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February 27, 2002

Evaluation of Inhalational Anthrax

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(8):984-985. doi:10.1001/jama.287.8.983

To the Editor: Dr Borio and colleagues1 discussed the role of clinicians in their description of 2 patients who died of bioterrorism-related inhalational anthrax. However, they did not mention the role of the medical examiner in these cases, despite the fact that both patients underwent autopsies by medical examiners. Medicolegal death investigators (ie, medical examiners and coroners) in each state are authorized by statutes to investigate deaths that are sudden, violent, suspicious, or unexplained.2 These cases include deaths attributable to homicide and inapparent causes such as some infectious diseases and toxic exposures.3 As Borio et al concluded, deaths from known terrorist events are homicides; therefore, they fall under the jurisdiction of medical examiners and coroners. Because medical examiners and coroners are also an important arm of surveillance for unrecognized terrorist attacks,3 clinicians must report suspicious deaths and confirmed deaths caused by terrorism to the proper medicolegal authorities for investigation.

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