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Exposure to Suspicious Substances Including “White
Powder” Guidelines for the General Public
It is important for all of us to remember that the panic, fear and anger
caused by exposure to substances that we believe could contain anthrax is
precisely the response planned for by the terrorists who initiated these
attacks.
The Department of Health, county health departments, local law enforcements
and emergency management offices around the state have been inundated by
responding to requests for assistance resulting from fear of exposure to
suspicious mail and packages. Much of the fear (and often the response) is
unwarranted.
We should remember that "white powder" is present everywhere. In
the past few weeks, some powdery substances that have caused considerable
distress turned out to be: non-dairy creamer, talc, crushed peppermint candy,
newsprint dust, tissue dust, disinfectant and detergent.
For most of us in Florida, the risk of acquiring anthrax from mail or package
handling is minimal.
First, we should all remember that the only deadly threat is from inhalation
anthrax, which is extremely rare. Cutaneous anthrax is very rarely fatal and can
be effectively treated well after symptoms develop. Outbreaks of cutaneous
anthrax occur periodically in the U.S., primarily in the West and Midwest as a
result of exposure to animals and animal products. No anthrax is contagious: it
cannot be spread from person to person.
The risk of exposure to anthrax from unopened mail is very low. This is
particularly true for inhalation anthrax. A large amount of spore material must
be inhaled in order to produce infection. It is highly unlikely that a
sufficient quantity would be present on the outside of a package. All of the
people currently diagnosed with inhalation anthrax were directly exposed
(through handling) to mail that carried the spores.
Disease or exposure has presently affected only three groups: those in the
news media business, politicians, and mail handlers. Others of us are at far
less risk. There is no evidence that the general public is a target (except for
fear).
Proper handling of opened mail can reduce the threat even in the unlikely
event that a letter or package contains anthrax. Holding the letter or package
away from direct exposure to the face can decrease the risk for inhalation
anthrax. Information on the management of suspicious packages can be found on
the DOH website at www.doh.state.fl.us
(follow the "More" directive.
In evaluating the potential for exposure to a suspicious agent, we should
consider:
What is the potential for this substance to be a real anthrax threat?
Would it address a reasonable target?
What are other reasons the material could be present?-- There is
always powder in a bakery.
Who (in the immediate area) might know why the material is present?
If, after objective consideration, the exposure is considered threatening,
information about handling or pickup of the material is available on the DOH
website, the county health department or by calling the Bureau of Epidemiology at
(850) 245- 4401.
Some frequently asked questions:
If I am exposed to white powder or a suspicious substance, shouldn’t I be
treated with Cipro?
No. Preventive treatment is provided ONLY to those people with an exposure
to a verified positive anthrax source such as the AMI building in Boca Raton
and a very limited number of postal EMPLOYEES in Palm Beach County. If you
have received a suspicious letter that has been picked up for testing,
treatment is not recommended pending the return of results on the sample.
Should I be tested?
Not if you are without symptoms associated with anthrax. Testing for
anthrax is indicated only for symptomatic people and for a limited few in
epidemiological studies. There is no routine test for anthrax. Remember,
anthrax-like symptoms can be caused by flu, colds and others conditions. The
history of exposure to a positive anthrax source is important in evaluating
symptoms.
What if I still want to be tested and/or treated?
It Is not recommended; no treatment will be provided in public health
facilities to people without bona-fide exposure to a positive anthrax
source. No testing will be provided without symptoms. You may be able to get
these services from your physician.
What if I used the post office in Palm Beach
County where anthrax was found?
The traces of anthrax in those offices were miniscule and don't constitute
exposure for visitors.
If I have white powder or other substance that needs to be tested, who will
pick it up?
If you seriously think that a sample needs to be tested, you should call
local law enforcement. Some counties have arranged to have samples picked up
by a HazMat team, but local law enforcement should be able to tell you this.
If, in your county, you don’t know who should pick it up, the county
health department will be able to help you.
What if local law enforcement refuses to pick it up?
You must realize that local law enforcement has been overwhelmed by such
requests. They may not be able to pick up the sample. They may also have a
criteria for ruling out low priority samples. You should ask why they are
not picking it up. If the reason does not appear to be a good one, ask to
speak to someone else. County health departments do not pick up samples.
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