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terrorist attack is illness ot death, There may berhany or few cases involveo, and the illness may be communicable (capable of being passed from one infected person to another, example, smallpox) or non-communicable (example, anthrax), In a serious event, consequential damages may include overloading and breakdown of Ihe health care system, and possible social disruplion, A Plague on Your City: Observations from TOPOFF, Thomas v, Inglesby, Rita Grossman, Tara O'Toole, Clinical Infectious Diseases 2001;32:436-445. A community's preparation to identify and respond 10 biological terrorist attacks will help it avoid or reduce these consequential damages, whether the illnesses result from bioterrorist events or naturally occurring epidemics, . The response to biological attacks differs from the response 10 chemical atlacks, because biological attacks are likely to be made covertly, and without notice until the population begins falling ill. Biological and Chemical Terrorism: Strategic Plan for Preparedness and Response, Morbidity and Mortality Weekly Report, Vol. 49, No, RR-4, April 21,2000, Recognition of a covert attack with a biological agent may be complicated by the initial resemblance of the symptoms to Ihose of less serious illnesses. The community's response will include identifying the type and source of the illness, treating the victims, and dispensing prophylactic medication (such as vaccines) to exposed populations Ihat are not yet ill, Local public health departmenls and private health care providers will be the first to see the illnesses resulting from a biological attack, and therefore have the primary responsibility for identifying and responding 10 the resulting illnesses, The earlier the pattern and type of illness can be identified, the source of exposure determined, and medical care and prophylaxis initiated, the more effective the community's response will be. . One of the most crucial actions a local government can take 10 prepare for a possible biolerrorist attack is to be certain that the local public health department and health care community have Ihe resources and knowledge to quickly identify and coordinate medical response to an infectious disease outbreak, The July 2001 Centers for Disease Control and Prevention publication entitled The Public Health Response to Biological and Chemical Terrorism: Interim Planning Guidancefor State Public Health says Ihat public health departmenls need to do the following in order 10 plan for and respond to terrorisl events: 1, Identify the types of evenls that might occur in their communities; 2, Plan emergency activities in advance to ensure a coordinated response; 3, Build capabilities necessary to respond effectively to Ihe consequences of those events; 4, Identify the type or nature of an event when it happens; 5, Implement the planned response quickly and efficiently; and 6, Recover from the incident. What type of activities might a local government undertake to meet these objectives? We provide some examples below. 1, Strengthen Information and Communications Technology .