BACKGROUND Family physicians are likely to care for patients that have been exposed to diseases associated with bioterrorism. Persons with seemingly nondescript initial disease symptoms could be harbingers of a larger outbreak, whether naturally occurring or purposefully created. METHODS We report a missed sentinel case of pneumonic tularemia associated with a naturally occurring outbreak. Th...

Ian Roberts, Professor of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK believes that most people in the USA and UK would have preferred not to go to war on Iraq. To persuade them to do so, they need to believe that they are being attacked. To this end, he said, in a letter published in the BMJ (Volume 326, p 820) that medical journals have (unwittin...

Syndromic surveillance is the regular collection, analysis, and interpretation of real-time and near-real-time indicators of diseases and other outbreaks by public health organizations. Motivated by the threat of bioterrorism, syndromic surveillance systems are being developed and implemented around the world. In a 2004 systematic review of publicly available information, 115 surveillance syste...

After the human anthrax cases and exposures in 2001, the Illinois Department of Public Health received an increasing number of environmental and human samples (1,496 environmental submissions, all negative for Bacillus anthracis). These data demonstrate increased volume of submissions to a public health laboratory resulting from fear of bioterrorism.

Since it first appeared as a clinical syndrome in Central Africa in the mid1970s, accompanied by isolation of the causative virus, Ebola virus disease has fascinated infectious disease clinicians, virologists, and epidemiologists because of the striking clinical syndrome exhibited by patients (which culminates in a hemorrhagic diathesis in approximately 35% of infected individuals) [1], high ca...

The threat of bioterrorism has heightened over the past few years, given the history of asymmetric warfare. This threat posed by biological weapons is especially challenging, given the unique characteristics of these agents coupled with the dearth of knowledge in this particular subject by health care first responders. As the history of biowarfare has shown, exposure to even minute quantities o...

Until 1997, the subject of bioterrorism was not discussed within the medical community and deliberately ignored in national planning efforts. Biological weapons were regarded as "morally repulsive." This complacency stemmed from a 1972 Biological Weapons Convention where all countries agreed to cease offensive biological weapons research. In the 1990s, however, the Soviet Union was discovered t...

Pandora’s box has been opened. At the time of writing this Editorial in early November, a magazine editor in Florida, two postal workers in the mail office of Congress and a hospital worker in New York have died of pulmonary anthrax. Thirteen more, including a 7-month-old baby, have been infected with anthrax spores sent via anonymous letters. Distributing anthrax through the mail is not an eff...

A decision taken with the intention of protecting society against attack by biological weapons could, perversely, increase the very same danger. That is the implication of a debate now raging in the USA over the support of research on pathogens that might be used by terrorists. An alleged shift in funding in the wake of the 9/11 disaster and the ‘anthrax letters’ sent during 2001 means that mor...