Preparing for chemical and biological terrorist attacks.

Improving the ability of the civilian medical community to respond to a chemical or biological terrorist attack requires more than simply providing cities with military training and equipment, according to a new report from a committee of the Institute of Medicine and the National Research Council. The committee identified more than 60 research and development projects that could help minimize damage caused by a terrorist attack. Examples include

* new drugs and vaccines to combat anthrax and smallpox,

* faster and easier-to-use chemical detectors and diagnostic tests, and

* communications software to improve disease surveillance and to provide information about possible attacks.

Preparations for biological or chemical terrorism should build on systems already in place, such as those designed to handle hazardous-material spills, infectious disease outbreaks, and natural disasters. Public health departments, poison control centers, and metropolitan police officials, who are already working in these areas, are best equipped to handle the challenges posed by terrorism. These entities must adapt new and emerging technologies for the detection of chemical and biological warfare agents. Especially needed are faster, simpler, cheaper, and more accurate tools for detecting and identifying a wide spectrum of toxic substances.

Knowing who is going to attack, when, and where is particularly difficult in a civilian setting. Military officials, by contrast, might know or suspect that an enemy has a stockpile of biological weapons and could vaccinate soldiers against some of these agents. In the civilian environment, the enemy, the weapon, and the time and place of attack may all be unknown, making this sort of preparation impossible.

Nevertheless, high priority should be given to preparing for certain types of attacks. Research is needed to advise federal authorities on how and where to stockpile antidotes to nerve agents, and on how to distribute them. A vigorous national effort should be mounted to develop, manufacture, and stockpile improved vaccines for anthrax and smallpox. And an aggressive program should be developed to locate substances that can repair or limit the damage caused by vesicants such as mustard gas, which burn and blister body tissues through contact with the skin and lungs.

Other recommendations include

* improvements in the laboratory and epidemiology capabilities of the Centers for Disease Control and Prevention (CDC), as well as at the state and local levels;

* research into methods for quickly evaluating medical conditions of victims of chemical agents, and for rapidly, effectively, and inexpensively decontaminating large groups of people and large amounts of equipment;

* development of educational materials on chemical and biological agents, both for the general public and for mental health professionals; and

* improvement and field testing of computer models to predict the spread of hazardous agents in an attack and to provide realistic training for emergency management officials.

To obtain a copy of Chemical and Biological Terrorism: Research and Development To Improve Civilian Medical Response, telephone [phone] or [phone].