Biological Terrorism

In the aftermath of the September 11, 2001 attacks and the subsequent mail-borne anthrax attack of October 2001, it has become dear that health care providers may be called upon to respond to victims of terrorism. Biological terrorism (BT), in particular, involves the use of virulent agents with the intent to cause mass casualties and/or induce fear, a scenario that if effected will severely strain the capacity of regional emergency medical services and pose unique management challenges to clinicians confronted with victimized children. Whether practicing as a pediatric emergency medicine specialist working in an urban children's hospital or as a general clinician in private office-based practice, pediatricians may be the first to suspect that a BT agent may have been utilized. Compared to adults, most caregivers have a relatively low threshold for having children and infants evaluated professionally when they become sick. Furthermore, pediatric patients may have a more rapid or severe response to a biological agent, potentially putting pediatricians and child care providers in the critical position of being the first to diagnose an exposure. The clinician's response to such a situation may determine whether the incident is controlled promptly or whether it evolves into a large-scale epidemiologic catastrophe