Since the terrorist attacks on Sept. 11, 2001 destroyed the World
Trade Center in New York, damaged the Pentagon and killed about 3,000 people,
the Illinois Department of Public Health, local health departments, health
professionals and others have received questions from the public about the
possibility of bioterrorism and ways to protect themselves. The following
frequently asked questions were developed to answer some of those
inquiries. Persons also should consider contacting their local health
department, physician or local emergency preparedness office for additional
What precautions should I take
regarding the threat of bioterrorism?
The Illinois Department of Public
Health and the federal government are not recommending any specific
bioterrorism-related precautions. However, in the event of a natural (for
example, tornado, flood or earthquake) or man-made disaster, lives can be saved
if people are prepared for the emergency. Every family should have the
following emergency supplies on hand:
- A battery-powered radio and a
flashlight, with extra batteries to each
- Bottled drinking water one
gallon per day per person, with a three - to seven-day supply recommended
- Canned or sealed package foods that do
not require refrigeration or cooking, and a can opener
- A blanket or sleeping bag for each family
- First-aid kit, including any special
prescription medications, such as insulin or heart tablets
- Toilet paper and paper towels
- Extra set of car keys, and a credit card,
cash or travelers checks
- Special items for infant (disposable
diapers), elderly or disabled family members
- Extra eye glasses, and contact lenses and
For more information, please refer
to the Illinois Department of Public Healths Surviving Disasters: A Citizens
What is the Illinois Department of Public Health (IDPH) doing to
protect the public from bioterrorism?
Preventing an attack is the job of
law enforcement -- the FBI, state and local police, and other law enforcement
If an attack should occur, IDPH has
developed plans to minimize the risk and to treat those who may become ill.
Working closely with other federal and state agencies, including local health
departments, hospitals, laboratories and law enforcement, and with doctors,
nurses, paramedics and other medical personnel, IDPH has implemented an
enhanced surveillance system that is constantly on guard for unusual clusters
of disease. In the past two years, more than 1,000 medical and public health
personnel have been trained to identify diseases that could be caused by
bioterrorists. If a cluster is detected, public health is prepared to move
quickly to identify the disease and its possible source. Public health
information, treatment options and other advice would be provided to the public
through the news media. Keep in mind, however, an attack may not be obvious for
days to weeks depending on the incubation period of the disease.
The Illinois Department of Public
Health is part of the Governors Illinois Terrorism Task Force. This task
force would direct a coordinated effort among law enforcement, fire
departments, emergency management, public health and other agencies at the
local, state and federal level in the event of a bioterrorist attack.
How can I tell if a letter or package is suspicious?
According to the FBI, you
should look for certain indicators. For
example, check the postmark to see if it was mailed from a foreign country.
Also check for no return address and for restrictive markings such as
personal or confidential. Look for misspelled words or
incorrect title. Suspect letters or packages may be rigid
or bulky and have excessive tape or string around them. They may exhibit a
should I do if I receive a suspicious letter or package?
- Do not shake or empty contents of
any suspicious envelope or package; DO NOT try to clean up powders or fluids.
- Place the envelope or package in a
plastic bag or some other type of container to prevent leakage of
- If you do not have a container,
then cover the envelope or package with anything (e.g. clothing, paper, trash
can,etc.) available and do not remove this cover.
- Leave the room and close the door,
or section off the area to prevent others from entering.
- Wash your hands with soap and
water to prevent spreading any powder to your face or skin.
If you are at home, then report the
incident to local police. If you are at work, report the incident to local
police and notify your building security official or an available supervisor.
If possible, list all people who
were in the room or area when this suspicious letter or package was recognized.
Give this list to both the local police and local public health authorities for
follow up investigation and advice.
Remove heavily contaminated
clothing and place in a plastic bag that can be sealed. Give the bag to law
Shower with soap and water as soon
as possible. Do not use bleach or disinfectant on your skin.
Are vaccinations recommended to protect against a
There are no vaccines recommended
for the general public.
What about anthrax vaccine?
The U.S. has an anthrax vaccine that
was licensed in 1970 and has been mandated for all U.S. military personnel; the
vaccine is not available commercially. Between now and 2005, members of the
military between the ages of 18 and 65 will receive a six-shot series of
anthrax vaccine. For additional information, consult the current U.S. Public
Health Services Advisory Committee on
Practices recommendations on anthrax vaccination.
What is anthrax?
Anthrax is a disease caused by an
organism acquired following contact with an infected animal or contaminated
animal product or following the intentional release of anthrax spores as a
biological weapon. In a bioterrorist attack, health authorities are concerned
about anthrax spores being released into the air where they can be breathed in
a persons lungs.
is not spread person to person. The last reported case of anthrax in Illinois
was in 1960.
is anthrax transmitted?
Anthrax infection can occur in three
forms: cutaneous (skin), inhalation and gastrointestinal. B. anthracis
spores can live in the soil for many years, and humans can become infected with
anthrax by handling products from infected animals or by inhaling anthrax
spores from contaminated animal products. Anthrax can also spread by eating
undercooked meat from infected animals. It is rare to find infected animals in
the United States.
What are the symptoms of anthrax?
Symptoms of disease usually develop
within 7 days of exposure depending on how the disease was contracted, with
most cases occurring within 48 hours of exposure. However, incubation periods
of up to 60 days are possible.
Most (about 95 percent) anthrax infections occur when the bacterium enters a
cut or abrasion on the skin, such as when handling contaminated wool, hides,
leather or hair products (especially goat hair) of infected animals. 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 percent of
untreated cases of cutaneous anthrax will result in death. Deaths are rare with
appropriate antimicrobial therapy.
symptoms may resemble a common cold. After several days, the symptoms may
progress to severe breathing problems and shock. After the onset of symptoms,
inhalation anthrax is usually fatal. Early antibiotic treatment of disease
before onset of symptoms increases the chances for survival.
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, fever are followed by
abdominal pain, vomiting of blood and severe diarrhea. Intestinal anthrax
results in death in 25 percent to 60 percent of cases.
Should I have a supply of antibiotics?
There are numerous germs a
bioterrorist may use in an attack: anthrax,
smallpox, tularemia and viral hemorrhagic fever. Many antibiotics are
effective for a variety of diseases, but there is no antibiotic effective
against all diseases. Keeping a supply of antibiotics poses other problems
because there is a limited shelf life before they lose their strength. There is
currently no justification for taking antibiotics. Antibiotics should only be
taken with medical supervision.
The federal government has
stockpiled antibiotics for large-scale distribution in the event of a
bioterrorist attack. Known as the
CDC's Strategic National
Stockpile, it was designed to ensure the availability and
rapid deployment of life-saving pharmaceuticals, antidotes, other medical
supplies and equipment to any U.S. location in the event of a terrorist attack
involving a biological or chemical agent.
about smallpox vaccine?
As the result of a successful
worldwide effort to eradicate smallpox, smallpox vaccine
was removed from the commercial market in 1983. Routine vaccinations were
stopped in the U.S. in 1972 because many people experienced side effects and
there was almost no risk of getting smallpox. The United States Public Health
Service maintains an emergency stockpile of approximately 15 million doses of
smallpox vaccine and the federal government has recently announced plans to
accelerate production of a new smallpox vaccine.
The U.S. Centers for Disease Control
and Prevention (CDC) would only recommend vaccination if there was clear
evidence that the disease had resurfaced and people in the U.S. were at risk of
acquiring infection. For more information, consult the current U.S. Public
Health Services Advisory Committee on
Practices recommendations on smallpox vaccination.
If I was vaccinated against smallpox before 1972, am I still
Probably not. Vaccination has been
shown to wear off in most people after 10 years, but may last longer if the
person has been successfully vaccinated on multiple occasions. If health
authorities determine you have been exposed to smallpox and are at risk of
infection, they would recommend that you be re-vaccinated immediately.
What is smallpox?
Smallpox is a disease caused by the
variola virus. It can be easily spread from person to person and
transmission usually occurs only after the patient develops a fever and rash.
After the incubation period, the patient experiences high fever, malaise,
headache and backache. Severe abdominal pain and delirium are sometimes
present. The last naturally acquired case of smallpox in the world occurred in
October 1977 in Somalia; the last cases recorded in Illinois were recorded in
All known variola virus
stocks are held under security at the CDC or at the State Research Centre of
Virology and Biotechnology in Russia.
Should I buy a gas mask?
No. A mask would only offer some
protection if you were wearing it at the exact moment that a bioterrorist
attack occurred. Most likely, a release of a biological agent would be done
without anyones knowledge. To wear a mask at all times, or just in case
of a bioterrorist attack, is impractical, if not impossible.
(SOURCES: Illinois Department of
Public Health, U.S. Centers for Disease Control and Prevention, U.S. Department
of Defense and Johns Hopkins University Center for Civilian Biodefense