Catching Bioattacks Early

Like it or not, Americans will be watched, probed, and even videotaped in coming years for any early sign that a terrorist might have let loose a deadly biological or chemical substance.

Step by step, a warning system is being put in place to spot unusual symptoms or behavior in groups of people - or what's called "clusters of syndromes" - that could alert emergency personnel to react.

Even the most destructive weapons in the bioterrorist's arsenal the thinking goes, can be thwarted if caught early on.

In an experimental step, the US Centers for Disease Control and Prevention is spending $1.2 million to set up a public/private partnership that will monitor 20 million people in all 50 states in an early-warning system for bioterror.

Epidemiologists are doing everything from tracking orange juice, tissue, and cough medicine sales at the grocery store to monitoring absentee rates in schools and watching video monitors of surveillance cameras, counting the number of times people sneeze. Scientists are looking for "spikes" in ordinary behaviors, in case they need to issue appropriate alerts.

Creating a large database of such information, of course, is just a first step. Governments still need to be sure they do issue accurate alerts, and have trained healthcare professionals at the ready; it was an alert doctor in Florida who discovered last year's anthrax attack, for instance.

Some local governments, such as San Francisco's, are avoiding such "syndromic surveillance" and instead are relying on a network of physicians to spot unusual circumstances. Cities may want to consider some combination of these approaches.

The government's criteria for issuing a bioterror alert system will need to be even more sophisticated than the general terrorist alerts issued since Sept. 11. And Americans must guard against letting fear build up in their thinking simply because government surveillance is looking for medical symptoms. While caution is needed to detect a bona fide terrorist attack, panic is not.

In fact, doctors and government officials should work just as diligently to make sure they are not spreading fear as they keep watch over the public.