What should you know about bioterrorism?
Anthrax. In the fall of 2001, anthrax was introduced into the United States postal system in an act of bioterrorism. Many workplaces and individual employees were affected by anthrax escaping from letters mailed to various locations, resulting in the need to deal with and prevent anthrax-related diseases in workplaces. In response, OSHA issued the following recommendation for dealing with suspicious mail:
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. It is important to note that the attached guidance emphasizes minimum disruption of suspect packages and their contents.
General mail handling:
l Be observant for suspicious envelopes or packages.
l Open all mail with a letter opener or method that is least likely to disturb contents. Do not use hands.
l Open packages/envelopes with a minimum amount of movement.
l Do not blow into envelopes.
l Do not shake, pour out contents.
l Keep hands away from nose and mouth while opening mail.
l Wash hands after handling mail.
Item that may trigger suspicion:
l Discoloration, crystallization, strange odors or oily stains
l Envelope with powder or powder-like residue
l Protruding wires or aluminum foil
l Excessive tape or string
l Unusual size or weight given size
l Lopsided or oddly shaped envelope
l Postmark that does not match return address
l Restrictive endorsements such as "Personal" or "Confidential"
l Excessive postage
l Handwritten, block-printed or poorly typed addresses
l Incorrect titles
l Title but no name
l Misspellings of common words
l No return address
l Addressed to individual no longer with organization.
Handling suspicious mail:
l Stay calm.
l Do not shake or empty the contents of any suspicious package or letter.
l Keep hands away from mouth, nose and eyes.
l Isolate the package or letter.
l Gently cover the envelope or package with anything available nearby (e.g. clothing, paper, inverted trash can, etc.) and do not remove cover.
l If an unknown substance spills from the package/envelope, do not try to clean up substance.
l Avoid creating air currents.
l Do not handle package/envelope any further.
l If material spills on floor avoid stepping near it. Avoid tracking any spilled materials to other locations.
l Wash hands with soap and water.
l Do not remove any potentially contaminated items from area.
l If contaminated, keep movements within the building to a minimum. This will keep contamination of building to a minimum. Remove heavily contaminated clothing as soon as possible and gently to minimize dispersal.
l If shower facilities are available, remove clothing in shower under water stream. Place clothing into a plastic bag or other container that can be sealed. This bag should be given to responders for proper handling.
l Contact supervisor/designated responder.
l Supervisors/designated responders will determine if further action is necessary such as:
l Notify others in the room, turn off any fans/portable heaters, evacuate the room and close the door.
l Ensure no one enters the room until proper authorities arrive.
l Report incident to security and to the Federal Protective Service so they may notify appropriate authorities.
l Report incident to facility management so they can shut down the room's ventilation system.
l List all people who were in the room or area when the package or letter was recognized. Give this list to the health and law enforcement officials.
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.
Tularemia. Tularemia, also known as "rabbit fever" or "deer fly fever," is a severe and sometimes fatal bacterial disease that can infect workers through a variety of environmental exposures, including insect bites, contaminated food or water, airborne bacteria, or in a laboratory setting. Approximately 200 human cases are reported each year in the United States. The page provides information on hazard and disease recognition, a bioterrorist threat evaluation, and important resources for control and prevention.
Tularemia, in aerosol form, is considered a possible bioterrorism agent. Although it is not easy to disseminate, it takes only a small amount of inhaled bacterium to cause infection. The following references provide information about evaluating the threat of tularemia as a biological weapon:
l Tularemia: Biological Weapon Background. Centers for Disease Control and Prevention (CDC) (2001, January), 29 KB PDF, 2 pages. This brief overview of tularemia includes biological weapon and background information.
l Bioterrorism Agent Fact Sheet: Tularemia/Francisella tularensis. Saint Louis University (SLU), Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), and BJC Healthcare (2001, October), 443 KB PDF, 3 pages. This fact sheet presents a description of the disease and its various forms, symptoms, diagnosis, treatment, and decontamination.
l Tularemia as a Biological Weapon. Dennis, D.; Inglesby, T.; and Henderson, D. et al. (2001, June 6). The Journal of the American Medical Association (JAMA), Vol. 285(21):2763-2773, 21 pages. This article contains information about the history of tularemia and its use in biological warfare, as well as its epidemiology, microbiology, pathogenesis, diagnosis, vaccination, and treatment. It also discusses infection control and decontamination procedures.
Ricin. The discovery of ricin on a mail-opening machine closed three United States Senate office buildings in the nation's capitol in early 2004. Although no illnesses or deaths resulted, the toxin can be used as a bioterrorist weapon in the workplace. As a result, OSHA has added ricin on its Safety and Health Topics Page. OSHA's information on the toxin includes hazard recognition, emergency response, and control and prevention, and also includes links to additional resources.