Detection of the sentinel anthrax case in the United States

First-hand knowledge of the detection of the first bioweapon in modern United States history is described in this article. The method by which the presumptive diagnosis of anthrax meningitis was made within 13 hours of the patient presenting to the emergency department is described using pre-analytic, analytic, and post-analytic phases. The lessons learned from this process are briefly presented so that other laboratories may learn from our experience: how to prepare; how to quickly analyze a potential bioweapon; how to communicate with staff and local, regional, and national authorities; and how to deal with disruptive media attention.