their health and well-being in the event of future attacks. Since then, preparedness activities have generated substantial interest and funding, and, as a result, federal, state, and local leaders are changing practices to prepare to respond to both natural and terrorist disasters; however, the improvements made are not nearly sufficient, noted some participants.

Usually politically motivated, the immediate goal of terrorism is to instill fear and confusion among the public. Immediately following an attack, the public’s fear is transformed into intense preparation for the next crisis; yet, with increasing periods of safety, the public’s sense of complacency tends to trump the preparedness activities, and, according to Dr. Julie Gerberding, Director of the Centers for Disease Control and Prevention, complacency is the enemy of public health. The public health and emergency management communities, therefore, have been charged with the task of conducting environmental analyses, educating and motivating the public to prepare themselves to mitigate the impacts of the next disaster, and communicating preparedness measures to the public before, during, and after an event. During the discussion, Gerberding reiterated that the public will need to become accustomed to the ideas that preparedness is not all or none. There can always be the potential for a scenario that is one step beyond the current level of preparedness. She further noted that this requires an ongoing sustained investment over time.


Prior to designing disaster prevention and response strategies, it is critical to understand the physical and social environment surrounding terror agents. According to Dr. Lynn Goldman, The Johns Hopkins University Bloomberg School of Public Health, responders to a biological, chemical, or physical attack must be able to determine the following: where the agent is in the environment, where it will spread, who will be exposed, what quantity of the agent to which the victims may be exposed, what will happen to the exposed, what must be done to reduce exposure, and how to best treat victims. To answer those questions, it is necessary to understand the harmful agent, how it reaches the human body, and the health effects that it has on the body.

As Goldman noted, while conventional bombs have accounted for 46 percent of international terror attacks between 1963 and 1993, and 76 percent of domestic terror attacks between 1982 and 1992, biological and chemical agents are of increasing concern. The Centers for Disease Control and Prevention has classified biological terror agents into three categories, based upon their potential to cause morbidity and mortality. Category A agents, such as anthrax, botulism, plague, and smallpox, are classified as high-priority agents because of their ability to inflict high mortality and heavily tax public health and medical resources. Category B agents, such as ricin, typhus, and Cryptosporidium parvum,

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