The Alexandria Health Department has hired an epidemiologist and a staff member to oversee anti-bioterrorism programs. In Loudoun, health workers have developed a plan for communicating with neighboring counties and cities in case of a smallpox outbreak, and the county is waiting for more experts to come on board this month.

In Arlington, public health officials have developed a detailed plan for responding to a bioterrorism threat, with specific responsibilities for staff members.

Across Northern Virginia, cities and counties have beefed up their health departments in preparing for a possible biological weapon attack that could infect residents with such diseases as smallpox or dangerous influenza.

Under state supervision, some health departments have developed ways to identify pathogens more quickly. Others have written action plans. Everything has been financed by the federal Centers for Disease Control and Prevention (CDC) in Atlanta, which allotted Virginia $22 million last month to continue planning and preparation.

In Arlington, officials are going a step further and participating in a federal test of how quickly hundreds of civilians could be vaccinated in case of attack.

Next month, the county plans to host a Department of Health and Human Services mock vaccination exercise with 500 people at Washington-Lee High School. Each will be given an orange to be injected with water as everyone moves through a line. Then, to approximate a crowd of 1,000, the group will repeat the process.

Officials said it's a way to see how the federal government responds to a large crowd that may need to be immunized quickly.

Arlington officials were quick to note, however, that the county was not singled out because it faces a special risk but only because it volunteered to participate in the federal exercise.

Overall, state officials cite progress in preparing for possible attack.

"I think we have made great strides in improving our ability to respond quickly," said Lisa Kaplowitz, Virginia's deputy commissioner for emergency preparedness and response. "What we're trying to do is develop an infrastructure, so that staff is in place, trained and equipped with a tested system."

Some of the most significant progress has been in hiring specialists. In recent months, each Northern Virginia health department has hired an epidemiologist or bioterrorism event coordinator. Statewide, all 138 new positions are expected to be filled by next month.

In addition, health departments have sent smallpox response plans to the CDC. Because funding comes from Uncle Sam, the state's budget troubles are not affecting local health departments' ability to hire and train extra staff. Some have found better ways to communicate with state labs. Others have developed procedures to cooperate with nearby military bases.

"One of the most important things we've been able to do is get our epidemiologist and bioterrorism director hired," said Charles Konigsberg, director of the Alexandria Department of Public Health. "Once we are able to hire staff, we're better able to complete our preparedness plans."

In Fairfax County, officials of 25 government departments, including schools, hospitals and the water authority, meet monthly for updates on how to respond to bioterrorism.

In addition, the county's hazardous materials team is on call 24 hours a day, seven days a week -- a procedure that started Sept. 11, 2001 -- and emergency procedures for all county staff members have been updated. The county has improved its communications system to contact county employees via e-mail immediately in an emergency, and it has reassigned personnel to focus exclusively on informing the public if bioterrorism occurs.

"We heard from the public that they wanted to make sure they were properly informed at all times," said Merni Fitzgerald, Fairfax's director of public information.

Throughout the region, plans have been developed to respond to potential diseases. Guidelines have been established for anthrax, plagues and viral fevers. Preparations include development of fact sheets for physicians, diagnoses for health care providers and directions on how to treat and control infection quickly.

For instance, in its report to the CDC on smallpox preparation, Virginia has recommended that several locations be available as inoculation sites if the federal government decides to vaccinate Americans in anticipation of an attack. President Bush has not decided whether to offer a smallpox vaccine, given concerns about potential side effects.

State officials have also identified sites that might be used after a smallpox attack and how public health staff members would relay information to physicians, emergency workers and the public.

Several local officials also said recent public health scares, including anthrax-related incidents, have helped them develop better-coordinated and detailed plans.

"I think we've learned a lot from last year and our recent cases of malaria," said David Goodfriend, director of public health for Loudoun County.

Last year, a 59-year-old contract worker at a State Department mail facility in Sterling contracted inhalation anthrax. Goodfriend said such events forced the county to communicate across jurisdictions, even across state lines with Maryland in the case of the malaria outbreak, to attack a public health problem jointly.

"We've been able to learn from those experiences and develop some good strategies," he said.

Regional and state officials acknowledge that preparing for bioterrorism means constantly retooling procedures to keep up with new information.

"It continues to be a work in progress," said Mark Penn, deputy coordinator for emergency services in Arlington, who said the county is constantly reviewing its plans to ensure that they are timely. "When you think you're done, you're really not done."

Each Northern Virginia health department has hired an epidemiologist or bioterrorism event coordinator to help coordinate attack responses.