Bioterrorism: how prepared are we?

Richard Preston’s The Cobra Event, which he dedicates to public health professionals, weaves a chilling, but compelling tale about a lone terrorist’s attack on Manhattan with a genetically engineered virus. Preston’s thought-provoking novel raises a logical question: How do we successfully contain and combat the threat of bioterrorism? To meet this emerging threat, we must address four important challenges. The first challenge is to be aware that an act of bioterrorism could happen. Its likelihood is entirely unknown, and an attack may never occur. However, we have seen terrorism emerge as one of the thorniest problems of the post-cold war era, and we have seen that terrorists are always searching for new weapons. We have already seen sarin nerve gas released in the Tokyo subway. Somewhere, sometime in the future, terrorists may well threaten to use, or attempt to use, a biological weapon against the United States. When discussing the possibility of a terrorist attack in the next few years, the president unequivocally stated, “This is not a cause for panic. It is cause for serious, deliberate, disciplined, long-term concern.” In other words, we must not be afraid, but we must be aware. Once we are fully aware that bioterrorism could happen, our second challenge is to be prepared. That is why the Department of Health and Human Services (HHS) is spending $158 million this fiscal year to prepare for bioterorrism and why the president has proposed increasing that investment by an additional $72 million in his Fiscal Year 2000 budget. This investment will fund our ongoing Anti-Bioterrorism Initiative. To increase our level of preparedness, the initiative is expanding its activities in a number of key areas: surveillance, medical and public health response, building a stockpile of drugs and supplies, and research and development. We are improving and strengthening the U.S. public health surveillance network by enhancing our capability to detect and report outbreaks, conduct epidemiologic investigations, perform laboratory tests to identify biological agents, and communicate necessary information and advisories rapidly through electronic technology. We are enhancing our medical and public health response capacity by spearheading an administrationwide effort to develop infrastructure at the local level by establishing in major American cities medical response teams to deal with the consequences of bioterrorism. We are also expanding our capacity to provide prophy-laxis, medical care, and infection control on a massive scale. We are creating, and will be maintaining, an unprecedented national …