Lessons from recent events in the United States and the United Kingdom

The recent terrorist attacks in New York have shown how all societies need rescue, health, and public health services to respond immediately to major disasters. Subsequent covert releases of anthrax (and scares and hoaxes) have been straining public health and reference laboratory services.1 The epidemic of foot and mouth disease in the United Kingdom has not directly threatened human health, but its control has required huge efforts and resources. Control measures have affected health services: primary care has had to deal with the stress experienced by affected communities; public health services have responded to disposing of over four million animals with concomitant zoonoses like bovine spongiform encephalopathy, Escherichia coli O157, and the specialist microbiological reference laboratories were needed to exclude cases of human infection.2

What lessons can be learnt from these events? This question is timely in Britain, because the arrangements for health protection in the new NHS are yet to be finalised, though we know that regional directors of public health will oversee this function (see box 1). 3 4

Events in the United States emphasise the need to be able to deliver …