Bioterrorism Resource Center

To help physicians better understand and prepare for incidences of bioterrorism, the Texas Medical Association has compiled the following compendium of current, scientific information.
Report any suspected outbreaks or unusual expressions of illness to the Texas Department of State Health Services at (800) 705-8868.

TMA Bioterrorism Toolkit
TMA's Bioterrorism Toolkit includes physician protocols on the diagnosis, reporting, etiology, and management of anthrax, botulism, smallpox, and plague, and one-page reproducible patient handouts on each disease.

Institute of Medicine (IOM).  Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program .  2002

Journal Articles

Horne AD, et al.  Preventive vaccines against bioterrorism: evaluation of efficacy and safety.   Vaccine. 2004 Nov 15;23(1):84-90.

Anton BP.  The First Amendment and scientific freedom in the era of bioterrorism. J Biolaw Bus. 2004;7(2):27-39.

Rainey GJ, Young JA.  Antitoxins: novel strategies to target agents of bioterrorism.   Nat Rev Microbiol. 2004 Sep;2(9):721-6.

Leissner KB, et al.  Bioterrorism and children: unique concerns with infection control and vaccination.   Anesthesiol Clin North America. 2004 Sep;22(3):563-77, viii.

Marks JD.  Medical aspects of biologic toxins.   Anesthesiol Clin North America. 2004 Sep;22(3):509-32, vii.

Walden J, Kaplan EH.  Estimating time and size of bioterror attack.   Emerg Infect Dis. 2004 Jul;10(7):1202-5.   Full-text access.

Martin W.  Legal and public policy responses of states to bioterrorism.   Am J Public Health. 2004 Jul;94(7):1093-6.  Full-text access.

Cupp OS, et al.  Agroterrorism in the U.S.: key security challenge for the 21st century.   Biosecur Bioterror. 2004;2(2):97-105.

Schuler A.  Billions for biodefense: federal agency biodefense funding, FY2001-FY2005.   Biosecur Bioterror. 2004;2(2):86-96.

Casman EA.  The potential of next-generation microbiological diagnostics to improve bioterrorism detection speed.   Risk Anal. 2004 Jun;24(3):521-36.

Ortolon K.  Bioterrorism fears.   Tex Med. 2002 Sep;98(9):28-34.   Full-text access.

Ortolon K.  Are we prepared: Medical Community, Public Health Agencies Ramping Up for Bioterrorism Response?   Tex Med. 2002 Jan;98(1):26-30.   Full-text access.

Franke, Johanna.  A New War: Don't Wait Till It's Too Late to Prepare for Bioterrorism.   Tex Med.  2000 Mar; 95(3)32-39.   Full-text access.


Blanchard JC, et al.   In their own words: lessons learned from those exposed to anthrax.   Am J Public Health. 2005 Mar;95(3):489-95. Full-text access.

Temte JL, Zinkel AR.  The primary care differential diagnosis of inhalational anthrax.   Ann Fam Med. 2004 Sep-Oct;2(5):438-44.  Full-text access.

Temte JL, Anderson AL.  Rapid assessment of agents of biological terrorism: defining the differential diagnosis of inhalational anthrax using electronic communication in a practice-based research network.   Ann Fam Med. 2004 Sep-Oct;2(5):434-7.   Full-text access.

Hupert N, et al.  Antibiotics for anthrax: patient requests and physician prescribing practices during the 2001 New York City attacks.   Arch Intern Med. 2004 Oct 11;164(18):2012-6.

Kyriacou DN, et al.  Clinical predictors of bioterrorism-related inhalational anthrax.   Lancet. 2004 Jul 31;364(9432):449-52.
Full-text access.

Wenner KA, Kenner JR.  Anthrax.   Dermatol Clin. 2004 Jul;22(3):247-56.

Anthrax Exposure: Are Your Medicare Patients Covered ? (TMA, Feb. 15, 2002)


Wilson SJ.   Factors affecting implementation of the U.S. smallpox vaccination program, 2003.   Public Health Rep. 2005 Jan-Feb;120(1):3-5.

Woods R, et al.   Diagnosing smallpox: would you know it if you saw it?   Biosecur Bioterror. 2004;2(3):157-63.

Heymann DL.  Smallpox containment updated: considerations for the 21st century.   Int J Infect Dis. 2004 Oct;8 Suppl 2:S15-20.

Lupatkin H, et al.  Smallpox in the 21st century. Anesthesiol Clin North America. 2004 Sep;22(3):541-61, viii.

Tom WL, et al.  Smallpox: vaccine reactions and contraindications.   Dermatol Clin. 2004 Jul;22(3):275-89.

Ortolon K.  Smallpox, big decision. Health care workers must decide whether to be vaccinated.   Tex Med. 2003 Feb;99(2):42-5.   Full-text access.

Rhode JG.  Smallpox still a danger.   Tex Med. 2002 Nov;98(11):10-1.  Request full-text access .

Patterson P, Reinarz JA.  Smallpox: mass vaccinations or not?   Tex Med. 2002 Jun;98(6):43-4.  Request full-text access .

Other Biological Agents/Diseases:

Weber SG, et al.  SARS, emerging infections, and bioterrorism preparedness.   Lancet Infect Dis. 2004 Aug;4(8):483-4. 

Park JB, Simpson LL.  Progress toward development of an inhalation vaccine against botulinum toxin.   Expert Rev Vaccines. 2004 Aug;3(4):477-87.

Cronquist SD.  Tularemia: the disease and the weapon.   Dermatol Clin. 2004 Jul;22(3):313-20.

Cobbs CG, Chansolme DH.  Plague. Dermatol Clin. 2004 Jul;22(3):303-12.

Salvaggio MR, Baddley JW.  Other viral bioweapons: Ebola and Marburg hemorrhagic fever.  Dermatol Clin. 2004 Jul;22(3):291-302.

Henghold WB 2nd.  Other biologic toxin bioweapons: ricin, staphylococcal enterotoxin B, and trichothecene mycotoxins. Dermatol Clin. 2004 Jul;22(3):257-62.


Dembek Z, et al.   A model curriculum for public health bioterrorism education.   Public Health Rep. 2005 Jan-Feb;120(1):11-8.

Amadio JB.  Bioterrorism preparedness funds well used at the local level.   Am J Public Health. 2005 Mar;95(3):373-4; author reply 374.  Full-text access.

Rumm PD.   Bioterrorism preparedness: potential threats remain.   Am J Public Health. 2005 Mar;95(3):372; author reply 372-3.
Full-text access

Terndrup T, et al.   Online bioterrorism continuing medical education: development and preliminary testing.  Acad Emerg Med. 2005 Jan;12(1):45-50.

Food and Drug Administration, HHS.  Establishment and maintenance of records under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule. Fed Regist. 2004 Dec 9;69(236):71561-655.   Full-text access.

Rotz LD, Hughes JM.  Advances in detecting and responding to threats from bioterrorism and emerging infectious disease.   Nat Med. 2004 Dec;10(12 Suppl):S130-6.

Klein KR, et al.  Testing emergency medical personnel response to patients with suspected infectious disease.   Prehospital Disaster Med. 2004 Jul-Sep;19(3):256-65.

Mann NC, et al.  Public health preparedness for mass-casualty events: a 2002 state-by-state assessment.   Prehospital Disaster Med. 2004 Jul-Sep;19(3):245-55.

Bashir Z, et al.  The impact of federal funding on local bioterrorism preparedness.   J Public Health Manag Pract. 2004 Sep-Oct;10(5):475-8.  Full-text access.

von Lubitz DK, et al.  Bioterrorism: development of large-scale medical readiness using multipoint distance-based simulation training.  Stud Health Technol Inform. 2004;98:221-7.

Gonzalez EH.  Public health educational intervention in a family medicine residency.   Fam Med. 2004 Nov-Dec;36(10):695-7.   Full-text access

Braun BI, et al.  Hospital bioterrorism preparedness linkages with the community: improvements over time.  Am J Infect Control. 2004 Oct;32(6):317-26.

Cohen HW, et al.  The pitfalls of bioterrorism preparedness: the anthrax and smallpox experiences. Am J Public Health. 2004 Oct;94(10):1667-71.   Full-text access.

Stein BD, et al.  Emotional and behavioral consequences of bioterrorism: planning a public health response.   Milbank Q. 2004;82(3):413-55.

Schur CL, et al.  Perspectives of rural hospitals on bioterrorism preparedness planning.   Policy Anal Brief W Ser. 2004 Apr;(4):1-6.

Folio LR, et al.  Initial experience with mass immunization as a bioterrorism countermeasure.   J Am Osteopath Assoc. 2004 Jun;104(6):240-3.   Full-text access.

Wynia MK, Gostin LO.  Ethical challenges in preparing for bioterrorism: barriers within the health care system.   Am J Public Health. 2004 Jul;94(7):1096-102.   Full-text access.

Hodge JG Jr, et al.  The HIPAA privacy rule and bioterrorism planning, prevention, and response.   Biosecur Bioterror. 2004;2(2):73-80.

Bravata DM, et al.  Systematic review: surveillance systems for early detection of bioterrorism-related diseases.   Ann Intern Med. 2004 Jun 1;140(11):910-22.  Full-text access.


Links to Bioterrorism Resources   Find links to associations like the Centers for Disease Control, Federal Emergency Management Association, Texas Department of Emergency Management, and more.