The health services will play a vital role in protection against covert releases

Although the threat of bioterrorism in the United Kingdom is still considered to be low, concern has heightened in the wake of the terrorist outrages in the United States on 11 September and subsequent covert releases of anthrax. 1 2 Potential events can be considered in three groups: deliberate release of a “weaponised” biological agents such as anthrax; use of a common pathogen such as salmonella; and hoaxes or false alarms. Release could occur covertly, or a warning may be given, or a suspect device discovered.

Experience of such incidents is limited. The use of a common pathogen is illustrated by deliberate contamination of salad bars in restaurants with Salmonella typhimurium by the religious sect led by Rajneesh in Oregon, United States, in 1984, causing illness in over 700 people.3 In 1995 the Aum Shinrikyo sect used sarin in the Tokyo underground.4 Subsequent investigations found that the sect was experimenting with Bacillus anthracis and Clostridium botulinumtoxin, and the incident prompted a wave of planning to deal with release of chemical and biological agents. Subsequently the UK Department of Health issued confidential guidance on the management of this type of incident to directors of public health and NHS trust chief executives in March 2000.5

When a device or suspect package is discovered, or a …