Recent events in the United States have demonstrated a critical need for recognizing nurses and emergency health care providers as important elements of the nation's first line of defense and response against terrorist attacks involving
biological, chemical, or radiological weapons. The
anthrax letter attacks of September/October 2001 demonstrate the importance of vigilance and attention to detail while interviewing and attending patients and when entering, reviewing, and cataloging patient records. Nursing professionals, emergency care responders, and physicians can perform a crucial role in our first-line defense against terrorism by detecting and reporting unusual or anomalous illness(es) consistent with possible exposure to
biological or chemical agents. Nursing professionals should become more familiar with the etiology and clinical symptoms of
biological agents of greatest current concern (
smallpox,
anthrax,
tularemia,
plague) and be alert for potentially anomalous or unfamiliar combinations of symptoms that could point to unwitting exposure to
biological toxins, toxic chemicals, or cryptic radiological agents. Public health surveillance systems must be developed that encourage and facilitate the rapid reporting and follow-up investigation of suspect illnesses and potential disease outbreaks that will ensure early identification and response for covert attacks involving
biological, chemical, or radiological weapons.