Many facilities in communities around the United States have received anthrax threat letters. Most were empty envelopes but some have contained powdery substances. The purpose of these guidelines is to recommend procedures for handling such incidents. The guidelines were produced by the Centre for Disease Control in the United States and have been re-issued by the Department of Health (Bermuda).

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, aerosolised mist. Diseases 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 actosolised 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 envelopes 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, trash can, 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:

If you are at HOME then report the incident to the local police.

If you are at WORK then report the incident to local police, and notify your building security official or an available supervisor.

7. LIST all people who were in the room or area when his suspicious letter or package was recognised. Give this list 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

1. 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!

2. Than 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.^.^.

If you are at HOME then report the incident to the local police.

If you are at WORK then report the incident to local police, and notify your building security official or an available supervisor.

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 responder 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 the people who were in the room or area, especially those who had actual contact with the powder. Give this list 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 AEROSOLISATION:

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. What to do next.^.^.

If you are at HOME, then dial "911" to report the incident to local police and medical officials.

If you are at WORK, hen dial "911" to report the incident to local police and medical officials, and notify your building security official or an available supervisor.

5. SHUT down air handling system in the building, if possible.

6. If possible, list all the people who were in the room or area. Give this list 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.

HOW TO IDENTIFY SUSPICIOUS PACKAGES AND LETTERS

Some characters of suspicious packages and letters include the following.^.^.

Excessive Postage

Hand written or poorly typed addresses

Incorrect titles

Title, but no name

Misspelling of common words

Oily stains, discolourations or odour

No return address

Excessive weight

Lopsided or uneven envelope

Protruding wires or aluminum foil

Excessive security materials 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