Public health preparedness for maritime terrorist attacks on ports and coastal waters.

OBJECTIVE: To assess the risk of mass casualties and necessary public health and provider preparation relating to maritime terrorist attacks on the US ports.

DESIGN: Articles were obtained by searching PubMed database, Google, and Google Scholar search engines using terms such as "maritime security," "maritime terrorism,""port security," "terrorist attacks on the U.S. ports," "terrorist nuclear attacks," "terrorist attacks on liquefied natural gas tankers," and "terrorist attack on high occupancy ships."

SETTING: U.S. ports and coastal waters.

RESULTS: Seventy-six journal articles were reviewed.

CONCLUSIONS: Morbidity and mortality high for nuclear terrorist attack; mortality low but morbidity potentially high for radiological attacks. It would be more difficult for terrorist attack on natural gas tankers to cause high mortality and/or morbidity.