title: Public response to an anthrax attack: reactions to mass prophylaxis in a scenario involving inhalation anthrax from an unidentified source.
abstract: An attack with Bacillus anthracis ("anthrax") is a known threat to the United States. When weaponized, it can cause inhalation anthrax, the deadliest form of the disease. Due to the rapid course of inhalation anthrax, delays in initiation of antibiotics may decrease survival chances. Because a rapid response would require cooperation from the public, there is a need to understand the public's response to possible mass dispensing programs. To examine the public's response to a mass prophylaxis program, this study used a nationally representative poll of 1,092 adults, supplemented by a targeted focus on 3 metropolitan areas where anthrax attacks occurred in 2001: New York City (n=517), Washington, DC (n=509), and Trenton/Mercer County, NJ (n=507). The poll was built around a "worst-case scenario" in which cases of inhalation anthrax are discovered without an identified source and the entire population of a city or town is asked to receive antibiotic prophylaxis within a 48-hour period. Findings from this poll provide important signs of public willingness to comply with public health recommendations for obtaining antibiotics from a dispensing site, although they also indicate that public health officials may face several challenges to compliance, including misinformation about the contagiousness of inhalation anthrax; fears about personal safety in crowds; distrust of government agencies to provide sufficient, safe, and effective medicine; and hesitation about ingesting antibiotic pills after receiving them. In general, people living in areas where anthrax attacks occurred in 2001 had responses similar to those of the nation as a whole.
authors.affiliation: Harvard Opinion Research Program, Harvard School of Public Health, Department of Health Policy and Management, Kresge, 677 Huntington Avenue, Boston, MA 02115, USA. gsteel@hsph.harvard.edu
authors.forename: Gillian
authors.initials: G
authors.lastname: SteelFisher
authors.forename: Robert
authors.initials: R
authors.lastname: Blendon
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Ross
authors.forename: Blanche C
authors.initials: BC
authors.lastname: Collins
authors.forename: Eran N
authors.initials: EN
authors.lastname: Ben-Porath
authors.forename: Mark M
authors.initials: MM
authors.lastname: Bekheit
authors.forename: Johanna R
authors.initials: JR
authors.lastname: Mailhot
mesh_terms: D000293:Adolescent; D000328:Adult; D000881:Anthrax / Q000517:prevention & control*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000523:psychology / Q000706:statistics & numerical data*; D001408:Bacillus anthracis; D055885:Biohazard Release / Q000517:prevention & control; D023482:Bioterrorism / Q000517:prevention & control; D004219:District of Columbia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D055118:Medication Adherence / Q000523:psychology; D009515:New Jersey; D009518:New York; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011639:Public Opinion; D035502:Trust / Q000523:psychology; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000900:Anti-Bacterial Agents