What is bioterrorism?
Bioterrorism is intentional use of infectious biological agents, or germs, to cause illness or death.

Has any biological agent been released in Connecticut?
Cases of anthrax have been reported in the state. It's been found only in letters, at this time. Numerous reports of "suspicious white powders" have been received; all tested so far have been negative for anthrax and appear to be normally occurring substances.

How is Connecticut (DPH) preparing for possible bioterrorist attacks?
DPH is working closely with hospital emergency rooms throughout the state, looking for clusters of sick patients which could indicate release of a biological agent. 

To effectively release a biological agent takes technical sophistication. Experts say the probability of a large-scale bioterrorist attack is low. However, because the low risk exists, many federal, state, and local agencies including DPH have been preparing for a possible attack for several years. In cooperation with  Office of Emergency Management and Homeland Security and other public agencies, DPH developed a surveillance plan for rapid detection and response to bioterrorism.

As part of this plan, DPH closely watches for evidence of release of a biological agent. All healthcare providers in Connecticut are required to watch for and promptly report any unusual disease clusters to the Department of Public Health. Additionally, surveillance systems are in place to rapidly detect an increase in unusual illnesses that might suggest release of a biological agent in the city. Early detection is key to a bioterrorist attack: Rapid detection means rapid response, which results in more lives saved.

Should Connecticut residents buy gas masks to protect themselves and their families?
No.
The Department of Public Health strongly discourages purchasing gas masks for protection against biological agents. Gas masks are intended for short-term use and would provide protection only if worn at the time of a known release. Masks also must fit properly. Improper use of gas masks can cause serious injury or even death by accidental suffocation, especially among persons with heart or lung disease.

Should Connecticut residents stockpile antibiotics to protect themselves against bioterrorism?
No.
DPH strongly discourage stockpiling antibiotics. Inappropriate use of antibiotics can cause a person to develop antibiotic resistance. In addition, using antibiotics without a doctor's prescription can cause serious reactions including diarrhea, abdominal symptoms, rash, allergic reaction, and dangerous interference with other medications. Individuals who stockpile antibiotics would also be more likely to use expired medications. Stockpiling could lead to inappropriate patient decisions to self-medicate, incomplete courses of antibiotics that might result in resistant organisms, the eventual use of expired medications, and/or shortages of national supplies for routine or emergency use.

The federal government has amassed a large stockpile of pharmaceuticals, including antibiotics, that are effective against likely bacterial bioterrorist agents. In the event of an attack, medication would be rapidly available.

What is anthrax?
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in hoofed mammals but can also infect humans. In humans, anthrax is primarily an occupational disease identified in persons who have contact with dead animals or animal hair, wool, and hides.

Anthrax symptoms usually develop within seven days of exposure, with most cases occurring within 48 hours. Incubation periods up to 60 days are possible. Anthrax can be spread by inhaling anthrax spores; through skin contact with infected animal products or contaminated soil; or by ingesting contaminated, undercooked meat.

Initial symptoms of inhalational anthrax might resemble a common cold. After several days, the symptoms can progress to severe breathing difficulties and shock. After onset of symptoms, inhalation anthrax is usually fatal. Early antibiotic treatment before the onset of symptoms increases chances for survival. Skin or cutaneous anthrax is marked by a boil-like lesion that appears and eventually forms an ulcer with a black center. Initial symptoms of intestinal anthrax include nausea, loss of appetite, vomiting, and fever, followed several days later by abdominal pain, vomiting of blood, and severe diarrhea.

In the event of an anthrax bioterrorist attack, a rapid investigation would be conducted to determine the time and place of the release and to identify persons exposed who need preventive antibiotics.

Is anthrax contagious?
No.
Direct person-to-person contact spread of anthrax is extremely unlikely. Even if a person develops symptoms of inhalation anthrax or gastrointestinal anthrax, the person is not contagious to others.

What is smallpox?
Smallpox is a severe viral infection that was eliminated from the world in 1977. Symptoms include fever, aches, vomiting, and a distinctive rash. Smallpox can be prevented with smallpox vaccination, which was discontinued in the United States in 1972. Persons who have been vaccinated against smallpox in the past probably have only limited, if any, antibody protection against this disease. No known treatment for smallpox exists, although approximately two-thirds of those infected with this virus have survived previous outbreaks. Plans are currently in progress to increase the current stockpile of this vaccine.

In the event of an outbreak, the Centers for Disease Control and Prevention (CDC) has clear guidelines to swiftly provide vaccine to people exposed to the disease. The vaccine is securely stored by the CDC for use in the case of an outbreak.

Is smallpox contagious?
Smallpox can spread from person to person. Transmission usually occurs only after the patient develops a fever and a rash. Although no treatment for the disease exists, a vaccine taken even four to five days after exposure can prevent death. In addition to providing protection, the vaccine halts spread of the disease.

If I were vaccinated against smallpox before 1980, am I still protected?
Probably not.
Vaccination has been shown to wear off in most people after 10 years but might last longer if a person has been successfully vaccinated on multiple occasions. If smallpox exposure were determined, immediate vaccination would be recommended. In addition to the existing vaccine stockpile, the Federal government recently announced plans to accelerate production of a new smallpox vaccine.

Are vaccines commercially available for anthrax or smallpox?
Neither vaccine is available or recommended. Neither vaccine is available to the general public or medical community. Because of the limited supply and risks of smallpox vaccine — especially in immune-compromised persons — widespread smallpox vaccination in the United States is not recommended. The anthrax vaccine requires six shots over an 18-month period with periodic boosters. This vaccine is available only for military personnel considered at higher risk for exposure to anthrax in combat settings.

Is the water supply safe from bioterrorism?
Most bioterrorism experts agree water reservoirs are an unlikely target. Methods already in place to filter and clean the drinking water supply are considered effective against most biological agents. Chlorine, for example, protects drinking water from other water-borne bacteria and would neutralize most biological agents. Additionally, the large quantity of water in a water supply would significantly dilute a biological agent, limiting its potential to do harm.

Can Connecticut residents do anything specific to prepare for a possible bioterrorist attack?
The best way for a family to be safe in any disaster is to prepare before disaster strikes. Consistent with disaster preparedness guidelines for any disaster, natural or man-made, families should stock a three- to four-day supply of necessities in case they have to remain inside their homes for safety. No specific preparation for a bioterrorist attack, beyond those for other disasters, is currently recommended.

The Connecticut Department of Public Health, along with other government agencies and health institutions, will do everything possible to protect public health. Should a bioterrorist event occur in Connecticut, the public would be informed immediately through the news media about health precautions. If antibiotics or vaccines were recommended, information would be provided on where to get medication from emergency clinics set up by the state in multiple locations in the affected area.