How to Respond to an Anthrax Threat Basic Briefing

1. How to Respond to an Anthrax Threat Basic Briefing

2. Objectives Define • What is anthrax and what do I need to know • Why is this happening now • Identify • What to look for in a suspicious letter or package • Steps you should take if anthrax is suspected • Know • Who to call • Roles of CDC, FBI, FPS, ATF, Local Law Enforcement • Update • Fact or Fiction

3. What is Anthrax Anthrax is a bacterial, disease caused by Bacillus Anthracis. Anthrax occurs in domesticated and wild animals, including goats, sheep, cattle, horses and deer, but other animals may be infected. Anthrax is an invisible bacteria that can live in soil, water, and dead animals. Picture of an Anthrax Spore

4. There are three forms: Skin or cutaneous form may be contracted by exposure to spores on an open area. First appears as a rash or blister that may resemble a bite, progressing to a painless ulcer with a black area in the center. Can be treated effectively with antibiotics. Represents 95% of cases of human anthrax. With treatment mortality rate is 1%.

5. Inhalational may be contracted by breathing in spores or dispensing within a closed space, e.g. the air conditioning system. First appears as flu like symptoms (1 – 7 days) Fever Malaise Fatigue Cough Mild chest discomfort followed by severe respiratory distress Can be treated with antibiotics if prompt treatment is initiated.

6. Gastrointestinal tract must be ingested most commonly through improperly cooked or contaminated meat. First appears as intense stomach pains, vomiting and diarrhea. Most cases appear within 48 hours. Is extremely rare in the US as animals are vaccinated in high risk areas. Can be treated with antibiotics if prompt treatment is initiated.

7. What Is the Treatment for Anthrax? Treatment with antibiotics beginning immediately after exposure has proven to be effective: Penicillin Doxycycline Ciproflaxin (Cipro)

8. Why is this happening now? • A little known fact for most people is that chemical and biological warfare (CBW) is the number 1 choice of terrorists today. • Biological arms are: • Easy to produce and difficult to detect once • created. • They are cheap and likely to cause human • fatalities and economic damage • They are likely to cause panic and fear

9. Now that we know • What it is. • How it is contacted. • What treatment is available. How can we reduce the threat of exposure?

10. What constitutes a suspicious letter or parcel? Some typical characteristics which ought to trigger suspicion include letters or parcels that: Excessive Postage, no postage, or non-canceled postage. No return address or fictitious return address. Improper spelling of addressee names, titles, or locations. Unexpected envelopes from foreign countries.

11. What constitutes a suspicious letter or parcel?(cont) Suspicious or threatening messages written on packages. Postmark showing different location than return address Distorted handwriting or cut and paste lettering. Unprofessionally wrapped packages or excessive use of tape, strings, etc. Packages marked as “Fragile - - Handle with Care”, “Rush - - Do Not Delay”, “Personal” or “Confidential”.

12. What constitutes a suspicious letter or parcel?(cont) Rigid, uneven, irregular, or lopsided packages. Packages that are discolored, oily, or have an unusual odor or ticking sound. Packages with soft spots, bulges, or excessive weight Protruding wires or aluminum foil. Visual distractions.

13. Suspect letter and package indicators. No return address. Mailed from foreign country. Excessive or no postage. Rigid or bulky envelope. Address: badly typed or written, misspelled, title with no name, wrong title with name. Restrictive markings (I.e., personal or confidential). Strange odor. Lopsided packages. No return address. Protruding wires. Oily stains on wrapper. Precautions: 1) Never accept mail, especially while in a foreign country. 2) Make sure family members and clerical staff no to refuse all unexpected mail at home or office. 3) Remember, it may be a bomb, treat it as suspect. For more information on bomb security or bomb threats, contact your local ATF office. Suspect letter and package indicators. No return address. Mailed from foreign country. Excessive or no postage. Rigid or bulky envelope. Address: badly typed or written, misspelled, title with no name, wrong title with name. Restrictive markings (I.e., personal or confidential). Strange odor. Lopsided packages. No return address. Protruding wires. Oily stains on wrapper. Precautions: 1) Never accept mail, especially while in a foreign country. 2) Make sure family members and clerical staff no to refuse all unexpected mail at home or office. 3) Remember, it may be a bomb, treat it as suspect. For more information on bomb security or bomb threats, contact your local ATF office. Picture of package with suspect and package indicators Courtesy of ATF http://www.atf.treas.gov/explarson/information/indic.htm

14. What Should You Do If You Receive an Anthrax Threat? 1. Do not shake or empty the contents of any suspicious envelope or package; 2. Double bag the letter or package in zipper-type or zip-lock type plastic bags using latex gloves, 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.). DO NOT REMOVE THIS COVER; 3. Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away);

15. What Should You Do If You Receive an Anthrax Threat (cont) 4. If the package is already open and the substance has been exposed, facility management should move employees from the area, group them in an area outside the room containing the material, and leave any handling of the material to responding emergency personnel; 5. Notify your immediate supervisor, the Security Office and both local police and the FBI, who will arrange to collect the letter/package and assess the threat situation; 6. WASH your hands with soap and water to prevent spreading any powder to your face; Ensure that all persons who have touched the letter wash their hands with soap and water;

16. What Should You Do If You Receive an Anthrax Threat (cont) 7. LIST all people who were in the room or area when this suspicious letter or package was recognized. Give this list to both the local public health authorities and law enforcement officials for follow-up investigations; 8. Place all items worn at the time in plastic bags and keep them available for law enforcement; If possible change clothing in the workplace and DO NOT let anyone else touch the clothing. 9. Shower with soap and water; 10. Notify Center for Disease Control (CDC) Emergency Response at 770-488-7100 for any questions of if you require further information. Also you can access their web site at: http://www.cdc.gov.

17. Fact or Fiction • Q: Is anthrax contagious? • A: No. Anthrax does not spread from person to person. It is a one-time agent; to catch it, a person must come directly in con tact with the bacterium. • Q: Should I take antibiotics to prevent infection? • A: No. Taking unnecessary antibiotics can result in the development of antibiotic-resistant strains of common bacteria. The course of treatment is long (60 days), and many people experience unpleasant side effects.

18. Fact or Fiction(cont) Q: Should I keep a supply of antibiotics on hand, just in case? A: No. Antibiotics should only be taken under the supervision of a physician, who has done an evaluation to minimize the potential for side effects or interaction with other medication. There is also the “shelf life” of the medication to consider. Q: Haven’t there been a lot of hoax letters in the past? A: Yes, but given the recent national and international events, and the confirmed exposures to anthrax, ANY incident will be responded to with the highest level of urgency.

19. What Sources are Available to Help Me? There are a variety of resources available to help federal Mail Managers cope with these threats and develop better means of responding: For additional information: http://www.firstgov.gov - use the search feature to locate your topic or organization. http://www.gsa.gov/mailpolicy - training, policy and the latest information for federal mail managers.  http://www.atf.treas.gov - ATF Bomb Threats and Physical Security Planning. 

20. What Sources are Available to Help Me? (cont) http://www.bd.cdc.gov - The Centers for Disease Control and Prevention(CDC) is responsible for coordinating all public health and would be contacted at the Emergency Preparedness and Response Branch, National Center for Environmental Health to report an incident at 770-488-7100.

21. http://www.fbi.gov/contact/fo/info.htm-To report suspected illegal intelligence or terrorism activity against the interest of the United States, telephone the ANSIR Coordinator at the FBI Field Office nearest you. http://www.framed.usps.com/postal inspectors -The U. S. Postal Inspection Service is the law enforcement branch of the U.S. Postal Service. The Postal Inspection Service extends full cooperation to all federal, state and local authorities in law enforcement matters to ensure greater protection to the public. What Sources are Available to Help Me? (cont)