Wherever possible, mail should be opened in the mailroom, or in a room located away from the main office area. Workers opening the mail should wear protective gloves made of latex or nitrile, and to the extent possible, should open the envelope or package away from the face.

Headquarters is in the process of purchasing nitrile gloves for all Customs offices, and will distribute them as quickly as possible over the next several days. In the interim, latex gloves that are stocked at most Customs offices to protect workers from exposure to bloodborne pathogens should be used.

Please review the fact sheets below on identifying suspicious packages and letters, procedures for opening mail, and general information on anthrax that can be posted in your work areas.

Following these steps will provide you with an added degree of safety, and will ensure an appropriate emergency response if an incident should occur.

Characteristics of Suspicious Packages and Letters
If you suspect a letter or package may be contaminated with anthrax, do not open it. Some characteristics of suspicious packages include:

• 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.

Procedures for Suspected Anthrax Contamination
1. Unopened Envelope or Package
If you encounter a package or letter is that you suspect may be contaminated with anthrax, do not open it.

The form of anthrax you would most likely see would be in the spore form. Anthrax spores are a dry powder similar to the consistency of bath powders. Anthrax spores are harmful only if inhaled, ingested or when introduced to an open wound or the eyes. Persons exposed to Anthrax spores are not contagious.

If a suspicious substance like this is in or on a letter or package, take the following steps:

1. Call 911 or the local police in your area;
2. Using latex gloves and a particulate mask if available, triple-bag the letter or package in a sealing type plastic bag;
3. Make sure that the letter or package is isolated and that the immediate area is cordoned off;
4. Wash your hands with soap and water only. Do not use caustic cleaners or abrasives as these could irritate and open small cuts in the skin;
5. Notify your immediate supervisor and the Terrorism Response Task Force (TRTF). TRTF's telephone number is (202) 927-6184. It is the responsibility of the TRTF to contact all appropriate local, state and federal health and law enforcement officials;
6. Ensure that anyone else who has come in contact with the letter or package washes his or her hands with soap and water;
7. Make a list of anyone who has touched the letter or package and provide the list to the TRTF;
8. Place the clothes you were wearing at the time of the exposure in a plastic bag. Shower with soap and water and have your clothes available for examination by the appropriate authorities.

2. Opened Envelope or Package
If you open an envelope or package that has a powder in it, and it spills out onto the surface:

1. Do not try to clean up the powder. Cover the spilled contents immediately with a garbage bag.
2. Turn off local fans or ventilation units in the area, if possible.
3. Leave the room and close the door, or section off the area to prevent others from entering.
4. Wash your hands with soap and water to prevent spreading any powder to your face.
5. Report the incident to the local police, local FBI office, local or state health department, building security and the GSA Federal Protective Service.
6. Remove heavily contaminated clothing as soon a 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.
7. Shower with soap and water as soon as possible. Do not use bleach or other disinfectant on your skin.
8. 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 local public health authorities so that proper instructions can be given for medical follow-up, and to law enforcement officials for further investigations.

Information on Anthrax

What is anthrax?
Anthrax is an acute disease caused by a spore-forming bacterium (Bacillus anthracis). Anthrax most commonly occurs in hoofed mammals (cattle and sheep) in agricultural regions but can also infect humans. It is important to note however, that anthrax is not spread from person to person.

How common is anthrax and who can get it?
Anthrax is most common in undeveloped agricultural regions outside of the United States including South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East where it occurs in animals. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. Anthrax infection can occur in three ways:

1. through breaks/cuts in the skin (cutaneous)
2. inhalation of spores (pulmonary), and
3. ingestion (intestinal).

What are the symptoms of anthrax?
Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.

1. Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black area in the center. If left untreated, other symptoms such as swollen glands, fever, and malaise often develop after several days. About 20% of untreated cases of cutaneous anthrax will result in death, but deaths are rare with appropriate antibodies.
2. Inhalation: Initial symptoms may resemble a common cold and include a cough, chills and aches. After several days, however, the symptoms may progress to severe breathing problems and shock. Left untreated, inhalation anthrax is usually fatal.
3. Intestinal: The intestinal disease form of anthrax may follow the consumption of undercooked, contaminated meat, and 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. Intestinal anthrax results in death in 25% to 60% of cases.

Can anthrax be spread from person-to-person?
Infection with anthrax requires direct contact with the bacterial spores. Person-to-person spread of anthrax has not been known to occur and is extremely unlikely. Communicability is not a concern in managing or visiting with patients with pulmonary (inhaled) anthrax.

How is anthrax diagnosed?
Anthrax is diagnosed by isolating B. anthracis from blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood or persons with suspected cases.

Is there a treatment for anthrax?
Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.

Is there a way to prevent infection?
Avoiding contact of contaminated animals or other items containing the bacterial spores can prevent infection. Avoid eating meat that has not been properly slaughtered and cooked. If a documented exposure to anthrax has occurred, early treatment with antibiotics can prevent the development of symptoms and the disease.

What about the anthrax vaccine?
An anthrax vaccine has been licensed for use in humans. However, it is currently only available to persons who work directly with the organism in the laboratory and military personnel deployed to areas with high risk for exposure to the organism

Source: U.S. Public Health Service