Published online by Cambridge University Press: 13 February 2006
Saturday night, downtown Baltimore, Maryland. A sold-out concert performance at the Joseph B. Meyerhoff Symphony Hall. Unknowingly, the 2,400 members of the audience become victims of a bioterrorist attack when an aerosol of plague (Y. pestis) is silently released. Over the course of the next 36 hours increasing numbers of residents seek medical attention at area hospitals for cough and fever. By mid-morning on Monday some 300 persons with these symptoms have received medical care; 17 of which have died. The State Health Department notifies the Center for Disease Control (CDC) and by mid-afternoon plague is confirmed first by the state laboratory and subsequently by the CDC's Washington, D.C. lab.I would like to thank Carrie Vivian for her contributions to the development of this exercise and Dena Owens and PS's anonymous reviewers for their insightful comments and suggestions on this manuscript. In addition, I would like to express my gratitude to the former mayor of Westminster, Maryland, Kevin Dayhoff, and the emergency responders for their contributions to and participation in this exercise.