The primary means of dissemination of this chemical is via aerosol, but can include dissemination through water and food as well. QNB’s absorption methods occur through inhalation, ingestion, dermal contact, and eye contact. When in an aerosol form, it travels along the ground, thriving in poorly ventilated, low-lying, and confined areas. Signs and Symptoms are usually fairly delayed (anywhere from 4 to 36 hours) but long lasting (3 to 4 days, dependent on severity of toxicity); directly dependent on dose and route of exposure (CDC, 2015). The mechanism of action of QNB is an inhibitor of neurotransmitter acetylcholine neurons as the postjunctional muscarinic receptors in cardiac and smooth muscle, as well as in exocrine glands, and the postsynaptic receptors in neurons (USAMRIDC, 2007).
If exposed to this agent, supportive care is the best means of mitigating life-threatening damage. Decontamination must commence, with the use of soap and water, once this is completed and it has been determined that severe toxicity has occurred, the use of physostigmine is indicated, although hospital staff must be aware and prepared to deal with a wide range of adverse affects. (Fitzgerald, 2015).
Although there have been no confirmed reports of this agent being used by governments, armies, terrorist organizations, factions, etc.; but the empirical data comes from tests