Edward M. Eitzen

Medical Preparedness for a Terrorist Incident Involving Chemical and Biological Agents During the 1996 Atlanta Olympic Games

During the 1996 Centennial Olympic Games in Atlanta, Georgia, unprecedented preparations were undertaken to cope with the health consequences of a terrorist incident involving chemical or biological agents. Local, state, federal, and military resources joined to establish a specialized incident assessment team and science and technology center. Critical antimicrobials and antidotes were strategically stockpiled. First-responders received specialized training, and local acute care capabilities were supplemented. Surveillance systems were augmented and strengthened. However, this extensive undertaking revealed a number of critical issues that must be resolved if our nation is to successfully cope with an attack of this nature. Emergency preparedness in this complex arena must be based on carefully conceived priorities. Improved capabilities must be developed to rapidly recognize an incident and characterize the agents involved, as well as to provide emergency decontamination and medical care. Finally, capabilities must be developed to rapidly implement emergency public health interventions and adequately protect emergency responders.

Immunization against Potential Biological Warfare Agents

The intentional release of biological agents by belligerents or terrorists is a possibility that has recently attracted increased attention. Law enforcement agencies, military planners, public health officials, and clinicians are gaining an increasing awareness of this potential threat. From a military perspective, an important component of the protective pre-exposure armamentarium against this threat is immunization. In addition, certain vaccines are an accepted component of postexposure prophylaxis against potential bioterrorist threat agents. These vaccines might, therefore, be used to respond to a terrorist attack against civilians. We review the development of vaccines against 10 of the most credible biological threats.

Future challenges in preparing for and responding to bioterrorism events

The future success of our preparations for bioterrorism depends on many issues as presented in this article. If these issues are properly addressed, the resulting improvements in bioterrorism preparations will allow us to better deter and mitigate a bioterrorism incident and will also provide us with the added benefit of improvements in early detection, diagnosis, and treatment of natural disease outbreaks. Emergency physicians must take an active leading role in working with the various disciplines to produce a better-prepared community.

Bioterrorism: agents of concern.

The intentional dispersal of biological agents by terrorists is a potential problem that increasingly concerns the intelligence, law enforcement, medical, and public health communities. Terrorists might choose biological agents over conventional and chemical weapons for multiple reasons, although it is difficult to predict, with certainty, which biological agents might prove attractive to terrorists. One can more confidently, however, derive a list of those few agents which, if used, would be of greatest public health consequence. It is these agents which will require the most robust countermeasures. We discuss the derivation of this short list of agents and the specific diseases involved.

Biological Weapons—A Primer for Microbiologists

Biological weapons are not new. Biological agents have been used as instruments of warfare and terror for thousands of years to produce fear and harm in humans, animals, and plants. Because they are invisible, silent, odorless, and tasteless, biological agents may be used as an ultimate weapon—easy to disperse and inexpensive to produce. Individuals in a laboratory or research environment can be protected against potentially hazardous biological agents by using engineering controls, good laboratory and microbiological techniques, personal protective equipment, decontamination procedures, and common sense. In the field or during a response to an incident, only personal protective measures, equipment, and decontamination procedures may be available. In either scenario, an immediate evaluation of the situation is foremost, applying risk management procedures to control the risks affecting health, safety, and the environment. The microbiologist and biological safety professional can provide with responsible officials a practical assessment of the biological weapons incident in order to help address microbiological and safety issues, minimize fear and concerns of those responding to the incident, and help manage individuals potentially exposed to a threat agent.