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Am Fam Physician. 2001;64(10):1668

As I mentioned in the previous “Inside AFP,” our editors will be working to provide information to help our readers respond to threats of bioterrorism. AFP's editor Jay Siwek, M.D., and editorial fellow Margaret Gourlay, M.D., Washington, D.C., have prepared a special editorial on bioterrorism that appears on page 1676 of this issue. Drs. Siwek and Gourlay provide a list of sources on the Internet that physicians can consult to obtain the most up-to–date information to handle situations arising from threats or acts of bioterrorism.

On page 1761 of this issue, AFP includes a special “Practice Guideline” that summarizes key points from the Centers of Disease Control and Prevention's (CDC) report on bioterrorism published in the October 19, 2001, issue of the Morbidity and Mortality Weekly Report. The MMWR report includes two chapters on bioterrorism, one focusing on the anthrax investigation and offering interim public health guidelines, and the other focusing on recognition of illness associated with the intentional release of a biologic agent, including anthrax, plague, botulism, smallpox, inhalational tularemia and hemorrhagic fever. The complete report is available through a link on the AAFP Web site or as a PDF AFP and the AAFP Web site will continue to bring you updates from the CDC as new recommendations are released.

As physicians who work in the Washington, D.C., area, Drs. Siwek and Gourlay have already been affected by recent terrorist attacks. The events of September 11 took from them a Georgetown University colleague who was on board the plane headed from Dulles International that ultimately plunged into the Pentagon. Although Dr. Siwek watched for wounded to arrive that day, like many other physicians he was disappointed waiting for survivors. Now Dr. Siwek and his colleagues are living in the midst of a continuing anthrax threat in the D.C. postal service area. Dr. Siwek reports he has already used the CDC guidelines summarized in this issue to differentiate a case of influenza from possible anthrax infection. Although luckily his patient did not have anthrax, the experience drove the point home to Dr. Siwek: physicians must be prepared to deal with the impact of unleashed bioterrorist weaponry.

Last month, Jonathan Temte, M.D., Ph.D., assistant professor of family medicine and infectious disease researcher at the University of Wisconsin, Madison, delivered a speech at the AAFP's Annual Scientific Assembly in Atlanta to help family physicians prepare for bioterrorism. This lecture is available at the AAFP Web site The AAFP Web site ( will also continue to add more updates on bioterrorism and links as new developments occur.

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