This is a personal opinion document from someone who is moderately knowledgeable in the area of weapons of mass destruction (WMD). If you have suggestions for improvement, especially for what to do about babies, send them to Jim Corey, 505-845-8083, jdcorey@sandia.gov. This document has been reviewed by an M.D. who is an expert in biological warfare and his recommended changes made.
This guide is meant for the “man in the street” (or woman), not for emergency personnel or personnel who need detailed technical information. It is meant to address a massive terrorist attack using anthrax as a biological agent. It is not meant to address anthrax in envelopes. Common sense should be used there. If a letter is suspicious, open it in the least intrusive way; e.g., use one of the letter openers which have the spike that runs under the top fold of the envelope with a razor blade following behind which slits the envelope. Look in the envelope carefully; a magnifying glass would be handy to have. If you see a powder in there, don’t investigate further; notify the authorities. Don’t sniff the envelope. Wash your hands immediately.
What is Anthrax?
The disease Anthrax is caused by the bacteria bacillus anthracis. Anthrax is normally found in sheep, cattle and horses but can be transmitted to humans who contact infected animals or their products. Usually humans acquire the disease by skin contact with the bacteria or by inhaling the bacterial spores found in sheep wool, but the bacterial spores may be used in a deliberate attack. Some conditions can cause anthrax bacteria to go into a dormant state surrounded by a shell that protects the bacterium; this is a spore. Contact with a human being can cause the shell to break down and the bacterium to become active.
About 1-6 days after inhaling 8,000 or more Bacillus anthracis spores into the lungs, there would be a gradual onset of vague symptoms of illness such as fatigue, fever, mild discomfort in the chest, and a possibly a dry cough. These are sometimes described as “flu-like” symptoms. One difference between the flu and anthrax is that there is reportedly no runny nose with anthrax. The initial symptoms would improve for a few hours or 2-3 days. Then, there would be sudden onset of difficulty in breathing, profuse sweating, cyanosis (blue colored skin), shock, and death in 24-36 hours. With the onset of the severe symptoms, death is virtually certain, even with treatment. However, if you do encounter a recognized anthrax attack, you have plenty of time to get medical attention.
There is no evidence of person-to person transmission of anthrax. Quarantine of affected individuals is not recommended. Anthrax spores may survive in the soil, water, and on surfaces for many years. Spores can only be destroyed by steam sterilization or burning, but not by regular disinfectants. There are such things as sporicidal disinfectants. Sandia National Laboratories has developed a spray foaming agent that will kill anthrax. The foam is licensed to two manufacturers, and you can buy it from either of them.
EnviroFoam Technologies offers the PIDS (Personal Incident Decontamination System)
2903 Wall Triana Highway, Suite 5B
Huntsville, Alabama
35824
(800) 542-4665
Modec offers MDF (Modec Decontamination Foam) in a 22-ounce spray bottle.
4725 Oakland St
Denver, Colorado 80239-2717
(800) 967-7887
http://www.deconsolutions.com/
In a 1999 anthrax scare, people got rid of their clothes and showered in a special shelter using soap and a diluted bleach solution. Their desks were cleaned with a 5 percent hypochlorite solution (i.e., standard household bleach). Spores, however, can survive for years. In 1941, the British released spores on an island near Scotland. The spores persisted until 1986 when the British decontaminated the island with formaldehyde and seawater. However, the Sandia foam does a better job of killing the anthrax spores and doesn't harm fabrics or discolor materials.
An infection of local animal populations such as sheep and cattle could follow a biological attack with spores. Infected animals could then transmit the disease to humans through the human's skin, mouth or nose. Veterinarians should be made aware of this possibility. Local health officials should take appropriate measures to prevent anthrax outbreak among animals and an ensuing human epidemic.
How Do I Recognize It?
Anthrax is cultivated in a liquid culture medium. The end result is anthrax spores—too small to be seen by the naked eye—which settle to the bottom of the culture medium. In a sophisticated program, such as a national biological weapon program, the spores would be separated out, dried, and then the solid mass would milled to a powder. This powder is more stable than anthrax kept in the liquid form. The powder from a sophisticated program would probably be fine grained. From a more primitive program, powder might have a granular quality something like brown sugar. A pure white material is unlikely to be anthrax, although it may be a different biological agent. A yellowish or brownish off-white material might be anthrax.
A terrorist group would probably not have the sophistication to produce the powder, although it might obtain some from a country, such as Iraq, which has a biological weapon program. More likely, the terrorist group would have the anthrax spores in a liquid concentration with much of the culture medium. Iraq supposedly used an infant formula plant to disguise a biological agent plant, and it may be that the nutrients in baby formula are appropriate as a culture medium for anthrax. The anthrax/culture medium liquid would somewhat more viscous than water and might have a straw-colored or milky appearance because of the culture medium.
Anthrax can be contracted in three ways: inhalation or ingestion of the spores or by getting the spores into an open cut or sore. An anthrax attack is one in which the aim is to cause sickness and death through inhaling the spores. Therefore, you should be prepared with something you can breathe through to filter out the spores. If the anthrax is military grade and dispensed from a military grade dispenser, the spores are very difficult to filter out. A filter rated as a HEPA (High Efficiency Particulate Air) filter might do the job. Some indoor air purifiers use HEPA filters. You might buy a replacement filter and fashion a mask out of the filter or out of the filter material. Possibly, a doubled sheet of felt from the hobby shop would be help, or a medical-rated facemask. In addition, keep open cuts or scrapes bandaged.
Check with your doctor to see if there’s any problem with you being administered Cipro antibiotic. Penicillin is an alternative to Cipro. Doxycycline can be used.
How Do I Recognize an Attack?
The liquid anthrax (and possibly the powder) might be sprayed from a moving vehicle such as a crop duster or a mosquito control fogging truck. If you see a crop duster dusting where there are no crops or a mosquito fogging truck where there are no mosquitoes, it may be an anthrax attack. The liquid might also be spraying from a pressurized canister set where the wind will disperse the agent.
The powdered anthrax would be difficult for a terrorist to spray. More likely, it would be disbursed by hand, such as throwing little bags of powder that burst on impact; e.g., throwing bags on top of subway cars where the powder will be dispersed throughout the system. Also, powder could be introduced into the air intake for a building, although one would hope that building owners would, at the least, install motion sensors and video cameras at their building air intakes. That way, an attack could be observed and an alarm sounded. Possibly, the intake could also be filtered.
In addition, you may not see the agent being disbursed, but may be warned of the situation by the police with loud speakers. If you didn’t see the release of the agent, but others did, you may observe some panicked behavior. Don’t you panic!
If the attack is through dispersal of the agent outdoors, there are certain conditions which are optimum from a terrorist’s point of view and certain conditions which are not optimum. Observing these conditions may help you decide whether or not what you are observing is actually an anthrax attack. Optimum conditions include a breeze of a few miles per hour, an inversion layer to hold everything that goes into the atmosphere over a city in place, and conditions which minimize exposure of the anthrax to the ultraviolet rays in sunlight. (The more ultraviolet light, which kills anthrax germs, the fewer viable germs will survive to cause infection.) Favorable conditions for the latter include cloud cover, night time, or maximizing the amount of atmosphere between you and the sun; e.g., dawn, sunset, and winter. Conditions which are not optimum for an anthrax attack include high winds, no inversion layer (no smog), and maximum ultraviolet (e.g., high noon on a summer day).
What Do I Do During an Attack?
It takes about 8,000 anthrax spores getting into your lungs—not your mouth and nose, but your lungs—to make you susceptible to catching pulmonary anthrax. In case of a release of spores, immediately cover your nose and mouth with your prepared filter. If it’s a layer of material, fold it over so that it impedes your breathing, but not by very much. Don’t do anything that makes you breathe hard. Make sure there’s no place for unfiltered air to get in. If the agent is coming from a line source that you can see, such as the spray trail from a crop duster, and the wind is blowing your way, walk directly toward it until you can get on the upwind side where the agent is blowing away from you. If the agent is coming from a canister and the wind is blowing it toward you, walk at a 90-degree angle to the direction of the wind until you are away from the canister. If dust is being used in an enclosed area, leave the area the best way you can. Keep breathing through your filter until you are away from the contaminated area. If the wind is already blowing the anthrax away from you, move out of the area and report to authorities.
If the attack is not an anthrax attack but a chemical agent (poison gas) attack, you will probably see some people down. If you observe this, proceed directly away from any perceived source as fast as you can. Your filter won’t do any good in a chemical attack.
What Do I Do After an Attack?
Don’t throw the filter away. Seal it in a plastic bag and give it to the police or other authorities. If you can’t do this, burn the filter in a hot fire. Wash thoroughly, concentrating on exposed areas of skin. Follow the directions of the police or other authorities. Seek medical attention.
Emergency Net at http://www.emergency.com/
Anthrax as a Weapon of Terrorism and Difficulties
Presented in Response to Its Use at http://www.defencejournal.com/dec98/anthrax.htm
Federation of American Scientists at http://www.fas.org/nuke/intro/bw/
How to identify suspicious mail - http://abcnews.go.com/sections/living/DailyNews/suspiciousmail_guide011012.html
Centers for Disease Control http://www.cdc.gov/
CDC Health Advisory about anthrax in the mail http://www.bt.cdc.gov/DocumentsApp/Anthrax/10122001Handle/10122001Handle.asp
Bill Frist on suspicious envelopes http://frist.senate.gov/Issues/Issues-National_Defense/FightingTerrorism/Bioterrorism/Anthraxletter/anthraxletter.html
FBI Advisory for Suspicious Packages http://www.fbi.gov/pressrel/pressrel01/poster101201b.pdf
Handling bioterrorism threats http://www.slu.edu/colleges/sph/bioterrorism/index.html
HHS Questions and Answers about Anthrax http://www.hhs.gov/news/press/2001pres/20011010a.html
Earthlink Questions and Answers about Anthrax http://www.healthscout.com/template.asp?page=newsdetail&ap=43&id=502254