Bioterrorism is no longer a subject of speculation. It is a reality that the American health system must anticipate. Beginning in September of 2001, events where initiated that involved the dissemination of Bacillus anthracis via the United States Postal Service. These events culminated in reported cases of anthrax in Florida, New York, New Jersey, the District of Columbia and Connecticut. Despite worldwide efforts, continued discovery of foreign and domestic caches of biological specimens suitable for weaponizing, raises the probability that terrorists will once again gain access to dangerous biological agents.

In addition to pathogens like Bacillus anthracis (which is not easily transferred from person to person), there are agents like the small pox virus (Variola major), which are highly contagious. Responding to outbreaks caused by weaponized agents, will require the rapid mobilization of public health workers, emergency responders, and private health-care providers. Large-scale outbreaks will also require unprecedented mobilization, procurement and distribution of large quantities of drugs and vaccines. These drugs and vaccines must be dispensed quickly if the are to have any effect.

Emergency Medical Services, hospitals and clinics will play a crucial role, in event detection and activation of the public health response. Professionals associated with these delivery systems must be prepared to implement their facility's Bioterrorism Readiness Plan. Bioterrorism Readiness Plans should encourage a low threshold of suspicion, by carefully and specifically identifying the role each caretaker would take in the event of a bioterrorism emergency. They should prominently list contact information for in-house infection control professionals, and local, state and federal departments (including the FBI).