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How to reduce the impact of “low-risk patients” following a bioterrorist incident: Lessons from SARS, anthrax, and pneumonic plague

Rubin, G. James and Dickmann, Petra (2010) How to reduce the impact of “low-risk patients” following a bioterrorist incident: Lessons from SARS, anthrax, and pneumonic plague. Biosecurity and Bioterrorism, 8 (1). pp. 37-43. ISSN 1538-7135

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Identification Number: 10.1089/bsp.2009.0059.


A bioterrorist attack may result in a large number of people who have not been exposed coming to medical facilities in search of treatment or reassurance. In this article, we review evidence from 3 previous biological incidents that are analogous to a bioterrorist attack in order to gauge the likely incidence of such “low-risk patients” and to identify possible strategies for coping with this phenomenon. Evidence from the anthrax attacks in the United States suggested that a surge of low-risk patients is by no means inevitable. Data from the SARS outbreak illustrated that if hospitals are seen as sources of contagion, many patients with non-bioterrorism-related healthcare needs may delay seeking help. Finally, the events surrounding the pneumonic plague outbreak of 1994 in Surat, India, highlighted the need for the public to be kept adequately informed about an incident. Although it is impossible to say what the likely incidence of low-risk patients will be during a future bioterrorist incident, several strategies may help to reduce it and to safeguard the well-being of the low-risk patients themselves. These strategies include providing clear information about who should and should not attend hospital; using telephone services to provide more detailed information and initial screening; employing rapid triage at hospital entrances, based, where possible, on exposure history and objective signs of illness; and following up by telephone those judged to be at low risk.

Item Type: Article
Official URL:
Additional Information: © 2010, Mary Ann Liebert, Inc.
Divisions: LSE Health
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 21 Apr 2011 09:10
Last Modified: 20 Oct 2021 03:14

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