M.A.B.A.S.
Division 20 Operational Guidelines, Procedures and Policies - 4
SUBJECT: BIOLOGICAL DISEASES - ANTHRAX
Response
to Anthrax Threat - Page 1 of 8
DATE IMPLEMENTED: October 17, 2001 Revised:
PURPOSE: The significant number of anthrax exposures and threats has presented a
challenge to police and fire departments.
To help standardize responses and to provide coordination with the
various agencies involved, the following procedures are recommended.
DEFINITION
ANTHRAX is a bacterial disease that can cause
serious illness in humans. It is caused
by contact with bacterial
spores most commonly found in cows or sheep.
It is not
contagious.
ANTHRAX THREAT is the threat
to use anthrax bacteria to cause illness.
All anthrax
threats, even hoaxes, should
be taken as the real thing until determined otherwise.
MODES OF TRANSMISSION/SYMPTOMS
Cutaneous: Most anthrax infections occur when the bacterium enters a cut or
abrasion
on the skin. Skin infection begins as a raised itchy bump
that resembles an insect bite,
but within 1-2 days develops
into a vesicle and then a painless ulcer, usually 1-3 cm in
diameter, with a
characteristic black necrotic (dying) area in the center. Lymph glands in
the adjacent area may
swell. About 20% of untreated cases of
cutaneous anthrax will
result in death. Deaths are rare with appropriate
antimicrobial therapy.
Inhalation: Initial symptoms may resemble a common cold. After several days, the
symptoms may progress to
severe breathing problems and shock.
Inhalation anthrax
usually results in death in
1-2 days after onset of acute symptoms.
Intestinal: The intestinal disease form of anthrax may follow the consumption
of
contaminated meat and is
characterized by an acute inflammation of the intestinal tract.
Initial signs of nausea,
loss of appetite, vomiting, and fever are followed by abdominal
pain, vomiting of blood, and
severe diarrhea. Intestinal anthrax
results in death in 25%
to 60% of cases.
GUIDELINES FOR FIRE DEPARTMENTS
These guidelines are intended to assist Fire Departments in a safe and
efficient
response to situations involving unknown substances contained in
letters,
packages, bottles, etc. Fire
fighters should utilize all investigative techniques to
determine origin and destination of any suspicious letter, package,
bottle, etc.,
containing an unknown substance, by contacting the return addressee
whenever
possible. If it is a legitimate
shipment or mailing, this may negate any further
actions.
M.A.B.A.S. Division 20
Operational Guidelines, Procedures and Policies - 5
SUBJECT: BIOLOGICAL DISEASES
- ANTHRAX
Response
to Anthrax Threat - Page 2 of 8
INVESTIGATION/IDENTIFICATION
Interview all individuals
who may have had contact with the item.
Do not touch or move the
item.
You
should note specific writing on the document, package or bottle including
postmark, return address or lack of return address, addressee, and any other
writing that may indicate some sort of threat.
Look
for stains, liquids, or oily substances on the item.
Look
for obvious presence of materials not usually included in letter or
packages. If powder, liquid, metal,
wires, aluminum foil, or anything unusual is present, it could very well be a
dangerous situation.
Suspicious
packages or letters may have restricted endorsements, such as "personal,
private, or confidential."
Addressee's
name or title may be inaccurate. May
have a title with no name.
Return
addresses may be fictitious or there may be no return address.
Writing
may be distorted, produced by homemade labels, or cut and paste lettering.
Be
aware of unusual odors emitted by the items.
Cancellation
or postmark may show a different address than the return address.
Items
may feel rigid; appear uneven or lopsided.
Packages
may be unprofessionally wrapped with several combinations of tape.
Packages
may be marked "fragile,"
"handle with care," "rush," or "do not
delay."
Packages
may have irregular shapes, soft spots or bulges.
Packages
may make a sloshing sound.
Be
aware of pressure or resistance when removing contents from an envelope or
package.
Look
for handwritten or poorly typed addresses or misspelling of common words.
Packages
may have excessive postage.
M.A.B.A.S.
Division 20 Operational Guidelines, Procedures and Policies - 6
SUBJECT: BIOLOGICAL DISEASES - ANTHRAX
Response
to Anthrax Threat - Page 3 of 8
LEGAL CONSIDERATIONS
Any
non-accidental biological use for the purpose of harming or threatening to harm
another person, place, the environment or animal, whether real or imagined, is
a potential crime and falls under the authority of Law Enforcement. The threatened use of weapons of mass
destruction is a Federal crime and should be reported to the FBI as soon as
possible. Any incident involving
anthrax as a threat should be treated as a crime scene with preservation of
evidence a top priority while protecting individuals.
FIRST RESPONDERS
ACTIONS/RESPONSIBILITIES
Response
to the scene should be a "Quiet Response" (no sirens/no emergency
lights). This will reduce anxiety for
those at the scene as well as the neighborhood. The terms terrorist, anthrax or biological should not be used in
radio traffic as this may draw unwanted people to the scene. The Incident Commander should not hesitate
to call for assistance. If advisory
assistance is needed, contact NORCOMM and ask for a BCTF response. The BCTF response is designed to aid a
stricken community incident commander on whether a full HAZMAT response is
needed.
FIRST ARRIVING OFFICER
1.
Assume
command
2.
Isolate
and secure area
3.
Request
a police presence at the scene
4.
Perform
a Size-Up: Gather as much information
about product as possible before entry
a.
View
from a distance
b.
Talk
to the victims/witnesses
c.
Ask
Police for information they have gathered
d.
Determine
likelihood of threat for this person or place
5.
Determine
scene safety
a.
Secondary
devices
b.
Active
dispensing/spreading of product
c.
Symptoms
in those already exposed
d.
Etc.
IDENTIFY/LOCATE VICTIMS
Note: Victims should be advised to stay in
building but exit room, close door, and move
to another room.
M.A.B.A.S.
Division 20 Operational Guidelines, Procedures and Policies - 7
SUBJECT: BIOLOGICAL DISEASES - ANTHRAX
Response
to Anthrax Threat - Page 4 of 8
1.
Determine
potential for direct contact with product
a.
Where?
b.
Duration
of exposure?
c.
Any
symptoms?
d.
Description
of product
1.
What
does it look like?
2.
Where
is it located?
3.
How
did it get there?
4.
Anything
unusual noticed around product?
5.
Any
unusual odors or mist?
2.
In
area where exposure may have occurred
a.
Where
in relation to product?
b.
How
long in the area?
c.
Any
symptoms?
d.
Description
of product
1.
What
does it look like?
2.
Where
is it located?
3.
How
did it get there?
4.
Anything
unusual noticed?
IDENTIFY CLASSIFICATION OF
THREAT
1.
Dry
product/powder hazard
a.
Primarily
a contact hazard
b.
Possibility
of inhalation still may exist, but is a slight risk
c.
Product
is not located in/near any HVAC or air distribution system
2.
Wet
spill hazard
a.
Product
is in liquid form, but does not include aerosol form
b.
Primary
route of entry is direct contact or ingestion
c.
Low
probability of inhalation if a biological agent
3.
Airborne
hazard
a.
Primary
inhalation hazard
b.
May
be dispensed as a powder, dust, or aerosol
c.
Possibility
of a contact hazard may still exist
d.
Dispersed
via HVAC, normal air currents, low yield explosives, aerosol spray
M.A.B.A.S.
Division 20 Operational Guidelines, Procedures and Policies - 8
SUBJECT: BIOLOGICAL
DISEASES - ANTHRAX
Response
to Anthrax Threat - Page 5 of 8
PERSONAL PROTECTION
Personal
protection levels will be determined by the facts you have gathered. Personal protection will be based on
probability of type of threat.
Dry Contact Hazard
1.
Contained
(still in container with no spills, direct contact, etc.)
a.
Level
C HAZMAT suit
b.
Double
latex gloves (powder free)
c.
FHEPA
air filter mask
2.
Spill
(any possibility of release from original container)
a.
Level
C HAZMAT suit with foot protection
b.
Double
latex gloves (powder free)
c.
HEPA
air filter mask or SCBA
Wet Hazard Non-Aerosol
1.
Level
B HAZMAT suit
2.
Double
latex gloves (powder free)
3.
HEPA
air filter mask or SCBA
Airborne Hazard including
Aerosol
1.
Level
A HAZMAT suit
2.
Double
latex gloves (powder free)
3.
SCBA
ENTRY FOR FIRST RESPONDERS
OR HAZMAT PERSONNEL
The
first responders, in a safe manner should try to determine if there is a
credible potential for contamination by determining if the package/envelope has
been opened and if something is visible.
If entry is to be made and you have any doubts as to whether first
responder personnel can perform a safe entry the Division Bio-Chemical Task
Force (BCTF) and/or the Division HAZMAT team should be requested from NORCOMM.
1.
Entry
personnel should wear the appropriate level of protection.
2.
Have
the ability to stay in radio contact
3.
Practice
the two in/two out rule
4.
Entry
personnel should turn off ventilation systems
5.
Entry
personnel should close off affected area, if possible
M.A.B.A.S.
Division 20 Operational Guidelines, Procedures and Policies - 9
SUBJECT: BIOLOGICAL DISEASES - ANTHRAX
Response
to Anthrax Threat - Page 6 of 8
If
the package/envelope is sealed and no substance is evident, the IC then will
secure the area and have Police assume control for investigation, assisting
them as needed. If law enforcement
requests the entry team to remove the material, do so in the appropriate
manner.
1.
Place
the materials in a clear plastic bag capable of being sealed, if possible
2.
Seal
the bag
3.
Place
the bag in a larger bag that is also capable of being sealed
4.
Place
both bags in a biohazard bag or metal "arson" can and seal
5.
Entry
team should then exit the building
6.
Entry
team reports to DECON for decontamination
7.
After
decontamination, suspect material should be turned over to law enforcement
If
the package is not sealed, entry personnel should attempt to get a sample of
material. Extreme caution should be
taken. Look for booby traps before
moving anything. If it is determined it
is safe to take a sample, do so in the appropriate manner.
1.
Use
tweezers or spoon to place a sample in a clear plastic bag capable of being
sealed
2.
Seal
the bag
3.
Place
that bag in a larger bag that is also capable of being sealed
4.
Place
both bags in a biohazard bag or metal "arson" can and seal
5.
Entry
team should then exit the building
6.
Entry
team reports to DECON for decontamination
7.
After
decontamination, suspect sample should be turned over to law enforcement
If
law enforcement requests the entry team to remove the remaining material, do so
in the appropriate manner.
1.
Place
the remaining material in a clear plastic bag capable of being sealed
2.
Seal
the bag
3.
Place
that bag in a larger bag that is also capable of being sealed
4.
Place
both bags in a biohazard bag or metal "arson" can and seal
5.
Entry
team should then exit the building
6.
Entry
team reports to DECON for decontamination
7.
After
decontamination, suspect material should be turned over to law enforcement