Recommendations are related to each of the following functions of the public health and medical response to bioterrorism: surveillance, epidemiology, laboratory capability, medical management, training and education, and information and communication. Among the recommendations for surveillance is the development of a national health surveillance system to provide early warning of bioterrorism incidents. Such a national system would integrate Federal, State, and local public health departments, health care providers, and nontraditional surveillance partners such as local pharmacies, emergency medical services, and the veterinary community. Recommendations regarding epidemiology include the hiring of additional epidemiological staff for State departments of health and the suggestion that the Centers for Disease Control and Prevention (CDC) emphasize a wider range of bioterrorism agents than those that currently receive most of the attention. Recommendations for laboratory requirements include the encouraging of physicians to take cultures and request laboratory analyses on a more routine basis to ensure that something unusual is not occurring among patients. Recommendations for medical management include localities' development of prophylaxis and treatment plans that are phased or divided into escalatory segments. Recommendations for training and education are based on the recognition that properly trained medical, public health, and emergency personnel are essential to a comprehensive detection, assessment, and response framework. Recommendations for information and communication focus on the need for improved information infrastructure and Federal efforts to provide State and local partners with both the necessary financial resources and the consultative expertise to build a national public health information network. In addition to the functions of the public health and medical response to bioterrorism, the recommendations also address Federal, State, and local preparedness and response, the public-private partnership, and the structure and planning of the Centers for Disease Control and Prevention.