Anthrax and Exposure to Suspicious Powder

In the fall of 2001, the United States experienced its first illnesses caused by the intentional release of anthrax. In all cases for which the cause was determined, illness followed contact with anthrax spores delivered in powder sent through the mail.

These events led to widespread concern about what to do in cases of exposure to suspicious powders or other substances. These concerns are addressed by the following questions and answers. Additional information is available from the federal Centers for Disease Control and Prevention.

About Anthrax

If there has been an exposure

What is anthrax?

Anthrax is a disease caused by the spore-forming bacterium Bacillus anthracis.

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What happens when a suspicious, unknown substance such as a powder is found?

Individuals or businesses that find a substance that they consider suspicious should do the following:

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How is the risk of a substance being anthrax determined?

Whenever a suspicious substance is reported, state or local police must make an assessment as to whether there may be a threat involved. They will investigate to see if there is any natural explanation for the substance that might not have been apparent at first.

White powder near an area in which sheet rock is being stored or installed, for example, probably would seem normal, whereas the envelopes and letters delivered to the television networks in 2001 were clearly threatening.

In many situations, of course, police determine that there is no threat and thus no reason to believe that the substance constitutes a risk.

If no risk is determined, the substance will not be tested. It can be cleaned the way you would clean anything unknown but not dangerous. There is no reason to do anything further.

If the police believe that there may be a threat, someone with the proper equipment and training for hazardous materials response will collect a sample, which will then be taken to the Vermont Health Department’s laboratory for testing.

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How likely is it that I have actually been exposed to anthrax?

In thousands of cases of suspicious substances investigated since the fall of 2001, anthrax has been found in only a few, all of which appeared to be focused on national political and media targets.

While we expect the chance of having a real anthrax event in Vermont remains extremely low, we continue to work with police and other officials to take all necessary steps to evaluate each incident and to assure your safety.

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Do I need to decontaminate myself, or throw away my clothes and belongings?

If you touched the suspicious substance, you should follow the hand-washing instructions given above. Any clothing you have packaged in plastic bags should be left undisturbed until test results are available. You do not need to perform other decontamination procedures or discard your belongings.

Do I need any treatment immediately, such as antibiotics or vaccines?

No. You do not need medication immediately after exposure to a suspicious substance. If preliminary laboratory test results and other risk assessment findings indicate that there is a possibility that the substance is anthrax, we will be contacting you and everyone else involved and advising you to start antibiotics while waiting for final test results.

If the final laboratory results then show there was no anthrax present, you will be advised to stop taking the antibiotics. If the final results confirm anthrax, you should continue taking the antibiotics for 60 days.

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How long will it be until I know what the test results are?

Preliminary results by PCR (polymerase chain reaction) test are usually available within a few hours after testing is started. Final confirmatory results take about 72 hours, although some tests may take a day or two longer.

Confirmatory tests involve growing cultures, and because these cultures may grow at different speeds, not all tests take the same amount of time.

Should I be tested for anthrax?

You do not need to be tested for anthrax just because you have been near a suspicious substance.

Anyone who has been exposed to a suspicious substance that preliminary tests and associated risk assessment indicate may be anthrax will immediately be urged to begin taking antibiotics as a precautionary measure.

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Would a nasal swab test be helpful?

No. Nasal swab tests are not used to diagnosis anthrax disease. Someone could be infected with anthrax without testing positive to a swab test, and, conversely, a swab could discover anthrax spores in a person who is not infected.

These tests do have some value in helping public health officials better understand exposure risks and they are appropriate for situations in which anthrax has been confirmed.

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Am I a risk to my family or to others?

No. After emergency personnel have completed their response, you may continue your usual activities at work or home. Removing clothing contaminated with the substance and washing skin and hair exposed to the substance is considered adequate protection.

Even when a person is actually ill with anthrax, it is not transmitted from person to person. You do not pose any risk to others.

Should I see a doctor?

Unless you become sick, it is not necessary for you to visit a hospital or doctor’s office. If you wish to contact your private physician to discuss your possible exposure, you should give your physician the Vermont Health Department number listed below.

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If I start to feel sick in the next couple days, what should I do?

If you should become ill, or develop a fever greater than 100.0 degrees, contact your doctor immediately. While you are probably ill with something that has nothing to do with this exposure, it would be important for you to have a thorough evaluation.

You and/or your doctor should also contact staff at the Vermont Department of Health. We will make recommendations to you and your health care provider about how best to evaluate and treat your symptoms, based on the circumstances of this possible exposure incident.

Who can my doctor or I call if we have questions?

If you or your physician has questions, please call the Health Department at 1-800-640-4374 or 863-7240. If it is a weekend or evening, an epidemiologist will be on call and able to return your call promptly.

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