{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:18:52Z","timestamp":1791688732543,"version":"4.3.4"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1935789318001131_abs1\" sec-type=\"intro\"><jats:title>Introduction<\/jats:title><jats:p>This paper assesses the total medical costs associated with the US anthrax letter attacks of 2001. This information can be used to inform policies, which may help mitigate the potential economic impacts of similar bioterrorist attacks.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789318001131_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Journal publications and news reports were reviewed to establish the number of people who were exposed, were potentially exposed, received prophylactics, and became ill. Where available, cost data from the anthrax letter attacks were used. Where data were unavailable, high, low, and best cost estimates were developed from the broader literature to create a cost model and establish economic impacts.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789318001131_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Medical spending totaled approximately $177 million.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789318001131_abs4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The largest expenditures stemmed from self-initiated prophylaxis (worried well): people who sought prophylactic treatment without any indication that they had been exposed to anthrax letters. This highlights an area of focus for mitigating the economic impacts of future disasters. (<jats:italic>Disaster Med Public Health Preparedness<\/jats:italic>. 2019;13:539-546)<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2018.113","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T10:02:14Z","timestamp":1542016934000},"page":"539-546","source":"Crossref","is-referenced-by-count":14,"title":["Medical Spending for the 2001 Anthrax Letter Attacks"],"prefix":"10.1017","volume":"13","author":[{"given":"Nicholas A.","family":"Zacchia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketra","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,11,12]]},"reference":[{"key":"S1935789318001131_ref36","doi-asserted-by":"publisher","DOI":"10.1037\/a0024570"},{"key":"S1935789318001131_ref37","first-page":"491","volume":"183","year":"2003","journal-title":"Br J Psychiatry"},{"key":"S1935789318001131_ref32","doi-asserted-by":"publisher","DOI":"10.3201\/eid0810.020330"},{"key":"S1935789318001131_ref31","first-page":"1124","volume":"8","year":"2002","journal-title":"Emerg Infect Dis"},{"key":"S1935789318001131_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/pds.828"},{"key":"S1935789318001131_ref18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-5-1"},{"key":"S1935789318001131_ref17","doi-asserted-by":"publisher","DOI":"10.3201\/eid1101.040272"},{"key":"S1935789318001131_ref16","doi-asserted-by":"publisher","DOI":"10.1057\/palgrave.jphp.3200083"},{"key":"S1935789318001131_ref15","doi-asserted-by":"publisher","DOI":"10.3201\/eid0810.020355"},{"key":"S1935789318001131_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6419.2007.00505.x"},{"key":"S1935789318001131_ref14","doi-asserted-by":"publisher","DOI":"10.3201\/eid0810.020353"},{"key":"S1935789318001131_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/0033-3352.00143"},{"key":"S1935789318001131_ref13","doi-asserted-by":"publisher","DOI":"10.3201\/eid0810.020329"},{"key":"S1935789318001131_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-5850.2008.00903.x"},{"key":"S1935789318001131_ref12","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2010.0053"},{"key":"S1935789318001131_ref6","first-page":"15","volume":"25","year":"2005","journal-title":"Public Budg Finance"},{"key":"S1935789318001131_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.02.005"},{"key":"S1935789318001131_ref11","year":"2009","journal-title":"J Homel Secur Emerg Manag"},{"key":"S1935789318001131_ref5","first-page":"1","volume":"25","year":"2005","journal-title":"Public Budg Finance"},{"key":"S1935789318001131_ref41","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2006.4.244"},{"key":"S1935789318001131_ref4","first-page":"1","volume":"5","year":"2002","journal-title":"J Homel Secur Emerg Manag"},{"key":"S1935789318001131_ref40","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025598106257"},{"key":"S1935789318001131_ref3","volume":"142","year":"2005","journal-title":"Ann Intern Med"},{"key":"S1935789318001131_ref2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0302.970201"},{"key":"S1935789318001131_ref1","volume-title":"Who You Gonna Call? 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