The Pediatric Group, P.A. - Bioterrorism Preparation II

MARK B. LEVIN, M.D.
JOHN M. COTTON, M.D.
TIMOTHY J. PATRICK-MILLER, M.D.
LOUIS J. TESORO, M.D.
HELEN M. ROSE, M.D.

THE PEDIATRIC GROUP, P.A.
66 Mt. Lucas Road, Princeton, N.J. 08540-2733 tel: (609) 924-4892, fax: (609) 921-9380 website: www.pedgroup.com

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BIOTERRORISM and CHEMICAL TERRORISM II

October 16, 2001

Try to keep in mind that the risk to personal safety of you and your family from this is far less than the risk of an automobile accident while driving to the supermarket!

HOW TO HANDLE ANTHRAX AND OTHER BIOLOGICAL AGENT THREATS
Edited from a CDC Health Advisory

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
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, 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.

2. 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.

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Suspicious Unopened letter or PACKAGE MARKED WITH THREATENING MESSAGE SUCH
AS "ANTHRAX":
1. Do not shake or empty the contents of any suspicious envelope 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 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 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.

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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. Then 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 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 responders 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 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.

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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.

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 the local FBI field office. If you are at
WORK, then 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.
5. SHUT down air handling system in the building, if possible.
6. 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 THAT COULD CONTAIN BIOHAZARDOUS MATERIALS

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
- Excessive security material such as masking tape, string, etc.
- Visual distractions
- Marked with restrictive endorsements, such as "Personal" or "Confidential"
- Shows a city or state in the postmark that does not match the return address

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