A review of these post-Amerithrax incidents revealed that all the cases were identified by astute clinicians using improved laboratory techniques. The time required to suspect and confirm the diagnosis of anthrax decreased with each subsequent incident, with increased awareness of animal sources of anthrax combined with improved compliance with laboratory reporting protocols. While syndromic surveillance systems did not identify the initial patients, these systems were used to search for additional cases. These efforts were enhanced when they were well coordinated among all jurisdictions.