American hospitals are not prepared to handle a widespread biological disaster, researchers reported Monday. A survey of 30 hospitals in four states and Washington, D.C., found the institutions unequipped — disturbing news for a country gripped by fears of additional anthrax attacks. 

Just one of the hospitals in the study had medicine stockpiled to fight a bioterror attack, emergency-room workers said. Twenty-six hospitals reported they could handle only 10 to 15 victims simultaneously, and 22 said they were not ready for a chemical or nuclear attack at all. 

Staff at only seven hospitals had any training to care for casualties resulting from bioterrorism. 

"If 'fully prepared' means you can handle 10 times your normal load, we'll never be fully prepared," said Dr. Stephen Cantrill, associate director of emergency medicine at Denver Health Medical Center. 

A hopeful sign might be the quick response by hospitals, suggesting preparedness was improving, to the isolated anthrax cases over the past couple of weeks, exhibiting "a great deal of heightened awareness" resulting from the Sept. 11 attacks, Cantrill said. 

The results of the year-long study by Dr. Janet Williams and colleagues at West Virginia University were unveiled at the American College of Emergency Physicians' annual meeting in Chicago. The findings probably apply to hospitals nationwide, attending experts said. 

"It's evident that hospital personnel keenly recognize a need for training," Williams said, though lack of time, available courses and funding were cited as obstacles. 

The four-day convention's agenda was amended after the Sept. 11 attacks to include sessions addressing terrorism, but it was not the first time the meeting had addressed the issue. ACEP represents more than 20,000 doctors who specialize in emergency medicine and who consider themselves "the front line" in treating victims of a mass attack. 

Doctors who attended the meetings said they used to feel like they were overreacting in calling for better disaster preparations. 

"We've been talking about this for years, and people in general have not been interested," said Dr. Jonathan Burstein of Harvard Medical School, a member of the college's task force on weapons of mass destruction. "Now, of course, everyone's coming to us and saying, 'Well, gee, we understand this is a problem.'" 

Since Sept. 11, most hospitals nationwide have begun to improve their ability to quickly diagnose anthrax, said Dr. Michael Carius, ACEP's president, in an interview. The simplest test involves merely swabbing fluid or discharge from the nose and examining it under a microscope. But in many cases, health care workers need to be trained to identify magnified anthrax spores, Carius said. 

"It's something that obviously we weren't testing for on a regular basis," Carius said. 

More than 250 people crowded a room at the meeting Monday for a slide show on how to identify skin rashes from anthrax and other potential biological and chemical weapons. 

One graphic photograph showed a patient's forearm with a large, black ulcerated sore — typical of cutaneous anthrax poisoning, instructor Dr. Kristi Koenig told the audience. 

Anthrax means "coal" in Greek, and refers to the telltale color of such lesions, said Koenig, national director of an emergency management group at the Veterans Health Administration in Washington, D.C. Dr. Eric Mailman, an emergency room physician at Swedish Hospital in Seattle, called the presentation an excellent crash-course in cases he, like most of the audience, had never seen. 

Already, Mailman said, worried patients were showing up in his emergency room with colds and flu they think might be anthrax "and we're not even deep into the cold and flu season." 

Such fears show the public needs better training, too, Carius said. 

If those with run-of-the-mill symptoms continue seeking emergency care, "we are going to inundate the medical system within the next few months," Carius said. 

The study sampled 22 rural hospitals and eight urban hospitals in Washington, D.C., Pennsylvania, Maryland, Virginia and West Virginia. Results also will be published in the November issue of group's medical journal, Annals of Emergency Medicine. 

The Associated Press contributed to this report