Additional Resources

General anthrax information

• Anthrax: Frequently Asked Questions. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• Anthrax in Humans and Animals, 4th ed. World Organization of Animal Health (OiE) World Health Organization (WHO), and Food and Agriculture Organization of the United Nations (FAO).
• Anthrax. Infectious Disease Control Unit, Texas Department of State Health Services.
• Anthrax. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• Anthrax. World Health Organization (WHO).
• Use of Anthrax Vaccine in the United States; Recommendations of the Advisory Committee on Immunizations Practices (ACIP). Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• Anthrax. The Center for Food Security and Public Health, College of Veterinary Medicine, Iowa State University.
• Anthrax. Medline Plus, U.S. National Library of Medicine.
• Anthrax. U.S. Food and Drug Administration (FDA), U.S. Department of Health and Human Services (HHS). Provides links to current drug information related to anthrax.

Cleaning and decontamination

• Clean Up Technologies. Environmental Protection Agency (EPA). Provides a centralized location to collect and disseminate information about decontamination technologies and also for technology vendors to provide information.

Information for healthcare workers and employers

• Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
• Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT, et al. "Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults." Emerg Infect Dis [Internet], (2014).
• Bioterrorism Readiness Plan: A Template for Healthcare Facilities. Association for Professional Infection Control and Epidemiology (APIC) Bioterrorism Task Force and Centers for Disease Control and Prevention (CDC) Hospital Infections for Bioterrorism Working Group.
• OSHA e-tool, "Hospital," Occupational Safety and Health Administration, U.S. Department of Labor (DOL).

Information for laboratory workers and employers

• Laboratory Testing for Anthrax: Frequently Asked Questions. Centers for Disease Control and Prevention, Public Health Emergency Preparedness and Response.
• Biosafety Laboratory Competency Guidelines. Morbidity and Mortality Weekly Report (MMWR), 15 April 2011, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS). Describes competencies involved with understanding the hazards in a laboratory setting.
• Laboratory Safety Guidance. The Occupational Safety and Health Administration (OSHA), U.S. Department of Labor (DOL).

Information for first responders and employers

• Guidance for Protecting Responders Health during the First Week Following a Wide-Area Aerosol Anthrax Attack. U.S. Department of Homeland Security (DHS).

Information for package and mail workers and employers

• Notice to Readers: Interim Recommendations for Protecting Workers from Exposure to Bacillus anthracis in Work Sites Where Mail Is Handled or Processed. Morbidity and Mortality Weekly Report (MMWR) 50(43); 961 (2001). Assists personnel responsible for occupational health and safety in developing a comprehensive program to reduce potential cutaneous or inhalational exposures to Bacillus anthracis spores among workers, including maintenance and custodial workers, in work- sites handling or processing mail.
• Securing the Mail. Provides information on identifying and responding to security threats in mail centers including:
  • U.S. Postal Inspection Service Guide to Mail Security Center. Publication 166 (March 2008). Provides general advice and recommends protective measures to help you assess, prevent, and respond to three types of threats: weapons of mass destruction; mail bombs and bomb threats; and mail center theft. This guide specifies procedural responses for a biological threat (anthrax) delivered by mail.
• Updated Information About How To Recognize and Handle a Suspicious Package or Envelope. Centers for Disease Control and Prevention (CDC) Health Advisory, CDCHAN-00050-01-10-31-ADV-N (2001).
• Best Practices for Mail Center Security, United States Postal Inspection Service, U.S. Postal Service.
• Meehan, P.J., Rosenstein, N.E., Gillen, M., Meyer, R.F., Kiefer, M.J., et al. Responding to Detection of Aerosolized Bacillus anthracis by Autonomous Detection Systems in the Workplace, Mortality and Morbidity Weekly Report (MMWR), 53, 1-11, (2004).
• Best Practices for Safe Mail Handling, Interagency Security Committee, U.S. Department of Homeland Security (DHS).

Information for animal and agricultural workers and employers

• Anthrax in Humans and Animals, 4th ed. World Organization of Animal Health (OIE), World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO).
• Treatment of Products. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• Anthrax: Differentiation of Naturally Occurring From Non-Naturally Occurring Epizootics of Anthrax in Livestock Population (2007), the U.S. Department of Agriculture (USDA).
• Overview of Anthrax, The MERCK Veterinary Manual.

Information on Anthrax as a bioterrorism agent

• NRT Quick Reference Guide: Bacillus anthracis (Anthrax). National Response Team (2022).
• Technical Assistance for Anthrax Response, Interim-Final Draft. National Response Team. This version of the NRT's Technical Assistance Document (TAD) for Anthrax Response is a partial update to the Interim-Final Draft November 2003 version. The updated information in this version is limited to a new Appendix E- Guidelines for Discharging Anthrax Decontamination Wastewater to Publicly Owned Treatment Works (POTWs).
• Notice to Readers: Occupational Health Guidelines for Remediation Workers at Bacillus anthracis-Contaminated Sites, Morbidity and Mortality Weekly Report (MMWR), 51(35) (2002) 786-789.
• Laboratory Testing for Anthrax: Frequently Asked Questions. Centers for Disease Control and Prevention, Public Health Emergency Preparedness and Response.

Training

• Anthrax. Centers for Disease Control and Prevention (CDC). Includes videos, slide sets & training materials, textbook information, historical archives and links to other training.
• Mail Security Center. U.S. Postal Service (USPS). Contains links to FAQs, posters, best practices, a mail center security handbook and other mailroom safety resources.
• See OSHA Directive CPL 02-02-073, (August 27, 2007) for enforcement procedures for compliance officers conducting inspections of emergency response operations. It defines additional terms and expands on training requirements for emergency responders and other groups such as skilled support personnel. This OSHA instruction revises CPL 02-02-059, issued April 24, 1998.

Hotlines and Helplines

For further assistance with specific aspects of worker health and safety associated with potential anthrax exposure, contact the following hotlines or helplines:

To report suspicious letter or package:

Call 911 (police, law enforcement), then contact your local FBI Field Office.

For vaccination information:

• Anthrax Vaccination. Centers for Disease Control and Prevention (CDC).

For state and local response planning:

• Contact Us. U.S. Department of Homeland Security (DHS), Federal Emergency Management Administration (FEMA). Provides grants to state and local training programs for terrorist preparedness.
• Contact Us. Centers for Disease Control and Prevention (CDC). Provides the Emergency Preparedness & Response Branch Hotline for local, state and federal agencies: 770-488-7100 (24/7 Emergency Operations Center). This line also assists health care providers with questions on emergency patient care. NOTE: This line is not for use by the general public.
• National Disaster Medical System. U.S. Department of Health and Human Services (DHHS). Provides a hotline: (301) 443-1167 or 800-USA-NDMS.
• The Laboratory Response Network Partners in Preparedness. Centers for Disease Control and Prevention (CDC). Maintains an integrated network of state and local public health, federal, military, and international laboratories that can respond to bioterrorism, chemical terrorism and other public health emergencies.
  • Contact the Laboratory Response Network (LRN)

For general worker health and safety information:

• Contact Us. OSHA: 1-800-321-OSHA (1-800-321-6742).