During the past four years large scale biological exercises took place in several districts of the state of Israel. The drills included hospitals, Health Maintenance Organizations (HMOs), Emergency Medical Services (EMS), public health district offices and interface agencies such as Israel Defense Forces (IDF) Home Front Command (HFC).

On January 2010 a comprehensive biological exercise was conducted in Tel Aviv. Tel Aviv Sourasky Medical Center (TASMC) together with the agencies mentioned above practiced the hospital competing with Exceptional Biological Event. New elements, which had never been inspected before, were evaluated in this drill:

• • Activating of a triage point at the hospital gate.

• • Opening a special registration point.

• • Staff protection from biological agents.

• • Activating a separate Emergency Department (ED) for bio- threat.

• • Detection and Containment ward.

• • Protected elevators and passageways

• • Interface agencies in and out the hospital.

Designated physicians, nurses and paramedical team, that practiced other events in the past, needed to be trained and practiced in order to be ready for a biological event. Wards that usually did not participate in such drills, needed to take part in this particular drill, while the routine work continued. This paper presents the hospital preparation for the drill, the methodology of training and preparedness, as well as the outcome of the drill.