TABLE 132.1 CHARACTERISTICS OF CHEMICAL AND BIOLOGIC ATTACKS Chemical weapons attack (differences in comparison to “routine” hazardous materials incidents) Biologic weapons attack (differences in comparison to natural infectious disease epidemics) Intent to cause mass casualties Intent to cause mass casualties More toxic substances More virulent agents Initial substance identification delayed Rare, nonendemic diseases, delayed diagnosis Greater risk to EMS first responders Greater risk to physicians and other first receivers Overwhelming numbers of patients Overwhelming numbers of patients Many “worried well” Many “worried well” Mass hysteria, panic Mass hysteria, panic Discovery of chemical dispersal device Discovery of biologic agent dispersal device Time frame may or may not be More compressed time frame of compressed outbreak High attack rates near release site Very high infection rates, morbidity, mortality Dead and dying animals More respiratory forms of disease than in natural forms Multiple epidemics at once Reduced rate of infection in sheltered persons Infected, dying animals EMS, emergency medical services Adapted from Henretig FM, Cieslak TJ, Eitzen EM Jr Biological and chemical terrorism J Pediatr 2002;141:311–326 Copyright © 2002 Elsevier With permission