"“This thought provoking book is a must read for anyone with concerns about or responsibility for early detection and containment of either emerging infectious diseases or the management of an epidemic caused by bioterrorism.

In this delightfully pithy volume, the authors manage to interweave the recounting of past public health system failures with some good introductory science and some important insights into the "clinical thought process". They conclude with straightforward recommendations for future actions.

The authors do a nice job explaining the nuances of prions and DNA vaccine and make a compelling case for strengthening the relationships between the public health, human and animal medical communities. The authors provide brief insights into several recent failures of the public health to detect and contain emerging infectious diseases before they became integrated into the nation's eco-systems. In recounting outbreaks of West Nile virus, cryptosporidium and bovine spongiform encephalopathy they raise a series of "what if" questions that should stimulate the reader to further readings.

The story of the Aralesk smallpox outbreak is in itself worth the price of the read. That relatively unknown smallpox outbreak caused by Soviet live agent testing, for once and for all, lays to rest some of the myths about the Soviets work to weaponize smallpox.

The book contains two illustrative bioterrorist scenarios, each of which is plausible and frighteningly realistic, and which by themselves make a compelling case for the nation's public health community to rapidly move to adopt a system of syndrome based disease surveillance.

It is those recurring discussions about the utility of syndrome-based surveillance that ultimately embody the book's central message. The clarity with which the authors discuss the strengths and weakness of the nation's current disease detection efforts and their shortfalls is refreshing and raises important policy issues. This book clearly illustrates the need for the nation to implement an emerging infectious diseases warning system that is syndrome-based rather than the one based on disease reporting. Hopefully, the public policy community as well as public health and clinical communities will read this book and act on its recommendations."x

— William D. Stanhope, Associate Director, Special Projects, Institute for Biosecurity, School of Public Health, Saint Louis University"