The events that occurred in the autumn of 2001 disturbed Americans’ sense of security within their borders. The terrorists’ hijacking of four airplanes prompted major efforts to strengthen homeland security through more rigorous screening of airline passengers and of international travelers at the borders, precautions that are now routine and are expected to be maintained.


The anthrax attacks called attention to the fact that the public health system is America’s best protection from bioterrorism. Increased funding for disease surveillance, public health laboratories, and emergency response systems has strengthened the ability of the public health system to respond to bioterrorist attacks as well as to natural disasters and epidemics. These precautions are just as important as other homeland security measures for Americans to be safe in their homeland.


The bad news continued. At about the same time that workers in the media and in Congress were being exposed, the disease was breaking out in postal workers in New Jersey, Maryland, and Virginia, although it took days to weeks to recognize what was happening. While it was known by mid-October that anthrax spores were being sent through the mail, they were not believed to escape from sealed envelopes. As it turned out, postal workers were among the most affected by the outbreak.