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The heat wave that swept across the Great Plains and Midwest in mid-July 1995 was one of the deadliest in US history. Regarded as one of the worst disasters ever to strike the City of Chicago, it claimed 522 lives by one count, and 733 by another. Yet within Chicago, the 1995 heat wave was not recognized as a disaster, nor even as a serious event, until almost after-the-fact. It was not until after the worst days of heat had passed that Chicago political leaders, journalists and residents began to grasp the toll it had taken. In a macabre drama that drew national television coverage, residents of greater Chicago discovered that hundreds of their neighbors and relatives - mostly old, frail and living in small urban apartments - had died. This multi-part case tells the story of the city''s unfolding emergency management and public health response to the heat wave. It focuses on the decision-making process within the office of Mayor Richard Daley about how to respond, as well as the logistics and limitations of medical response. More broadly, this case, developed for the Kennedy School''s Domestic Preparedness project, raises questions considered relevant to public health response to so-called bio- terrorism. How can authorities know with certainty that deaths and illnesses are running above normal levels? How can they identify the cause or causes, as well as identifying the population that is most vulnerable? What pre-emptive, defensive measure can authorities take to deal with such threats? The (B) case describes the aftermath of the 1995 heat wave, including its political fallout and emergency management changes considered as a result.