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: