Preparedness for a bioterrorism event in Alaska. Part 1: Detection and identification of a biologic event

U.S. military and public health experts are increasingly concerned that the general public is at risk for terrorist attacks. Traditional weapons of mass destruction such as explosive and chemical devices remain the most likely forms of terrorism, however the threat of bioterrorism is also present and may be increasing. An intentional biologic event may be covert and if so, will not become apparent for days or even weeks when many ill people present with an unidentified illness. Health care providers will be the first responders during a biologic attack and will be called upon to diagnose diseases such as anthrax, tularemia or even smallpox. In the first of a two-part article, a hypothetical scenario is presented to illustrate how such an attack might first be discovered and the agent identified. As the scenario unfolds, evidence is collected that suggests the outbreak was intentional. Information about epidemiologic clues, disease syndromes and specific high-risk agents are discussed.