23 October 2001
Issued by Department of Provincial and Local Government (National Disaster Management Centre)
INTRODUCTION
Fear of bio-terrorism attacks have been sweeping the world in recent days. At least 13 people have been exposed to the deadly bacterium in the United States and one has died. Envelopes containing the animal disease Anthrax have been sent to media organisations as well as politicians. Confirmed incidents have so far been restricted to the US, but a number of false alarms and hoaxes have been reported around the world.
It has become necessary to take note of a possible Anthrax threat and the precautionary steps to be taken.
WHAT IS ANTHRAX
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in wild and domestic animals (cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur in humans when they are exposed to infected animals or to the intentional release of anthrax spores as a biological weapon.
WHY HAS ANTHRAX BECOME A CURRENT ISSUE?
Anthrax is considered to be a potential agent for use in biological warfare and several incidents have recently occurred not only in the United States but world wide.
HOW IS ANTHRAX TRANSMITTED
Anthrax infection can occur in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can live in the soil for many years, and humans can become infected with anthrax by handling products from infected animals or by direct contact or inhaling anthrax spores that are intentionally released as a biological weapon.
WHAT ARE THE SYMPTONS OF ANTHRAX?
Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.
Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin. 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 necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.
Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal.
Intestinal: The intestinal disease form of anthrax is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, 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?
The disease is infectious and not contagious, in other words, direct person-to-person spread of anthrax is extremely unlikely to occur. Communicability is not a concern in managing or visiting with patients with inhalational anthrax.
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.
HOW TO HANDLE ANTHRAX AND OTHER BIOLOGICAL AGENT THREATS
Anthrax threats are very similar to bomb threats and cannot be ignored. Dealt with responsibly, no anthrax threat, even if it is real, should have serious consequences. Many facilities in communities around the world 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. For anthrax to be effective as a covert agent, it must be aerosolised 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 Letter or Package
Do not shake or empty the contents of any suspicious envelope or package;
DO NOT try to clean up powders or fluids.
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 cordon 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 or skin.
What to do next