Home > Patients & Visitors > Health Library > Terrorism and Other Public Health Threats
Public health threats are events or disasters that can affect you and your community. Examples of public health threats are:
Public health threats can affect air quality, cause shortages of safe water and food, and cut off electricity, gas, telephone, and other services. You and your family members may be separated.
Disasters are hard to predict and usually are out of your control. But you can take steps to help keep yourself and your family safe.
Here are some things you can do to help prepare for a disaster:
Following these steps can help you be better prepared for any type of public health threat.
There are many things in our environment that can be harmful. Chemicals, fumes, viruses, bacteria, and low-level radiation are just a few of them. When these substances are released in large quantities or get out of control, they can become urgent public health threats. Guidelines for how to prepare for and avoid a problem often depend on how the substance is spread.
In general, a health threat may spread through a community:
Call your local health department for information about health threats in your area.
Chemicals are the most likely source of air contamination. An accident at a plant or factory or a train wreck might release large amounts of a hazardous chemical into the air, for instance. A terrorist attack could involve the deliberate release of a toxic chemical or gas.
In a bioterror attack, bacteria or viruses causing diseases such as anthrax, pneumonic plague, smallpox, or tularemiacould be released in an aerosol form. Anyone who inhaled the substance could be affected.
Although air itself does not become radioactive, the release of radiation into the environment can create radioactive dust and dirt (fallout) that can make the air unsafe. A "dirty bomb" could work in this manner, causing a relatively minor explosion but doing its real damage by releasing radioactive materials into the environment.
You cannot do much in advance to protect yourself from a hazardous substance released into the air. If there hasn't been an obvious explosion or a known terrorist attack, the air could become contaminated without anyone knowing it until people or animals start to have symptoms.
As with other potential emergencies, it makes sense to have a disaster kit with water, food, first aid items, tools, and other essentials. Concern over terrorist threats has prompted some people to consider adding the following items to their supplies:
Vaccines for anthrax and smallpox are available for certain high-risk groups but are not recommended for the general public at this time. The U.S. Food and Drug Administration (FDA) has approved human vaccines to protect against bird flu (avian influenza). But immunization is not currently available for the public. The vaccines are kept in a U.S. government stockpile.footnote 1For more information, see Bioterrorism and Vaccinations.
If a hazardous substance is released into the environment:
Chemicals, heavy metals like lead and mercury, and living organisms such as bacteria and viruses can all be threats to a safe water supply. These substances can also contaminate food.
Unintentional contamination of water as a result of chemical leaks or spills, natural disasters, and other causes has been a much bigger problem than deliberate contamination. Likewise, accidental food contamination by botulinum toxin (the agent that causes botulism), E. coli, and other harmful organisms during the storage or preparation of food is much more likely than intentional food poisoning.
Intentional poisoning of food and water has occurred, though. The use of food and water to expose people to biological or chemical weapons is also possible. Terrorists could release living organisms such as the bacteria that cause tularemiaor botulism into the water or food supply. Hazardous chemicals could be deliberately released in liquid or solid form. Radioactive materials could be released into the water.
With the exception of a known accident (such as a chemical spill into the water supply) or an announced terrorist or criminal incident, you probably would not know that you had consumed contaminated water or food unless you developed symptoms. To reduce your risk of consuming contaminated food or water and to be better prepared for public health emergencies affecting the water supply:
If there is an emergency affecting the water supply:
Some bacteria, viruses, and other biological agents can be spread from person to person or from animals or insects to people. The ease of international travel has made many of these health threats more difficult to contain. Recent health threats such as SARS (severe acute respiratory syndrome), the West Nile virus, and monkeypox have made people more aware of how easily disease can spread not only within a community but from one community to the next.
With some exceptions such as smallpoxand pneumonic plague, which are contagious diseases, most biological agents that could be used as bioterror weapons are not spread from person to person.
The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have current, reliable information on communicable diseases and health concerns throughout the world. For updates on specific health emergencies, visit their websites:
To reduce your chances of being infected with or spreading a contagious disease:
Also see the Bioterrorism and Vaccinationssection of this topic. A vaccine for smallpox is available for certain high-risk groups but is not recommended for the general public at this time.
The U.S. Centers for Disease Control and Prevention (CDC) has developed plans on how to respond to bioterrorism threats. Certain diseases have been identified as posing the greatest threat. These diseases are:
Although the CDC is addressing all of these potential threats, vaccines are available only for anthrax and smallpox. Currently these vaccines are not recommended for the general public. But the CDC has advised special vaccinations for people at high risk for exposure to anthrax or smallpox, such as certain health care workers or military personnel. For more information, see:
A little organization can go a long way towards helping you feel ready to handle the unexpected. Having an emergency plan and an emergency supplies kit for your household can help you and your family be better prepared for any kind of disaster.
Putting together an emergency plan is easy:
You may have other things that you want to include, especially if you have children in school or if anyone in your household has special needs. Review your plan yearly, and make sure that phone numbers, email addresses, and other items are still current.
The essentials of an emergency kit are the same no matter what the situation: food and water, first aid supplies and medicines, blankets and clothing, special-needs items (such as baby formula), and certain tools and household items, including a battery-powered radio, a flashlight, and extra batteries. You can also use a radio or flashlight that is powered by a hand crank and so does not need batteries.
Visit the American Red Cross's website at www.redcross.org for a checklist to use as you gather supplies. Store everything in one place, preferably a cool, dark location. Consider putting together a smaller version of your emergency kit that you could take if you had to leave home or shelter in place.
After you've assembled your emergency supplies, remember to check and replace them periodically:
It is hard to prepare for a terrorist attack because no one knows what form it might take or when or where it may occur. But being prepared for general emergencies-including fires, natural disasters, power failures, fresh-water shortages, and similar events-makes sense and will help to reassure you and your family.
The following agencies provide extensive information about disaster planning and terrorism:
In any disaster situation, transportation and communication may be interrupted, and medical services may be overwhelmed. You may need to evaluate or treat minor or major injuries or provide first aid, because medical care may not be immediately available. You may feel more confident when an emergency happens if you know what to do ahead of time and have resources at hand. The following topics discuss emergencies that can occur in a disaster situation:
Emergency procedures you may want to know include:
A natural disaster, industrial accident, or terrorist attack can cause a lot of situations that lead to injury or illness. In some cases your home may need to be evacuated or may be damaged. A disaster may interrupt water supplies, food supplies, sewer and trash services, and heat and electricity. You may be exposed to the elements or have less-than-adequate shelter for a period of time. The following topics can help you avoid or cope with injuries related to food safety, sanitation, and exposure:
The topic Dealing With Emergenciesprovides more information about how to cope with injuries that can occur during or right after a disaster.
You may feel overwhelmed after an accident, natural disaster, or terrorist attack. Some people who witness a traumatic event that seemed life-threatening develop a stress reaction known as acute stress disorder, which can last up to a month after the event.
Symptoms include feeling numb, reliving the event through disturbing memories or dreams, and avoiding anything that may be a reminder of the event. Symptoms are so intense that they disrupt daily activities like going to work and interacting with other people.
If the symptoms last more than a month or don't develop until more than a month after the event, you may have post-traumatic stress disorder (PTSD). Even if you were not injured or in danger, you can still get acute stress disorder or PTSD if you felt physically threatened or witnessed violence. For more information, see the topic Post-Traumatic Stress Disorder (PTSD).
People who have experienced or witnessed a traumatic event often need help from health professionals who are specially trained. If symptoms are severe enough to disrupt your daily life or do not improve after 2 weeks, talk with a doctor.
If you lost a loved one or friend in a disaster or accident (or even a pet, your home, or important possessions), you will need time to cope with feelings of grief and loss. For more information, see the topic Grief and Grieving.
Traumatic events can also cause feelings of depression that may need treatment. For more information, see the topic Depression.
U.S. Food and Drug Administration (2007). FDA approves first U.S. vaccine for humans against the avian influenza virus H5N1. FDA News. Available online: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108892.htm.
Other Works Consulted
American Academy of Pediatrics (2006, reaffirmed 2011). Chemical-biological terrorism and its impact on children. Pediatrics, 118(3): 1267-1278.
American Red Cross (accessed January 2013). Terrorism. Available online: http://www.redcross.org/prepare/disaster/terrorism.
Centers for Disease Control and Prevention (2012). Emergency Preparedness and Response. Available online: http://www.bt.cdc.gov.
Centers for Disease Control and Prevention (2012). Severe acute respiratory syndrome (SARS). Available online: http://www.cdc.gov/sars/index.html.
Cieslak TJ, et al. (2008). Disaster preparedness and response. In RB Wallace et al., eds., Wallace/Maxcy-Rosenau-Last Public Health and Preventive Medicine, 15th ed., pp. 1285-1294. New York: McGraw-Hill.
Federal Emergency Management Agency (2004). Food and Water in an Emergency. Available online: http://www.fema.gov/pdf/library/f&web.pdf.
Federal Emergency Management Agency (2012). Are You Ready? A In-Depth Guide to Citizen Preparedness. Available online: http://www.ready.gov/are-you-ready-guide.
Hill-Kayser CE, et al. (2015). Radiation terrorism. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 19th ed., CD chap. 263e. New York: McGraw-Hill Education.
Hurst CG, et al. (2015). Chemical terrorism. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 19th ed., CD chap. 262e. New York: McGraw-Hill Education.
Lane HC, Fauci AS (2015). Microbial bioterrorism. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 19th ed., CD chap. 261e. New York: McGraw-Hill Education.
U.S. Department of Homeland Security (2010). Be informed. Available online: http://www.ready.gov/be-informed.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerMartin J. Gabica, MD - Family Medicine
Current as ofMay 7, 2017
Current as of:
May 7, 2017
E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine
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