The Anthrax Attacks 25-Years Later: Who Will Sound the Alarm.

In the backdrop of current global turmoil, the prospect of a bioterrorism threat may be of greater concern than at any other period in the modern era. Now, twenty-five years after the 2001 Anthrax attacks, referred to as Anthrax Bioterrorism in the Mail, the fundamental questions remain: What went well, what lessons did we learn, and are we better prepared for future events? The experience of this event led to essential revisions and advancements across all aspects of preparation for future potential bioterrorist attacks, including prevention, communication, and response. The previously unavailable capabilities afforded by current and widely accessible artificial intelligence (AI) platforms have ushered in significant improvements in biosecurity. At the same time, these advancements may be misused in ways that challenge existing biosafety measures. Rapid and effective responses to bioterrorism begin with recognition. Thus, it is important to remember that the identification of the U.S. index case of anthrax bioterrorism was made possible through the "on-the-ground" ability of individual clinicians and laboratory personnel to recognize a potential case of bioterrorism.