ANTHRAX HITS, MISSES TRACED IN CDC STUDY
02 Jan 2003
Source: Hartford Courant, September 18, 2002.
Anthrax Hits, Misses Traced In CDC Study
By DAVE ALTIMARI, Courant Staff Writer
The lethal anthrax released when a member of Sen. Tom Daschle's staff opened a letter last October immediately infected 28 people, according to a study released Tuesday.
But quick treatment with antibiotics probably saved the lives of some of those staffers and kept others from being infected, the study by the U.S. Centers for Disease Control and Prevention says.
Two postal workers died after inhaling anthrax spores as the Daschle letter passed through the mail system. But many more would have died if antibiotics, specifically Cipro, hadn't been administered to everyone else working at the two postal facilities that processed the mail, the study concludes.
The study also quantifies, for the first time, how unusual it was for a housebound 94-year-old woman from Connecticut to contract inhalation anthrax and die.
Ottilie Lundgren (case 23) of Oxford probably came into contract with anthrax from a contaminated piece of mail that was among 85 million pieces that went through two postal facilities in the two weeks after letters sent to the Washington offices of Daschle and Sen. Patrick Leahy passed through.
The study, compiled by health officials in the five states where anthrax was found, as well as by the CDC's National Anthrax Epidemiologic Investigation Team, does not contain any surprises. But it analyzes how the anthrax spread through the mail system and the characteristics of the victims infected by it.
Among its conclusions:
Of the 625 Senate workers potentially exposed when Daschle's staffer opened the letter, 28 tested positive for anthrax. The report concluded that antibiotics "likely prevented further cases in postal workers and almost certainly averted disease in Senate staff."
The anthrax in the letters to Daschle and Leahy probably was more potent than that in an earlier batch of letters sent to media representatives, because everyone infected by the second batch developed inhalation anthrax, the more serious form of the disease. The report theorizes that the mailer may have intentionally placed smaller, particle-sized powder in the second batch to cause greater harm.
The median age of the victims was 46. Lundgren was the oldest, and the 7-month-old child (case 8) of an ABC employee was the youngest. Those who contracted inhalation anthrax were much older - 56 on average - than those who contracted cutaneous, or skin, anthrax, the less serious form of the disease. Their average age was 35.
Of the 10.5 million people in the areas around the New Jersey and Washington postal facilities that processed the Daschle and Leahy letters, no anthrax cases were reported other than Lundgren and Kathy Nguyen (case 22), a 61-year-old hospital worker from New York City who also died of inhalation anthrax, based on a survey of hospitals in the areas.
The risk of contracting anthrax through cross-contaminated mail is low, despite Lundgren's death. The study said 85 million pieces of mail were processed at the Brentwood facility in Washington, D.C., and the Hamilton Township facility outside Trenton, N.J., in the weeks after Oct. 9, when the Daschle/Leahy letters went through. No one else, other than postal employees, got sick.
"Why her?" Lundgren's niece, Shirley Davis, asked Tuesday. "It's mind-boggling, it really is, that this poor old lady in little rural Oxford got anthrax. I still can't believe it."
Despite extensive testing of everything in Lundgren's Oxford house, no anthrax was ever found. Investigators believe she contracted the disease through a piece of contaminated mail because they found anthrax at the Wallingford postal facility that processed her mail, and an anthrax spore on another letter, to a Seymour address 4 miles away.
Postal officials determined that the Seymour letter was processed on a high-speed sorter in New Jersey 15 seconds after one of the letters to the two senators.
The Nguyen case is just as mystifying. Investigators found no anthrax in her apartment. Although it has not officially been determined that she contracted the disease through contaminated mail, investigators believe that is the most likely scenario.
The results of the CDC study didn't surprise Neil Lustig, director of the Pomperaug Health District, which covers the region where Lundgren lived.
Lustig said CDC officials spent a lot of time in Connecticut after Lundgren died because no one thought, at the time, that anthrax could be spread by cross-contaminated mail and that only a little bit could kill someone.
"They really didn't think anthrax could travel around and then fall off a letter and infect someone," he said. "It goes to show how insidious this particular bug is that it could sit on a letter and then spread through the air once it's shaken."
Lustig said that, as bizarre as Lundgren's infection was, it amazes him almost as much that no one else got sick.
"Why weren't there hundreds of people getting sick?" Lustig asked. "She [Lundgren] wasn't the only elderly person living at home. Did everyone else just fight the bug off or get lucky enough not to get sick? We'll probably never know."