Protecting public health in the age of bioterrorism surveillance: is the price right?

Millions of dollars have been spent improving the bioterrorism surveillance capabilities of the public health system. Yet relatively little attention has been paid to the benefits that such expenditures yield. To assess the impact of an aerosol release of Bacillus anthracis, this article collects the available evidence on the potential benefits of environmental detection relative to the costs of a bioterrorist attack like the one in 2001, which occurred in the absence of any such detection. The cost-benefit model shows that biological surveillance that reduces time to treatment to 48 hours yields economic benefits that range from $1.11 billion to $50.74 billion depending on the nature of the release and the value of statistical life one assigns. The author collected annual costs of the current biological surveillance system, BioWatch, for the cost-benefit analysis. The costs of BioWatch are justified when the probability of a biological threat exceeds 1.26 percent.