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
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. In
other words, it is not contagious.

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 with or without the threatening message such as "ANTHRAX": (Or any other disease)

• Do not shake or empty the contents of any suspicious envelope or package.
• PLACE the envelope or package in a plastic bag or some other type of
  container to prevent leakage of contents.
• If you do not have any container, then COVER the envelope or package with
  anything (e.g., clothing, paper, trash can, etc.) and do not remove this
  cover.
• Then LEAVE the room and CLOSE the door, or section off the area to prevent
  others from entering (i.e., keep others away).
• WASH your hands with soap and water to prevent spreading any powder (germs)
  to your face.

What to do next

• If you are at HOME, then report the incident to local police.
• If you are at WORK, then report the incident to local police, and notify
  security official, and the Administrator Of The Day. Do not show other
  co-workers the content if you receive it, because then you will be expanding
  the number of people exposed to the contents. The AOD will contact the
  Infection Control Coordinator and Administration.
• LIST all people who were in the room or area when this suspicious letter or
  package was recognized. Give this list to the Infection Control Coordinator
  for distribution to both the local public health authorities and law
  enforcement officials for follow-up investigations and advice.

Envelope with powder and powder spills out onto surface:

• DO NOT try to CLEAN UP the powder. COVER the spilled contents immediately
  with anything (e.g., clothing, paper, trash can, etc.) and do not remove this
  cover!
• Then LEAVE the room and CLOSE the door, or section off the area to prevent
  others from entering (i.e., keep others away).
• WASH your hands with soap and water to prevent spreading any powder (germs)
  to your face.

What to do next

• If you are at HOME, then report the incident to local police.
• If you are at WORK, then report the incident to local police, and notify
  security official, and the Administrator of the Day. DO not show other
  co-workers the content if you receive it, because then you will be expanding
  the number of people exposed to the contents. The AOD will contact the
  Infection Control Coordinator and Administration.
• 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.
  SHOWER with soap and water as soon as possible. DO NOT USE BLEACH OR OTHER
  DISINFECTANT ON YOUR SKIN.
• If possible, list all people who were in the room or area, especially those
  who had actual contact with the powder. Give this list to the Infection
  Control Coordinator for distribution to both the local public health
  authorities so that proper instructions can be given for medical follow-up,
  and to law enforcement officials for further investigation.

Question of 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.

• Turn off local fans or ventilation units in the area.
• LEAVE area immediately.
• CLOSE the door, or section off the area to prevent others from entering
  (i.e., keep others away).

What to do next

• If you are at HOME, then dial "911" to report the incident to local police
  and the local FBI field office.
• If you are at WORK, then dial "911" to report the incident to local police
  and the local FBI field office, and notify your Infection Control
  Coordinator, Engineering Director, Security Officer, and Administration.
  SHUT down air handling system in the building, if possible.
• If possible, list all people who were in the room or area. Give this list to
  the Infection Control Coordinator so that it can be distributed to both the
  public health authorities so that proper instructions can be given for
  medical follow-up, and to law enforcement officials for further investigation.

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, discolorations 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