FOOD.-In the event of a known or suspected biological attack, all exposed or unpackaged foods not in critical supply should be destroyed. In most instances, food can be rendered safe for consumption by application of moist-heat cooking procedures. In some instances, deep-fat cooking is adequate. Some foods, however, cannot be sterilized because the treatment would render them unacceptable for consumption.

WATER.-Chlorination is by far the almost universal method of purifying water, and it destroys most of the biological agents. Boiling may be required to ensure proper decontamination in exceptional cases.

The military establishes water points in the field whenever possible. The equipment location at these points provides for filtration as well as chlorination and, when properly operated, is effective in removing organisms that produce disease. Some biological agents cannot be destroyed by normal water- purification techniques. When biological agents are known to have been used, all drinking water must be boiled. In the preparation of water for large numbers, the boiling procedure should be supervised. Water boiling may, of necessity, become an individual responsibility and may be so directed.

For small groups of people, the Lyster bag is provided as a suitable container for the storage of water that has already been treated. Water that has not been made potable previously is purified in the Lyster bag by means of chemicals. Water purification procedures are discussed in detail in the Preventive Medicine Manual, NAVMED P-5010.

DECONTAMINATION
Personal decontamination following actual or suspected exposure to biological agents will depend upon the existing tactical situation and the facilities available. If the situation permits, contaminated clothing should be carefully removed and the body washed thoroughly with soap and water before donning fresh clothing. Specific attention should be given to decontamination and treatment of skin lesions.

Normally, each individual is responsible for his own decontamination. If a person is physically unable to decontaminate himself, this process has to be performed by other available personnel. Since illness resulting from exposure to biological warfare may be delayed because of the incubation period, decontam- ination may occur before the individual becomes ill. Decontamination of the wounded is the responsibility of Medical Department personnel. When the situation and the condition of the casualty permit, decontamination should come first. However, massive hemor- rhage, asphyxia, or other life-endangering conditions naturally receive priority.

In general, all candidates for decontamination should first have all exposed areas thoroughly washed with soap and large amounts of water, the mask adjusted, and all contaminated clothing removed. The casualty may then be moved to a clean area where the wounds can be treated.

Decontamination procedures are the same as those used for casualties of chemical warfare.

RADIOLOGICAL WARFARE
Radiological-the "R" in CBR-warfare is more frequently referred to as nuclear warfare. The principles of treatment of casualties, as developed from previous experiences in conventional warfare, are applicable in the treatment of casualties produced by radiological warfare. With the exception of ionizing radiation effects, the type of injuries produced in nuclear warfare are similar to those of conventional warfare. Standardized techniques of treatment must be adopted for all types of casualties so the greatest number of patients can receive maximum medical care in the shortest period of time with the greatest economy of medical personnel and equipment.

HISTORY
The death and devastation evidenced by the first and only use of nuclear power in wartime (in Hiroshima and Nagasaki, Japan, at the end of World War II) has, to date, kept it from being used again. Although a nuclear nonproliferation treaty has been signed by most of the major powers, nuclear weaponry is still a part of the arsenal of many countries of the world, some of which, if given the opportunity and excuse, would not hesitate to employ it to achieve victory at any cost.

History has shown that nuclear warfare is capable of producing a large disparity between the available medical care and the number of casualties requiring care. The capabilities of medical facilities and personnel must be surveyed to determine how and where they can best be utilized. Both professional and nonprofessional personnel must be trained in additional skills related as far as possible to their primary duties. Within medical organizations, efficiency will depend upon controlled patient flow, adequate supplies, and continuing essential housekeeping and administrative functions. To meet the requirements, it is essential that all medical service personnel be trained to assume some additional responsibilities.