After an overview of bioterrorism's long history, the article discusses the threat of smallpox and the importance of training medical personnel to recognize the smallpox rash and take appropriate action. A case study of a creditable anthrax scare is then described. It occurred in October 2001 at Mercyhurst College in Erie, PA. A suspicious letter with a return address for Egypt and forwarding address to Robert J. Heibel, director of the Research Intelligence Analyst Program at Mercyhurst, was opened by an office assistant. When the letter was opened, a white powder spread throughout the room and contaminated the office assistant, who then ran down the hallway to the ladies room to wash, spreading the contaminant throughout the first floor. The FBI deemed the threat credible, and over 400 students and faculty were decontaminated and treated. Hamot Medical Center took a mobile response team of doctors, nurses, patient care technicians, security, lab technicians, and communication media personnel in response to the incident. When the incident occurred, quick screen and specific agent identification was not yet available, so the patient's reported location became pertinent information as care was rendered. The Mercyhurst incident was considered less lethal because the agent used was not anthrax and because the suspected agent was not contagious. This article discusses the significance of the anxiety response when a bioterrorist incident is suspected, and recommends preparatory education regarding exposure to the agent; methods of transmission; signs and symptoms of exposure; follow-up care if there is shortness of breath, cough, and fever; and information on symptoms. The article advises that early identification and response is the key to limiting the harm from a bioterrorism incident. It further advises that the forensic nurse should be exposed to education and training that encompasses all aspects of bioterrorism response, since during an attack the forensic nurse will interface with representatives from the areas of public health, law enforcement, and emergency management services. 9 references