Updated Recommendations for Handling Suspicious Packages or Envelopes

This information supplements CDC's recommendations for recognizing and handling suspicious packages or envelopes that were published as a CDC Health Advisory on October 27, 2001, and replaces information about identifying suspicious packages that was published as a Health Advisory on October 12, 2001.

Letters containing Bacillus anthracis (anthrax) have been received by mail in several areas in the United States. In some instances, anthrax exposures have occurred, with several persons becoming infected. To prevent such exposures and subsequent infection, all persons should learn how to recognize a suspicious package or envelope and take appropriate steps to protect themselves and others.

Identifying Suspicious Packages and Envelopes

Some characteristics of suspicious packages and envelopes include the following:

• Inappropriate or unusual labeling
  • Excessive postage
  • Handwritten or poorly typed addresses
  • Misspellings of common words
  • Strange return address or no return address
  • Incorrect titles or title without a name
  • Not addressed to a specific person
  • Marked with restrictions, such as "Personal," "Confidential," or "Do not x-ray"
  • Marked with any threatening language
  • Postmarked from a city or state that does not match the return address
• Appearance
  • Powdery substance felt through or appearing on the package or envelope
  • Oily stains, discolorations, or odor
  • Lopsided or uneven envelope
  • Excessive packaging material such as masking tape, string, etc.
• Other suspicious signs
  • Excessive weight
  • Ticking sound
  • Protruding wires or aluminum foil

If a package or envelope appears suspicious, DO NOT OPEN IT.

The following are updated CDC interim recommendations:

Handling of Suspicious Packages or Envelopes

• Do not shake or empty the contents of a suspicious package or envelope.
• Do not carry the package or envelope, show it to others, or allow others to examine it.
• Put the package or envelope on a stable surface; do not sniff, touch, taste, or look closely at it or any contents that may have spilled.
• Alert others in the area about the suspicious package or envelope. Leave the area, close any doors, and take actions to prevent others from entering the area. If possible, shut off the ventilation system.
• Wash hands with soap and water to prevent spreading potentially infectious material to face or skin. Seek additional instructions for exposed or potentially exposed persons.
• If at work, notify 911 and a supervisor or a security officer.  If at home, contact 911.
• If possible, create a list of persons who were in the room or area when this suspicious letter or package was recognized and a list of persons who also may have handled this package or letter. Give the list to both the local public health authorities and law enforcement officials.

These recommendations were published on October 25, 2001, in "Update: Investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy." MMWR 2001; 50: 909-919.