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.

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.

How to Identify Suspicious Packages and Letters

Look for any of the following characteristics when trying to identify a suspicious package or letter:

  • Excessive postage for the weight of the parcel
  • Handwritten or poorly typed address
  • Incorrect titles
  • Title, but no name
  • Misspellings of common words
  • Oily stains, discolorations of color
  • No return address
  • Excessive weight
  • Lopsided or uneven envelope
  • Protruding wires or aluminum foil
  • Excessive packing material such as masking tape, string, etc.
  • Visual distractions
  • Ticking sounds
  • Marked with restrictive endorsements, such as "Personal" or "Confidential"
  • Shows a city or state in the postmark that does not match the return address

What to Do if You Receive a Suspicious Package or Letter

If you think you have a suspicious package or letter, follow these steps:

  • Do not shake or empty the contents of any suspicious envelope or package.
  • Place the envelope or package in a plastic bag or some other type of container to prevent leakage of the contents.
  • If you do not have any container, then cover the envelope or package with anything (e.g., trash can, clothing, book) and do not remove this cover.
  • Leave the room and close the door. Or, section off the area to prevent others from entering.
  • Wash your hands with soap and hot water to prevent spreading any powder to your face.
  • Report the incident to the local police. If you are at work, also notify your building security official and a supervisor.
  • If you open the letter or package, do not try to clean up the powder. Cover the spilled contents immediately with anything (e.g., clothing, trash can, paper) and do not remove this cover.
  • Remove heavily contaminated clothing as soon as possible. Place the clothing 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 hot water as soon as possible. Do not use bleach or any other disinfectant on your skin.
  • Make a list of all the people who were in the room or area when this suspicious letter or package was recognized. Give the list to both the local public health authorities and law enforcement officials for follow-up investigations and advice.

Learn more about anthrax , including symptoms, risk factors, diagnosis, and treatment.