Symptoms of disease usually occur within 7 days after exposure and vary depending on how the disease was contracted. The serious forms of human anthrax are inhalation anthrax, cutaneous anthrax, and intestinal anthrax. Infection can be treated with antibiotics. However, if not promptly treated, inhalation of anthrax is often fatal. Initial symptoms of inhalation anthrax infection may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock.

Most anthrax infections occur when the bacterium enters a cut or break in the skin (cutaneous) when handling contaminated products of infected animals (such as wool, hides or leathers, or other hair products, especially goat hair). The skin infection begins as a raised itchy bump resembling an insect bite. Within 1-2 days, the bump develops into a vesicle and then a painless ulcer about 1-3 cm in diameter, with a characteristic black dying area in the center. Additionally, lymph glands in the adjacent area may swell. Deaths are rare in cutaneous infections with appropriate antimicrobial therapy.

The intestinal disease form of anthrax may follow the consumption of contaminated food and undercooked meat from infected animals. Infection is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea.

Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. According to the Center for Disease Control, unless you are also exposed to the same source of infection as the patient (such as B. anthracis spores or contaminated animal products), communicability is not a concern with patients who have inhalation anthrax.

How to Handle Anthrax & Other Biological Agent Threats

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.
• 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”:

• DO NOT shake or empty the contents of any suspicious envelope or package.
• [Preferably with gloves,] 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 to your face.

What to do next…

• If you are at HOME, then report the incident to local police (Santa Monica Police Department, 310-458-8491).
• If you are at WORK, then report the incident to local police, and notify your building security official or an available supervisor.
• 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 and advice.

Envelope with powder and powder spills out onto a 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 to your face.

What to do next…

• If you are at HOME, report the incident to local police. (Santa Monica Police Department, 310-458-8491).
• If you are at WORK, report the incident to local police, and notify your building security official or an available supervisor.
• 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 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, dial “911” to report the incident to local police and the local FBI field office.
• If you are at WORK, dial “911” to report the incident to local police and the local FBI field office, and notify your building security official or an available supervisor.
• 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 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 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

For more information, please visit the Santa Monica Police Department's Bomb Threat page.

Precautions if you Work in a Mailroom OR
Receive Suspicious Letters:

• Wash your hands with antibacterial soap and warm water before and after handling the mail.
• Disposable latex gloves may be appropriate, especially if you have open cuts or skin lesions on your hands.

Helpful Phone Numbers:

• Los Angeles County
  Office of Emergency Management Information Hotline
  (800) 980-4990
• State of California,
  Governor's Office of Emergency Services
  (800) 550-5234

Other Helpful Websites:

• Center of Disease Control:
  www.bt.cdc.gov.
• County of Los Angeles Emergency Operations Center
  www.lacoeoc.org
• Governor's Office of Emergency Services
  www.oes.ca.gov
• Federal Bureau of Investigation
  www.fbi.gov
• Santa Monica Fire Department
  www.santamonicafire.org
• U.S. Department of Homeland Security
  www.dhs.gov or www.ready.gov

This page was last modified on 01/26/2008