The psychological burden of bioterrorism

Planning for the public's psychological and behavioral reactions to a bioterrorist attack must address individual and community preparedness, response, and recovery. Bioterrorism raises issues requiring skilled risk communication and education including isolation, quarantine, administering vaccinations and distributing medications. The United States anthrax attacks, the international outbreak of Severe Acute Respiratory Syndrome (SARS), and the U.S. smallpox vaccination program offer useful lessons. The Iraqi missile attacks on Israel and the Tokyo sarin gas attacks highlight challenges of emergency medical evaluation and triage. Early public health interventions should identify symptoms and behaviors linked to psychological distress and suggest strategies to restore well-being.