Special Report: Aftermath of Terror

CDC Issues Tips for Avoiding Anthrax But Stops Short of Broad Guidelines

By SARAH LUECK and KATHY CHEN, Staff Reporters of THE WALL STREET JOURNAL

The Centers for Disease Control and Prevention stopped short of issuing firm guidelines on how people should protect themselves from mail that might carry anthrax, after days of wrestling with how to inform the public on the issue.

Amid growing suspicions -- but no proof -- that contaminated mail caused two fatal cases of inhalation anthrax in New York and Connecticut, the agency said "persons remaining concerned about their risk may want to" take precautions such as keeping mail away from their faces, not blowing or sniffing mail contents and washing their hands after handling mail.

Officials decided not to target populations that may be at particular risk, such as the elderly or immune-deficient, and didn't specify that people receiving mail from the contaminated facilities should be cautious. Earlier in the week, CDC director Jeffrey Koplan did say elderly and sick people should be careful opening mail, a warning echoed by the New York City Health Department. Dr. Koplan said the risk of catching anthrax from mail that went through processing facilities around the time of letters laced with the bacteria is "very, very low, but it's not zero."

The guidelines, contained in the CDC's weekly health bulletin, came amid friction among government agencies and some members of Congress over how the anthrax scare has been handled.

The Inspector General for the U.S. Postal Service said it is examining whether the cleanup of anthrax -- and the way of determining whether cleanups are needed -- is adequate, spokeswoman Sandra Harding said.

Health officials have raised the possibility that the elderly and immune-compromised may be infected by fewer spores than younger, healthier people. Though there is no firm data to back that up, some have suggested those populations take more precautions.

But if the CDC were to recommend that elderly and sick people not handle mail processed in the contaminated facility in Hamilton, N.J., for example, that would raise a host of new issues. Would older postal workers have to stop handling mail at facilities where anthrax had been found, due to the possibility of lurking spores?

Friction between the CDC and the Postal Service was palpable at a news conference the Postal Service held earlier this week, on the heels of a comment Dr. Koplan made to reporters on Monday. "Tens of thousands and maybe more letters" may be at risk for cross-contamination by anthrax, Dr. Koplan said, in trying to illustrate why it would be impossible to identify and notify people who received such mail.

Deputy Postmaster General John Nolan called the comment "pure speculation. Some letters were cross-contaminated, but the numbers have been extremely small."

Meanwhile, Federal Bureau of Investigation officials said the letter written to Vermont Democrat Sen. Patrick Leahy that contained anthrax, which they opened for the first time Wednesday, appears to be "virtually identical" to the one sent to Senate Majority Leader Tom Daschle; both are photocopies. One FBI agent involved in the investigation said agents were pessimistic about whether the letter itself would yield much evidence that could point authorities toward a suspect, since the Daschle letter didn't yield any clues.

"So far, they are identical in every way, and I'm anticipating they'll be identical too in terms of what this letter won't tell us," an FBI official said. He said, however, scientists would continue analyzing the anthrax inside the letters for clues.

The CDC also said blood samples drawn from hundreds of people in Washington could provide the first clues to how the human body reacts when exposed to anthrax.

In an attempt to begin solving some of the mysteries about how anthrax is transmitted and how to combat it, the CDC also is taking blood from workers at the Brentwood postal facility in Washington and from people who were present in the Hart Senate Office Building when an anthrax-laden letter was opened there in October.

The CDC said the study could provide new information about who was exposed without necessarily getting ill. It also will help the CDC determine whether the blood test for anthrax antibodies, developed to test the effectiveness of the anthrax vaccine, is useful if there is a future outbreak, said Bradley Perkins, a CDC anthrax expert. He said he didn't know whether people in other locations had blood taken.

In the Hart Building, people will be divided into groups based on how close they were to the letter when it was opened. Information on the level of antibodies in their blood may indicate how far anthrax there spread.

At Brentwood, a blood drive held before the contaminated mail was processed may allow the CDC to compare pre-exposure and post-exposure blood samples to determine the effectiveness of the center's testing, Dr. Perkins said.