1. Anthrax Safety Training course Office of Engineering Safety Texas Engineering Experiment Station (TEES) & The Dwight Look College of Engineering “A safe, healthful, and secure environment for scholarship and research.” Anthrax Awareness and Mail Handler Safety Training

2. Title of Lesson on Slide Master Our Goals The mission of the Office of Engineering Safety is to ensure a safe & healthful environment for scholarship & research. Purpose To that end, the purpose of this training is to abate the risk of unnecessary exposure, by increasing awareness of hazards and the tools & techniques to prevent potential exposure.

3. Title of Lesson on Slide Master Biological Warfare (BW) Agents History Oldest of the NBC Triad of Agents –Nuclear, Biological & Chemical (NBC) Used for > 2,000 years –Used in sieges of middle ages –Smallpox blankets given to Native Americans –Germany in World War I –Japan in World War II

4. Title of Lesson on Slide Master Why Anthrax for Terrorism? Agents are readily available Agents are relatively easy to manufacture Large amount not needed in enclosed space Stores indefinitely Incident difficult to recognize Easily spread over large areas Psychological impact Can overwhelm existing resources

5. Title of Lesson on Slide Master Potential Terrorist Targets Enclosed spaces Urban areas Large crowds (high profile events) Critical facilities and infrastructure Accessible facilities with significant hazard / damage potential (materials in transit) Facilities of interest to terrorists’ cause

6. Title of Lesson on Slide Master Intent of Terrorism A classic model of economic efficiency To produce the maximum fear & stress With the least expenditure of effort & expense

7. Title of Lesson on Slide Master Anthrax Fact Not contagious Very Rare--chances of getting infected are the same as they were before all the recent news stories Almost always successfully treated when caught in the early stages of the infection Fiction It can’t happen to us NBC agents are so deadly the victims will all die anyway There is nothing we can do

8. Title of Lesson on Slide Master 18-20 15-18 7-12 4-6 (bronchioles) 1-5 (alveoli) Infection Severity Particle Size (Micron, Mass Median Diameter) The ideal aerosol contains a homogeneous population of 2 or 3 micron particulates that contain one or more viable organisms Maximum human respiratory infection is a particle that falls within the 1 to 5 micron size Less Severe More Severe Aerosol / Infectivity Relationship

9. Title of Lesson on Slide Master Anthrax - Microbiology Bacillus anthracis: gram +, spore-forming bacillus Endemic infection in animals Humans develop infection naturally from handling contaminated fluids or hides (“Woolsorters Disease”)

10. Title of Lesson on Slide Master Cutaneous Anthrax Enters through cut/abrasion on skin Usually occur within 7 days 95% of infections Symptoms –Raised itchy bump  vesicle  painless ulcer with a black center –Reddish brown sore that breaks open and forms a scab Deaths are rare with treatment (1%) Can be spread by physical contact

11. Title of Lesson on Slide Master Anthrax Pictures Early Stage Anthrax Day 7 Anthrax

12. Title of Lesson on Slide Master Anthrax Pictures AnthraxHealing Anthrax

13. Title of Lesson on Slide Master Inhalation Anthrax In the lungs and respiratory system Person-to-person transmission has never been confirmed 1 to 6 day incubation period Resemble cold symptoms, except no runny nose Fever chills general discomfort, uneasiness, or ill feeling Headache nausea & vomiting, shortness of breath cough Congestion of the nose & throat, pneumonia Joint stiffness joint pain Initial improvement followed by abrupt onset of respiratory distress, shock, and death in 24 to 36 hours Inhalation route has highest mortality and is most likely used by terrorists

14. Title of Lesson on Slide Master Gastrointestinal Anthrax In the stomach and intestines Caused by eating undercooked animal meat containing anthrax 2 to 5 day incubation period Loss of appetite, fever, diffuse abdominal pain, nausea, constipation, diarrhea and vomiting. In 2 to 4 days, severe swelling of the abdomen develops Blood loss, electrolyte imbalances, subsequent shock and ultimately, death follow. Death occurs in 25 percent to 60 percent of cases.

15. Title of Lesson on Slide Master Anthrax - Treatment Use high dose antibiotics –Ciprofloxacin –Doxycycline Treat for 60 days If vaccine administered, 35-40 days

16. Title of Lesson on Slide Master Anthrax - Pediatric Treatment Prophylaxis Penicillin Doxycycline IV Therapy Penicillin Doxycycline

17. Title of Lesson on Slide Master Personal Protective Equipment (PPE) Gloves: disposable, non-latex gloves MicroGrip Polyshield Purple Nitrile Gloves (#40101) Maskssingle-use, disposable, particulate respirators Brands: 3M, Wilson, North, Moldex Safety Glasses: Brow guard, solid side shields, disposable May be worn over eyeglasses Johnson& Johnson Barrier Protective Glasses (#10837-502) Clothing:Lab coat or smock Minimum: long sleeves, long pants, closed-toe shoes

18. Title of Lesson on Slide Master PPE for Workers Handling Mail Protective, impermeable gloves should be worn by all workers handling mail Provide multiple sizes to assure proper fit Glove material (nitrile, vinyl) should be based on safety, fit, durability and comfort Workers should avoid touching their skin, eyes, or other mucous membranes to avoid spread of any contamination Workers should consider wearing long-sleeved clothing and long pants to protect exposed skin PPE can be discarded in regular trash unless suspicious mail is discovered

19. Title of Lesson on Slide Master Identifying Suspicious Packages / Letters Excessive postage Handwritten or poorly typed addresses Incorrect titles Title, but no name Misspellings of common words Oily stains, discoloration or odor 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 Ticking sound Marked with restrictive endorsements, such as “Personal” or “Confidential” Shows a city or state in the postmark that does not match the return address

20. Title of Lesson on Slide Master Suspicious Mail Items Letter & Package Indicators

21. Title of Lesson on Slide Master How to Handle Anthrax Threats To cause infection, Anthrax organisms must be rubbed into abraded skin, swallowed, or inhaled as a fine, aerosolized mist. Anthrax must be aerosolized into very small particles to be effective--very difficult to do Anthrax is not spread from one person to another person. Disease can be prevented after exposure to the anthrax spores by early treatment with the appropriate antibiotics. If there is no powder or other substance, there is no anthrax Do Not Panic

22. Title of Lesson on Slide Master Suspicious Packages or Envelopes Do not shake or empty the contents PLACE the envelope or package in a plastic bag or other type of container If you do not have any container, then COVER the envelope or package with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover. LEAVE the room and CLOSE the door and keep others away WASH your hands with soap and water to prevent spreading any powder to your face. If you are at HOME, then report the incident to local police. If you are at WORK, then report the incident to local police, and notify your building proctor, safety officer, or an available supervisor. LIST all people who were in the room or area when this suspicious letter or package was recognized and give this list to the authorities

23. Title of Lesson on Slide Master If Powder Spills Out DO NOT try to CLEAN UP the powder. COVER the spilled contents immediately with anything and do not remove this cover! LEAVE the room, CLOSE the door, and keep others away REMOVE heavily contaminated clothing ASAP and place in a plastic bag, or some other container that can be sealed and give the bag to the emergency responders for proper handling. WASH exposed body parts with soap and water. If you are at HOME, then report the incident to local police. If you are at WORK, then report the incident to local police, and notify your building proctor, safety officer, or an available supervisor. If possible, list all people who were in the room or area, and give this list to the local authorities

24. Title of Lesson on Slide Master Double-Bagging of Suspicious Mail Items With your gloved hands… Carefully insert the item into a sealable plastic bag Large “Zip-lock” bags work well Have another person hold open a second bag Insert the sealed bag into the second bag Remove your protective gloves, being careful not to touch the outer surfaces Insert the gloves into the second bag, and seal it Retain the bagged items for authorities Wash hands thoroughly, using hot water & soap!

25. Title of Lesson on Slide Master TAMU Emergency Phone Numbers http://www.tamu.edu/00/data/emerg.html TAMU Emergency Assistance9-911 University Police Department5-2345 TAMU — EHSD5-2132 Maintenance Service 5-4311 Office of Engineering Safety5-4986 Engineering Facilities Office5-5568

26. Title of Lesson on Slide Master Sources US Department of Health & Human Services Centers for Disease Control & Prevention (CDC) http://www.bt.cdc.gov/learningresources.asp Federal Bureau of Investigation (FBI) http://www.fbi.gov/ National Domestic Preparedness Office http://www.ndpo.gov/ US Postal Service (USPS) http://www.usps.gov/ Federal emergency Management Agency (FEMA) http://www.fema.gov/

27. Title of Lesson on Slide Master Remember Use Common Sense! Use Reasonable Precautions! Wash Your Hands! Don’t Live in Fear!

28. Title of Lesson on Slide Master Prepared by: http://engineering.tamu.edu/safety/

29. Title of Lesson on Slide Master

30. Anthrax Safety Training Course Office of Engineering Safety Texas Engineering Experiment Station (TEES) & The Dwight Look College of Engineering “A safe, healthful, and secure environment for scholarship and research.” Anthrax Awareness and Mail Handler Safety Training