The single local sources of exposure in most of these cases limited the value of these incidents to test the ability of syndromic surveillance systems to detect potential bioterrorist attacks. However, each incident provided valuable experience in the use of advanced laboratory and syndromic surveillance systems in the identification of anthrax cases. Although 10 years of surveillance system development has enhanced our nation's preparedness, use of outbreak modeling exercises in conjunction with regional and national multijurisdictional public health working groups, such as the Distribute Community of Practice, can further test and develop our ability to respond to bioterrorist attacks and emerging disease.