Bmj Usa: Editor's Choice

Preparing for disaster

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E67

This article originally appeared in BMJ USA

I am writing this column two days after the United States and Great Britain commenced military action against terrorist and Taliban targets in Afghanistan. The media and the public are turning their attention from the disasters of September 11 to the possibility of new disasters, especially attacks with biological and chemical agents. In recent days, public health officials and the FBI have launched an investigation into the anthrax contamination of the Boca Raton, Florida, offices of American Media Inc, after the death of one of its employees from anthrax and the discovery of anthrax spores on the decedent's computer keyboard and in the nasal passages of a coworker.

Newsweek magazine carried a cover story (October 8) under the headline “Biological & Chemical Terror: How Scared Should You Be?” Apparently, people are very scared. The Los Angeles Times (October 5) reported that gas masks are “sold out just about everywhere in America.” People are looking for ciprofloxacin to protect against anthrax, as well as for anthrax and smallpox vaccines. The web site tracks the most frequently searched words or terms on the Internet; in the past 24 hours, gas masks was number 6 (after hotmail,,, google, and world trade center).

In the face of the current threat of more attacks, physicians need to educate themselves about biological and chemical agents likely to be used in attacks. Doctors will be on the front lines of any domestic attack involving these agents, and they need to be able to recognize and treat the symptoms and diseases they cause. Patients are looking to their doctors for advice and, where appropriate, reassurance. Physicians also need to be involved in their communities' disaster preparedness planning.

It is difficult for a monthly journal like BMJ USA to report on the fast-paced events that are swirling around us. Nevertheless, we will endeavor to provide useful and relevant information to our readers, beginning with an editorial on bioterrorism in this issue (BMJ USA p 497).

In the meantime, physicians should seek out additional information from authoritative sources on the Internet, in other journals, and through seminars and conferences. Good sources include: the Johns Hopkins University Center for Civilian Biodefense Studies (, the US Centers for Disease Control and Prevention (, and the American Medical Association ( 6206.html).

Rosen (BMJ USA p 497)

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