CDC Sets 'Tips' on Handling Mail

Precautions Aimed at Cutting Risk From Anthrax Traces

By Ceci Connolly and Ellen Nakashima, Washington Post Staff Writers

The Centers for Disease Control and Prevention plans to issue a nationwide alert today on precautions people may take to reduce the chances of contracting anthrax from mail contaminated with traces of the bacteria.

Although the risk appears small, the agency, in a shift in tone that is causing consternation at the U.S. Postal Service, has decided to offer what one official called "prudent tips" for mail handling during this time of uncertainty.

The move by the CDC puts added pressure on the already beleaguered Postal Service to notify recipients of potentially contaminated mail and revives a broader debate in the Bush administration over what alarms, if any, to sound on potential bioterrorist threats.

Just five weeks ago, CDC Director Jeffrey P. Koplan said it was "highly unlikely to virtually impossible" for someone to develop pulmonary anthrax from spores that floated from one piece of mail to another.

Even now the CDC does not have proof that cross-contaminated mail can infect, let alone kill. But in recent days, as anthrax spores have been found in the vicinity of one victim, officials have grown increasingly fearful that that is the case.

The debate and evolving public health policies stem from the unexplained deaths of Ottilie Lundgren, a Connecticut woman who did not work or travel far beyond her home, and Kathy T. Nguyen, a New York City hospital worker with no obvious links to previous targets.

No anthrax bacteria have been found in their homes, workplaces or other locales the women frequented. But spores were discovered in a Connecticut post office and on a letter that may have come in contact with Lundgren's mail on its way to a neighboring town. That letter moved through a Trenton mail sorter about 20 seconds after an anthrax-contaminated letter addressed to Sen. Patrick J. Leahy (D-Vt.).

Those discoveries "have raised concerns that the two unsolved cases of inhalational anthrax may be due to contact with cross-contaminated mail," said CDC spokesman Tom Skinner. "This could make some people feel nervous about opening their mail. We're saying people who think they may have gotten a cross-contaminated letter and are concerned about opening the mail may take the following steps to help reduce the already low risk."

The agency was still revising the report last night, but the recommendations are likely to mirror advice that has been given in the past, such as watching for suspicious packages, not using letter openers that might jostle spores, and keeping mail away from the face and washing hands after opening mail.

The guidelines will be published in this week's Morbidity and Mortality Weekly Report, which is read by researchers, health care professionals and the media.

Postal officials continued to resist any suggestion that they should alert people who received mail that passed through the same sorting machines that handled tainted letters sent to Leahy or Senate Majority Leader Thomas A. Daschle (D-S.D.). They said that unless they are told otherwise by the CDC, it is not their role to advise the public of potential health risks.

Postal officials yesterday also disclosed that they have extensive information that could identify homes and businesses that received mail that passed through the postal system at about the same time as the Daschle and Leahy letters, indicating it could have become contaminated.

Officials have address information on some of the mail that passed through Trenton, the Brentwood station in Washington, and the southern Connecticut station in Wallingford between Oct. 6 and mid-November.

Bar code information on mail can reveal a letter's destination. Depending on the number of digits, authorities can focus on a specific post office, block on a route or sometimes even the precise address.

While postal officials said they offered the information to the CDC, the health officials never advised them to use it to alert the public.

And although the FBI has that information, investigators refuse to release it unless requested by the CDC, said Rep. Christopher H. Smith (R-N.J.).

"I understand that the CDC does not want to cause any undue alarm in this matter," Smith wrote the CDC. "But in a time where vague threats of possible terror attacks are becoming commonplace, I think the CDC has an obligation to the people who could be at risk from anthrax cross-contamination."

Meanwhile, scientists at Fort Detrick, Md., finally opened the Leahy letter yesterday and took a sample of powder inside to be tested, officials said. The letter itself remains in its envelope, still unread, as scientists prepare to remove it so as not to allow any of the material in it to waft away.

Investigators have been extraordinarily careful in handling the Leahy letter because of their experience with the anthrax powder in the Daschle letter. That very fine powder was quickly dispersed in the air when a Senate staffer opened it. The Leahy letter was opened in a controlled environment to keep any of the material from absorbing moisture in the air or being picked up by air currents.

And in Florida, the Environmental Protection Agency released data from a massive search for anthrax spores inside the American Media Inc. building in Boca Raton, where the recent spate of anthrax attacks began, killing photo editor Bob Stevens and sickening work-mate Ernesto Blanco.

After taking more than 460 culture swabs, investigators found 88 positive samples, including sites on each of the three floors. Spores were found on top of a fax machine, on a magazine rack, on bookshelves, on desks and in an elevator entrance. They were in the carpeting near a water cooler, in a stairwell, on a television, near a coffeepot and in other locations.

The new evidence suggests that the spores were easily spread through the building on air currents and perhaps on people, and that the powder may have been of similar high quality to that found in the Senate letters.