At the end of his or her shift, hours after discharging the first young man with those vague symptoms, the patient returns acutely short of breath, cyanotic, and hypotensive. A terrorist needs to go no further than an Internet connection to download the appropriate recipe with easily obtainable ingredients. It is sobering. The two most likely potential methods of dissemination are a line source and a point source. A line source technique is the most effective dispersal means for biological agents.
Inversions normally occur at dawn, dusk, or night.
The point source technique uses small bomblets deployed in a saturation mode. The saturation technique overcomes the meteorologic requirements for line source dissemination. Small packages or envelopes may contain biological agents, but unless they also contain a dispersal device, they are not likely to pose an inhalational threat. Cutaneous exposure provides the least potential for significant morbidity and mortality, since intact skin provides an excellent barrier against most of these agents except mycotoxins. However, mucous membranes, abrasions, or other lesions may provide a portal of entry for bacteria, viruses, or toxins.