The Department of Homeland Security (DHS) has issued guidance developed by a federal interagency working group to educate first responders on protective actions they should take in the event of a wide-area anthrax release.

The guidance focuses on a large-scale Bacillus anthracis (B. anthracis) aerosol attack in a major U.S. city and for minimizing the amount of exposure in the first week of a response. Information is provided on pre- and post-event vaccination, personal protective equipment, and decontamination recommendations.

The Guidance for Protecting Responders’ Health during the First Week Following a Wide-Area Aerosol Anthrax Attack (.pdf) is expected to evolve over time based on the understanding of risks, stakeholder feedback, scientific developments, and new environmental monitoring techniques.

First responders play a critical role in ensuring a rapid distribution of post-exposure prophylaxis to reduce the risk of fatality associated with inhalation anthrax.

Current recommendations for post-exposure prophylaxis for the general population include timely administration of a minimum 60-day course of oral antimicrobial drugs (e.g., doxycycline or ciprofloxacin) following potential or imminent exposure to B. anthracis spores in combination with three doses of anthrax vaccine adsorbed (AVA, BioThrax™), given subcutaneously at 0, 2, and 4 weeks for those not previously vaccinated.