Review Article| Volume 26, ISSUE 2, P313-327, June 2006

Medical Strategies to Handle Mass Casualties from the Use of Biological Weapons

      Biological weapons have been used since antiquity. In 184 bc, Hannibal ordered earthen pots to be filled with serpents of every kind and hurled onto the ships of Pergamene warriors. Military leaders during the Middle Ages tossed plague-infected victims over the walls into the city of Kaffa. In the fifteenth century, Pizzarro presented indigenous peoples of South American with variola-contaminated clothing, and in 1754 the English gave American Indians smallpox-laden blankets. In modern times, concern for the use of biological weapons has increased, particularly in the United States in the aftermath of September 11, 2001, when anthrax-laden letters were sent to members of Congress [
      • Allegra P.C.
      • Cochrane D.
      • Dunn E.
      • et al.
      Emergency department visits for concern regarding anthrax-New Jersey, 2001.
      ]. This article reviews the definitions of biological weapons and mass casualties. In addition, it discusses the main operational and logistical issues of import in the medical management of mass casualties from the use of biological weapons. Strategies for medical management of specific biological agents also are highlighted.
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