Bioterrorism: the need to be prepared

Postal distribution of anthrax spores in October 2001 in the USA resulted in cases of pulmonary anthrax. In consequence, interest and concern about terrorist attacks on civilian populations using biological weapons have increased, particularly when one recent authoritative assessment suggested that an attack using some form of unconventional weapon on a Western city was 'inevitable'. This article reviews the steps necessary to minimise the probability of a successful attack. Despite best endeavours, the possibility remains that significant numbers of casualties will arise, emphasising the need to plan for reception, triage, decontamination and treatment of patients. The medical Royal Colleges could assist the education of the wider medical community about aspects of pathology hitherto considered to be primarily military but which have now become important for civilian physicians.