation of biological warfare during, 419and biological defense program, 431defoliant use during, 56, 62, 104–105, 297mask use during, 124, 394plague outbreaks during, 480, 483riot control agent during, 56, 62, 104–105riot control agent use during, 308–309

VIGSee Vaccinia-immune globulin (VIG)

Viral encephalitides, 561–579aerosolized, 570–572alphavirus structure and replication, 569–570antigenicity, 564–567clinical manifestations, 572–576diagnosis, 572–576differential diagnosis, 574–576epidemiology, 567–568history and significance, 563–564immunoprophylaxis, 564, 576–579pathogenesis, 570–572treatment, 576weaponization, 562–564See also specific virus

Viral hemorrhagic fevers, 591–600aerosolized agents, 592antiviral therapy, 598–599classification, 593clinical manifestations, 594–595diagnosis, 596–597epidemiology, 592–594immunoprophylaxis and immunotherapy, 599infectivity, 592isolation and containment procedures, 598nosocomial transmission, 592–593, 595–596treatment, 597–599See also specific virus

Viral hemorrhagic fever (VHF) syndrome, 592Viruses

modification, 680–681possible biological warfare agents, 439See also Biological agents; specific agent

Virus particlesprogeny, budding and release, 570

Vitamin B12aSee Hydroxocobalamin

Vitamin E, 217, 671VKA

See 2,4-Dichlorophenoxyacetic acid (VKA)Voicemitters, 364, 366, 368–370Volatility, 122–123Voles, 594Vomiting

CS-induced, 314–315mustard-induced, 212, 216nerve agent–induced, 145, 168relation of cholinesterase activity to, 139

Vomiting agents, 119, 292, 308, 319See also specific agent

von Deimling, General, 15von Liebig, Justus, 89

Medical Aspects of Chemical and Biological Warfare

720

von Steinmetz, Erich, 16von Tappen, Hans, 14VX, 118–119, 130, 230

aging half-time, 162, 183as anticholinergic antidote, 301and blood cholinesterase activity, 138–139decontamination, 158, 354–355, 387delivery systems, 121detection, 378, 380history, 49–50, 57–58, 63, 70, 131LCt50, 141–142long-term health effects, 234molecular model, 140nations with capability for use, 114–116neuropsychiatric effects, 152, 234pharmacology, 141physical properties, 122–123pulmonary effects, 148–149and pyridostigmine pretreatment, 184–186treatment, 163and wound decontamination, 356

W

Waco, Texas, 75, 291, 310Waitt, Alden H., 29–30, 45, 47Walcott, C. D., 17Walter Reed Army Medical Center, Washington, D. C., 432,

434Ward, Kyle, Jr., 30Warning systems

See Alarms; Detection; specific detectorWar Research Service (WRS), 43, 426–427Wart hog disease, 460Washington, George, 417Washington Post, 114Water

decontamination with, 158, 353–354, 357–358, 388, 616,669–670

Water intakeand protective gear use, 370–371, 406–407

Water solubilityof toxic inhalants, 249

Water supply contamination, 442, 446, 459Water testing kit

M272 Chemical Agent, 380Water treatment

for toxin contamination, 617–618Watson, Gerald G., 71Watson, James D., 679WBGT index

See Wet bulb globe thermometer (WBGT) indexW bomb, 632Weapons disposal programs, 45–46, 62–64, 72, 411–412, 431,

525, 564Weapons of mass destruction

comparison, 458–459Weather

and agent delivery, 122–123, 125and protective gear use, 125, 329–330, 367, 370–371, 394,

403, 405–407Webster, William H., 73, 114, 117, 462Wedum, Arnold G., 430Western equine encephalitis (WEE)

clinical manifestations, 574diagnosis, 574immunization, 576–579pathogenesis, 570–572

treatment, 576Western equine encephalitis (WEE) virus, 562–564

B-11 strain vaccine, 579CM-4884 strain vaccine, 579

Western equine encephalitis (WEE) virus complex, 565–567Wet bulb globe thermometer (WBGT) index, 329–330, 407Wheat blast fungus, 460Wheat stem rust, 51, 60Wheezing, 251–252White phosphorus (WP), 27, 260, 262Whole-body-protection equipment items, 375Wilson, George, 13Wilson, Woodrow, 16–17, 19Winter, Dennis, 92Winterization kits

for masks, 366Wipedown mitts, 387Wisner, Frank, 455Woehler, Frederick, 89Work/rest cycles

heat categories and, 329–330, 371, 403, 405World Health Organization, 419, 443, 456, 540, 542–543World Trade Center bombing (New York), 446World War I, 5, 13–25, 90–97

Allied chemical warfare program, 13–16, 93–94biological warfare programs, 16, 21–22, 90–97, 417, 446,

459, 540chemical casualties, 6, 24, 91–92, 100–101, 200, 205chemical warfare usage, 14–20, 96, 290cyanide use during, 273decontamination facilities, 97–98detection, 23gas casualty treatments, 23–24, 95–101mustard use during, 16, 19–24, 95–101, 119, 198, 200–201,

205, 210, 212–214, 216, 237–238, 393protective devices, 15–18, 22, 91–94, 363–364, 393riot control agent use during, 309–310, 320smokes used during, 260toxic inhalational injury during, 248, 254–260, 343

World War II, 36–47, 103–104anticrop research programs, 460biological warfare programs, 36–37, 42–44, 103–104, 417–

419, 426–427, 446, 483–485, 540, 632, 644–645chemical warfare preparations, 37–40, 125, 131, 200, 290civil defense program, 41cyanide use during, 273defensive equipment, 40–42demilitarization of captured weapons after, 45–46detection, 42plague outbreaks during, 482protective devices, 37, 40–43, 103, 365, 394Q fever outbreaks during, 524smokes used during, 262tularemia outbreaks during, 504U.S. chemical warfare policy, 44–45

Wound botulism, 644Wound contamination, 124, 347–348, 356Wound decontamination, 352, 355–357, 387Wounds

in casualties with combined injuries, 340, 347–348exploration and debridement, 356–357foreign material in, 356off-gassing from, 356thickened agents in, 356

WPSee White phosphorus (WP)

Wyeth, 551Wyeth-Ayerst Laboratories, 149, 163, 302

Index

721

Wyoming MOU, 72

X

Xenopsylla cheopis, 482–483, 486–487Xylyl bromide, 14

Y

Yatapoxvirus, 542Yellow cross

See Mustard (HS)Yellow fever, 593–595, 599

history, 10, 12, 32, 37, 50, 418Yellow rain, 419, 421, 609, 656–660, 665–666, 668Yeltsin, Boris, 4, 68, 420, 422, 453–455Yemen Civil War, 56, 104, 200, 657Yersin, Alexandre J. E., 482Yersinia enterocolitica, 485Yersinia pestis, 75, 463, 482, 485–486, 491

detection, 383lethality, 439

outer-membrane proteins (Yops), 485–486, 491staining for, 495–496virulence factors, 485–486See also Plague

Yersinia pseudotuberculosis, 482, 485Yom Kippur War

See Arab–Israeli War of 1973Yperite

See Mustard (HS)Ypres, Belgium, 14–15, 90, 200, 248, 308Y 62-63 virus, 566–567

Z

Zaire, 432, 435, 594Zhukov, Georgi, 54Zinc, 363Zinc cadmium sulfide, 52Zinc oxide (HC), 260–262Zone of Interior (ZOI), 326Zyklon B, 273