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What to do when in doubt

By Beth Daley, Globe Staff, 11/4/2001

   
 KEEPING SAFE

Articles:
How genuine is the risk?
Taking practical steps
Staying safe on the job
Handling new kind of stress
Talking with children
Is it just the flu?
What to do when in doubt
Hospital readiness
How the body fights back
Are there other threats?
Not all terror threats equal

Graphics:
How to talk to your kids
5 signs you need help
What works, what doesn't
How anthrax is diagnosed
Inside a bacterial invasion
In case of emergency...
Identifying a mail threat
Safety resources

Compare cold & flu to other bioterror threats:
Cold & Flu
Anthrax
Botulism
Hemorrhagic Fever
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Smallpox
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More anthrax coverage

A letter comes to your house in a handwritten envelope with no return address. Maybe it's a bit discolored. Maybe it comes from a place where you don't know anyone.

What do you do?

First, put the letter down and wash your hands vigorously with soap and water. Then, do what health and safety officials are asking everyone in Massachu-ufsafebodysetts to do if they encounter suspicious mail or white powder - use a healthy dose of common sense.

Overwhelmed with thousands of phone calls and items to be tested for anthrax spores, authorities say you should run through specific questions about whatever you have found before picking up the phone to dial 911:

Is it expected?You should try not to call authorities about mail that you anticipated receiving. The same goes for white powder in an unsurprising place, like near the cosmetics section in a pharmacy. Many packages and shoe boxes include packets of a white substance to absorb moisture that may break open. Newspapers may appear powdery because of loose fibers or because of a white powder used in the collating process. Magazine publishers also use cornstarch to help ink dry.

Is it threatening? Call 911 if any writing on a letter, package, or other object specifically mentions a threat of anthrax - or any other danger. So far, state officials have responded to about 20 such threatening letters. All have turned out to be hoaxes. But since there is no easy way to tell the difference between a hoax and a real threat, authorities are treating any threatening letters or packages as real and will continue to do so.

Is it suspicious? This is the hardest question to answer. Suspicious mail might have no return address or have an odor. Suspicious white powder might be found somewhere unexpected, such as underneath a desk in an office.

The trouble is, most people get lots of mail and encounter lots of white powder that meets one or many of those descriptions. Health official Paul Jacobsen suggests you stop and ask yourself this question: On Sept. 10, what would I have thought of this?

Except in one case, ''the known cases of anthrax are related to mail and government agencies,'' says Jacobsen, deputy commissioner of the state Department of Public Health. ''None of them have had any connection with anybody's home as far as we know.''

With billions of pieces of mail moving through the system, the odds that your mail has been affected are minute. But if you feel you've ruled out all possible reasons for the discovery of white powder or unusual mail, you should call 911. You do not need to call the state Department of Public Health directly. (Officials there say that if you feel a need to drop items off to be tested, you should call first.)

You should also not move mail or packages you feel are suspicious. Anything truly contaminated should be covered and left untouched so the contamination does not spread.

After you call 911, the local fire department will be notified to visit your house or business and assess the situation. If they can't rule out anthrax right away, they will call the state fire marshal's hazardous materials team to come in with air masks and moon suits to bag the substance and take it to the state lab to be tested. Be warned, however: All items tested are superheated and most will be thrown away.

In the unlikely event you have been exposed to anthrax, first, wash your hands. Then call 911. If an object you submit tests positive for anthrax, health officials will immediately start treating you with antibiotics, whether or not you have symptoms.

Although anthrax cannot be transmitted from person to person, health officials will also probably start treating family, friends, and anyone you were in contact with until they can pinpoint where the contamination came from. They will also determine if your home or office needs to be closed for decontamination.

There are no easy answers, but authorities stress that people should exercise ''reasonable caution'' and go about their normal lives.

So far, the state hazardous materials team has made more than 450 visits since Sept. 11 - more than 10 times the number they usually make.

Ralph Timperi, who runs the state Department of Public Health laboratory in Jamaica Plain, says scientists in his lab have been working seven days a week testing items for anthrax - and he fears that a glut of low-risk items could interfere with the lab's ability to report an anthrax finding quickly.

In addition to letters, the agency has tested a pay phone in Pittsfield, a green postal collection box in Seekonk, shoes, an iron, a Christmas gingerbread house, and even a VCR. At least two Dunkin' Donuts bags have been sent to health authorities because residue from a powdery donut was inside. Someone reported a white powder on a supermarket baking aisle, which turned out to be flour.

This does not mean that there are no real bioterror threats that could crop up. But of close to 2,000 items tested by the state lab so far, not one has shown signs of anthrax.

Authorities have not been called about anything but anthrax, although there was a hoax in Newton last week regarding a package marked ''small pox'' that turned out to hold cheese.

Police warn that anyone caught even trying to send a hoax letter about anthrax or any other potential contaminant in the mail will be arrested.

This story ran on page 10 of the Boston Sunday Globe's Common-sense Guide to Keeping Safe on 11/4/2001.
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