CDC

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:
  http://www.bt.cdc.gov/DocumentsApp/Anthrax/10122001Handle/10122001Handle.asp