How would New Haven residents react if they awoke one morning to learn that there had been fi fteen confi rmed incidents of smallpox across the state of Connecticut and that the government suspected at least two hundred more asymptomatic cases? Would citizens muster up the courage to attend class or go to work? Would they avoid public places altogether? Ken Rubano, the Director of Bioterrorism at the New Haven Health Department, has been trying to answer these questions for the past fi ve years.

The New Haven Bioterrorism Department was created shortly after 9/11 and the anthrax scare that immediately followed. The two independently orchestrated terrorist attacks prompted state and local health departments across the country to establish internal divisions to focus solely on bioterrorism. These divisions were charged with the task of assembling, practicing, and executing protocols for biological attacks. A decade after the fall of the Soviet Union, many thought the United States had reentered the era of dirty bomb threats.

But the anthrax mailings eventually stopped, and U.S. health departments became gradually less proactive in their efforts to combat bioterrorism. As resources disappeared and state pressure eased, the New Haven Health Department redirected its focus towards more pressing city concerns. For a year and a half, the bioterrorism division received little funding or attention. Then the United States invaded Iraq.

The Iraq War prompted another wave of bioterrorism fears. Health departments across the nation rushed to prepare for the possibility of biological attacks, especially smallpox. Believing that Saddam Hussein’s regime was hiding both nuclear and biological weapons of mass destruction, the Bush Administration and the Center for Disease Control (CDC) fed bioterrorism plans to state health departments who subsequently passed them down to the local level. These orders required that state and local health offi cials develop the capability to vaccinate their entire populations against smallpox within days of an outbreak. Continued
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