This study was developed in response to cases of anthrax in 2001, which created anxiety about exposures to agents of biological terrorism. Shortly thereafter, many patients presented to physicians or EDs requesting testing or treatment for possible exposures to anthrax or other agents. Although very few Americans have truly been exposed to biological weapons, concerned patients may create a burden on our healthcare system.

Although this study was originally designed to address patients with possible exposures to biological agents, it can be rapidly restructured to study patients with possible exposures to a variety of agents or syndromes, including SARS, MERS, Avian influenza, Ebola virus, or other serious public health concerns. It will be important to study the types of patients presenting with these concerns and the management provided to better understand how emergency physicians should care for such patients. Since, 2003, we have kept site IRB approvals for this study open, so that in the event of a public health threat in the U.S., we will be able to rapidly implement the study at all sites.