In the wake of terrorist attacks last week, local and state health authorities are stepping up efforts to prepare for a possible biological or chemical attack.
They're tracking ambulance runs and hospital emergency rooms for certain symptoms, putting physicians and labs on alert and considering stockpiling drug supplies.
Some of the actions are part of emergency plans already in place; others are steps officials are adding to make Maryland as prepared as possible.
"We want to make sure our systems are geared up to respond as best we can," said Dr. Bob Bass, the state's EMS director.
In the past week, local and state public health officials have been meeting with hospitals, fire departments, police and emergency medical personnel to ensure that staffs are being trained and to beef up coordination.
Officials say no threat has been made of such an attack. But according to federal health officials, unlike explosives or chemical releases, biological attacks could go undetected for days. Even when victims seek treatment, it would be easy for physicians to overlook initial symptoms or misdiagnose the problem.
To watch for signs that people might have been exposed, Baltimore officials are starting to track the symptoms of patients from every ambulance run in the city, said Dr. Peter Beilenson, city health commissioner. Hospital emergency rooms also will be monitored.
The state health department is sending notices to physicians around Maryland, asking them to be alert for the possibility, Bass said.
They will be watching for sharp increases in common symptoms such as respiratory or gastrointestinal problems, typical reactions to some of the harmful biological agents. Beilenson said officials are considering tracking purchases of over-the-counter medicines used to treat those symptoms.