By Gary Stephenson
Johns Hopkins Medicine

More than one-half of 631 physicians tested were unable to correctly diagnose diseases caused by agents most likely to be used by bioterrorists, such as smallpox, anthrax, botulism and plague, according to a Johns Hopkins study published in the Sept. 26 issue of Archives of Internal Medicine.

However, test scores improved dramatically for the same physicians after they completed an online training course in diagnosing and managing these diseases caused by bioterrorism agents, according to the study.

"Most American physicians in practice today have never seen any cases of these diseases in their practice," said Sara Cosgrove, an assistant professor in the School of Medicine's Division of Infectious Diseases. "Preparation will be key to dealing with a major catastrophe, such as a major bioterrorist attack. Education and training health care providers in disease recognition, treatment and prevention strategies have the potential to significantly limit the effects of a bioterrorism attack."

In the study, 631 physicians at 30 internal medicine residency programs in 16 states and Washington, D.C., were tested before and after taking an online course in bioterrorism disease on how to recognize and treat bioterrorism-related diseases. On the pretest, correct diagnosis of diseases due to bioterrorism agents was smallpox, 50.7 percent; anthrax, 70.5 percent; botulism, 49.6 percent; and plague, 16.3 percent, for an average of 46.8 percent, the researchers report. Correct diagnosis averaged 79 percent after completion of the course. Correct management of smallpox in the pretest was 14.6 percent; anthrax, 17 percent; botulism, 60.2 percent; and plague 9.7 percent, for an average of 25.4 percent. Correct management averaged 79.1 percent after course completion.

Other Johns Hopkins researchers involved in the study are Stephen Sisson, Trish Perl and Xiaoyan Song.

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