As highlighted in “Inside AFP” in the previous issue of American Family Physician,¹ the American Academy of Family Physicians (AAFP) has taken action in response to the recent terrorist attacks in the United States. Three weeks after the September 11 tragedy, the AAFP's Annual Scientific Assembly featured a lecture on bioterrorism, which is available on the AAFP Web site,² and more continuing medical education activities relating to bioterrorism are being planned. In this issue, we highlight information from the Centers for Disease Control and Prevention (CDC) to help physicians become prepared for potential bioterrorist attacks (see page 1761).^3,4

We have also considered featuring original articles on biologic, chemical, and radiologic weapons of mass destruction. However, the process of writing, reviewing, revising, and editing an article typically takes many months, and we want to offer our readers the most current, reliable, and comprehensive information immediately available. To expedite this process, we have compiled a list of authoritative Web site resources on these subjects.

It is essential that family physicians be prepared to respond to issues surrounding biologic warfare. Family physicians will, in many cases, be the first to triage victims of suspected or actual bioterrorist attacks. In addition, many patients will approach their family physician with questions about exposure to germ or chemical weapons, signs and symptoms of disease, and how to protect themselves and their family members against such threats. It is important for physicians to be familiar with CDC policy for diagnostic testing and reporting of possible exposure to agents used as biologic weapons, and to review prophylaxis and management recommendations. The CDC bioterrorism Web site (www.bt.cdc.gov) features the most recent Biological and Chemical Terrorism Strategic Plan for Preparedness.⁵ Several other sites offer comprehensive summaries of sample collection methods, vaccines, chemotherapy, and chemoprophylaxis for agents used as biologic weapons.

Next, we must educate our patients and ourselves to instill the proper awareness of exotic diseases that pose a threat. At the same time, we must remain pragmatic. Family physicians may be called on to distinguish a rash of chickenpox from that of smallpox; to counsel patients with influenza-like symptoms who request testing for anthrax; and to inform patients about proper immunization protocols. We must explain to patients why it is not appropriate for them to stockpile antibiotics and why it is important for them to receive a timely influenza vaccination. We should be able to answer their questions thoughtfully while recognizing the importance of allaying their fears.

Finally, we must be prepared to dispel myths about bioterrorism to be able to prevent epidemic hysteria. Indeed, mass psychogenic illness may be indistinguishable from illness caused by true bioterrorist infection.⁶ A powerful defense against bioterrorism is accurate and timely information for physicians and patients. We recommend the resources in the accompanying table as a starting point for family physicians to obtain up-to-date continuing medical education about bioterrorism.