[The Israeli medical response plan for an unusual biological event]

Lack of national preparedness for biological warfare or a bioterrorism event as well as for a natural outbreak of a dangerous agent may lead to grave consequences (large-scale morbidity and mortality) in the short and long term. Threat assessment and its consequences are the basis for the contingency for such an event, with the medical community playing the leading role. In this article we present the principles of the Israeli medical response plan for an unusual biological event--whether of natural origin or a deliberate attack. The primary goals of the preparedness program are reducing mortality and morbidity, preventing a disaster, decreasing the irrational public response and inducing the resumption of the normal course of life. The program presented and its phases are universal, with the proper modifications needed to be implemented according to the specific etiology and the circumstances of the event. In order to successfully deal with the incident, national-level coordination of many non-medical organizations is required. An integration body in the Ministry of Health is a prerequisite for the early detection of the outbreak and for the rapid and proper identification of the etiologic agent. An effective triage system which screens the truly-exposed, the sick and their contacts among the many worried-well engorging the medical organizations, should be the spearhead for an integrated health system dealing with disease prevention and treatment. Public relations and recruitment of the media for transferring relevant information are a vital part of the response. In this rare and unfamiliar emergency situation the basic principle is to use existing response systems, implementing most of the routine procedures and functions, modified according to guidelines from central governmental bodies.