in infectious diseases are concerned about the possibility of a “postantibiotic era.” As a result, our ability to detect, contain, and prevent emerging infectious diseases is in jeopardy.
In the wake of the events of September 11, 2001, credible threats of terrorism that include the potential use of nuclear, chemical, and biological agents have had significant impacts on the funding and costs of providing laboratory services. The identification of clinical cases and environmental contamination caused by deliberate dissemination of Bacillus anthracis through the mail system during the early part of 2002 emphasized this lesson for a number of microbiology laboratories. These events and the fear of additional terroristic use of other infectious agents have not only alarmed the public, the government, and the medical and microbiological community but also focused attention on technical capabilities, biologic safety infrastructure, and staff preparation (71, 72).
Unfunded programs will impact training costs, acquisition and deployment of equipment, facility modification, and other unfunded mandates, such as the CDC-issued rules (August 2002) requiring all laboratories to report to the government whether they are in possession of “select agents” that could be used in a bioterrorist attack. The rule is available at http://www.selectagents.gov/regulations.html (accessed 5/26/2015) (4). However, increased federal concerns about laboratory preparedness have generated some increased funding for specific areas of the laboratory; it is more likely that in the event of actual or suspected biological attacks, the impact on the laboratory will be to significantly increase laboratory services. These increases will focus on unusual/potentially dangerous diagnostic challenges and on the potential massive increase in demand for routine laboratory services required for the care of large numbers of acutely ill patients.
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