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Emergency Planning and Preparedness (EPP) |
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What is Anthrax?
Anthrax is a disease caused by the spore-forming bacteria Bacillus
anthracis. Although it can occur naturally when humans are exposed
to infected animals or animal parts, anthrax spores can be used as
a biological weapon. In the United States in the fall of 2001, several
letters containing anthrax spores were sent through the mail; 22 people
were infected with anthrax and 5 of these people died. All of the
people who died had the inhalation form of anthrax.
No case of anthrax related to bioterrorism has occurred in Canada.
There are three forms of anthrax:
- Cutaneous (skin infection), the most common and most easily treated, is acquired when anthrax spores enter the skin through cuts and abrasions.
- The inhalational form (lung infection) is acquired by breathing in anthrax spores.
- The gastrointestinal form (gut infection) is acquired by eating anthrax spores in contaminated food.
What are the signs and symptoms of anthrax?
- Cutaneous anthrax presents as an itchy, swollen area on the skin (much like an insect bite) that blisters and then enlarges into a painless, round, black ulcer. Areas of the skin that were in direct contact with the suspicious substance are the most likely to be affected.
- Inhalational anthrax initially presents as a flu-like illness: fever, shortness of breath, cough, muscle aches, mild chest discomfort and vomiting. Within hours to days, after a possible short period of improvement, it can progress to severe illness.
- Gastrointestinal anthrax presents with sores in the mouth or throat, nausea, vomiting, bloody diarrhea and abdominal pain and can progress to severe illness.
Symptoms of anthrax could take up to 60 days to show, although most people will not become ill unless they are exposed to a large number of spores.
How do I handle a potential exposure?
What do I do if I may be exposed?
If you suspect that you or anyone in your household has been exposed
to anthrax, or has received a suspicious
package (PDF file size 333KB) contact your
local emergency services (Police, Fire or Emergency Medical Services)
immediately; by calling 9-1-1. Emergency
services personnel will assess the situation and advise you what to
do next.
In addition, you can take precautions to protect yourself. You should:
- Isolate the article and leave the immediate area.
- Wash your hands and other exposed areas with soap and water. Do not use bleach or other disinfectants on your skin as they may cause skin damage.
- Take a shower with soap and shampoo.
- If some of the powder has spilled on your clothes, you can wash your clothing with warm water and ordinary laundry detergent and bleach.
What is the treatment?
Antibiotics are effective against the anthrax bacteria. Anthrax
is not contagious between infected people.
Is there a vaccine and how do I get it?
Anthrax vaccine is not a licensed vaccine in Canada and is therefore
not available. The vaccine currently available and in use by the
US military has numerous side effects and requires multiple doses
to maintain immunity. Research is underway to develop a better and
safer vaccine.
Can I get treatment if I have been exposed but
do not have symptoms?
Yes, you can take antibiotics if you have been exposed to anthrax
spores to prevent illness. The antibiotics most commonly used for
preventing illness are ciprofloxacin and doxyccycline.
Responding to Threat of Anthrax Release
While there have not been any cases of intentional anthrax release in our city, or anywhere in Canada we still need to be vigilant. The transmission of anthrax is very difficult - it is not highly infectious and it is not contagious.
Toronto Public Health works with Toronto's Police, Fire and Emergency Medical Services to coordinate protocols, clarify our respective roles and functions to ensure smooth inter-agency cooperation when dealing with potential cases of anthrax and other biological agents. We have also been consulting with provincial and federal health authorities and colleagues in other jurisdictions. In addition to assisting with emergency response activities and providing advice to health professionals and hospitals, TPH has communicated information to the general public and worked with targeted groups to help manage and reduce levels of stress in the community.
A targeted delivery of anthrax through the mail is not an everyday occurrence and we should not expect our individual, daily routines to be interrupted by such a thing.
It is very important, from a public health point of view, that we do everything we can to reduce and minimize levels of anxiety in our community. We all may have vulnerable neighbours who may feel the stress of international events more intensely than most of us. Our city is home to people from around the world, some of whom have directly experienced the trauma of terrorism and may need additional support during this period. Talk through issues of concern with family, friends and your spiritual leaders. Manage your stress down and stay healthy."
City Guidelines for Handling Suspected Hazardous Material Delivered Through the Mail
The following is an excerpt from a message sent to all City of Toronto employees. It provides an example of precautions to follow in opening mail.
A number of staff expressed concern about the possibility of an anthrax incident at City of Toronto offices. The City has been in contact with Canada Post to ensure that its guidelines for handling hazardous materials are up-to-date. Couriers are requested to provide their name, the company name, license plate information, etc., each time they deliver couriered materials.
City staff in the mail rooms at City Hall, Metro Hall and the civic centres check incoming mail for suspicious signs, including:
- irregularly shaped envelopes
- excessive weight or thickness for the envelope/package
- unusual odours
- the feel of springiness, metallic components or stiffeners in letters
- oily or greasy stains on the packaging
- excessive postage
- small holes, protruding wire, string or metal foil
- excessive wrapping, binding or tying of the package
- unbalanced or lopsided envelope/package
- absence of a return address
- mismatched return address and post marks
- odd or unexpected addressees (i.e, President, City of Toronto).
Staff who receive suspicious envelopes/packages should:
- not open it
- not move it
- cover the envelope or package with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover
- clear the immediate area and do not let others touch the envelope/package
- immediately notify Corporate Security
- if the facility has no on-site security call the police at 9-1-1.
- list all people who were in the room or area when the suspicious letter/package was found. Give this list to public health authorities, security and police for follow-up.
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