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February 20, 2002

Bioterrorism Preparedness and Response: Clinicians and Public Health Agencies as Essential Partners

Author Affiliations

Author Affiliations: Centers for Disease Control and Prevention, Atlanta, Ga.

JAMA. 2002;287(7):898-900. doi:10.1001/jama.287.7.898

Beginning in mid-September 2001, the United States experienced unprecedented biological attacks involving the intentional distribution of Bacillus anthracis spores through the postal system.1 The full impact of this bioterrorist activity has not been assessed, but already the toll is large. A total of 22 persons have developed anthrax and 5 have died as a direct result.2-5 More than 10 000 persons were advised to take postexposure prophylactic treatment because they were at known or potential risk for inhalational anthrax; in addition, more than 20 000 others started such treatment until the investigation provided reassurance that exposure was unlikely and treatment could be stopped; thousands more were victims of hoaxes or false alarms, and still more were worried coworkers, friends, and family members of those directly affected.6 The impact was not limited to the United States. Hoaxes involving threatening letters or powder-containing envelopes were reported from several countries; mail cross-contaminated with B anthracis was distributed to some US embassies, and persons in remote corners of the world were advised to take prophylactic antimicrobial treatment.