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Guidelines – How to Handle Suspicious Mail


Guidelines on How to Handle Suspicious Letters or Packages
(Last Revised October 19, 2001)

Many facilities nationwide are receiving anthrax threat letters. As a result, hospital emergency departments and health care providers are seeing many patients seeking testing/treatment due to contact with suspicious substances. The purpose of these guidelines is to recommend
procedures for handling such patients.

Characteristics of suspicious packages and letters include the following:

  • Contains a threatening note
  • Contains a suspicious powdery substance (both the NYC and the District of Columbia letter contained a brown, powdery material)
  • Excessive postage
  • Handwritten or poorly typed addresses
  • Incorrect titles or title but no name
  • Misspellings of common words
  • Oily stains, discolorations or odors
  • 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 or ticking sound
  • Marked with restrictive endorsements such as “Personal” or “Confidential”

Protocol for Response to Possible Anthrax Exposures

  • Persons involved in an anthrax threat involving a letter with “powder” should report the incident immediately to the New York Police Department (911), who will conduct a credibility threat assessment. The NYCDOH Public Health Laboratory will only accept specimens of powder or letters or other substances for testing for anthrax when submitted by the police or FBI.
  • Detailed guidelines for handling suspicious packages or letters and scenes where there is a suspicious powder are given in a CDC Health Alert which can be found at:

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