Many facilities in communities around the country have received anthrax threat letters. Most were empty envelopes; some have contained powdery substances. The purpose of these guidelines is to recommend procedures for handling such incidents.

DO NOT PANIC!

1. Anthrax organisms can cause infection in the skin, gastrointestinal system, or the lungs. To do, so the organism must be rubbed into abraded skin, swallowed, or inhaled as a fine, aerosolized mist. Disease can be prevented after exposure to the anthrax spores by early treatment with the appropriate antibiotics. Anthrax is not spread from one person to another person. 

2. For anthrax to be effective as a covert agent, it must be aerosolized into very small particles. This is difficult to do, and requires a great deal of technical skill and special equipment. If these small particles are inhaled, life-threatening lung infection can occur, but prompt recognition and treatment are effective.

SUSPICIOUS UNOPENED LETTER OR PACKAGE MARKED WITH THREATENING MESSAGE SUCH AS “ANTHRAX”:

1. Do not shake or empty the contents of any suspicious envelope or package.
2. PLACE the envelope or package in a plastic bag or some other type of container to prevent leakage of contents.
3. If you do not have any container, then COVER the envelope or package with anything (e.g., clothing, paper, trashcan, etc.) and do not remove this cover.
4. Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
5. WASH your hands with soap and water to prevent spreading any powder to your face.
6. What to do next…call 9-1-1.
7. LIST all people who were in the room or area when this suspicious letter or package was recognized, or anyone else who may have come into contact the area of exposure. Give this list to both the local authorities and police. 

ENVELOPE WITH POWDER AND POWDER SPILLS OUT ONTO SURFACE:

1. DO NOT try to CLEAN UP the powder. COVER the spilled contents immediately with anything (e.g., clothing, paper, trashcan, etc.) and do not remove this cover!
2. Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
3. WASH your hands with soap and water to prevent spreading any powder to your face.
4. What to do next…call 9-1-1.
5. REMOVE heavily contaminated clothing as soon as possible and place in a plastic bag, or some other container that can be sealed. This clothing bag should be given to the emergency responders for proper handling.
6. SHOWER with soap and water as soon as possible. Do Not Use Bleach Or Other Disinfectant On Your Skin.
7. If possible, list all people who were in the room or area when this suspicious letter or package was recognized, or anyone else who may have come into contact the area of exposure. Give this list to both the local authorities and police. 

ROOM CONTAMINATION BY AEROSOLIZATION: 

For example: small device triggered, warning that air handling system is contaminated, or warning that a biological agent released in a public space.

1. Turn off local fans or ventilation units in the area.
2. LEAVE area immediately.
3. CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).
4. SHUT down air handling system in the building, if possible.
5. What to do next…call 9-1-1.
6. If possible, list all people who were in the room or area when this suspicious letter or package was recognized, or anyone else who may have come into contact the area of exposure. Give this list to both the local authorities and police. 

HOW TO IDENTIFY SUSPICIOUS PACKAGES AND LETTERS:

Some characteristics of suspicious packages and letters include the following…

• Excessive postage
• Handwritten or poorly typed addresses
• Incorrect titles
• Title, but no name
• Misspellings of common words
• Oily stains, dis-colorations or odor
• No return address
• Excessive weight
• Lopsided or uneven envelope
• Protruding wires or aluminum foil
• Excessive security material such as masking tape, string, etc.
• Visual distractions
• Ticking sound
• Marked with restrictive endorsements, such as “Personal” or “Confidential”
• Shows a city or state in the postmark that does not match the return address

SYMPTOMS OF ANTHRAX

Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days. 

Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of Cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy. 

Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal. 

Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases. 

Remember your chance of contracting any disease from an envelope or other container is extremely low.

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This Page was last updated on 12/17/08
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