Case 23 CONFIRMED

The patient, a 94-year old widow whose husband died in 1977, lived alone in a small town in Southwest, Connecticut.  She probably had contact after October 12 with a cross-contaminated anthrax letter, sent on October 9 from Trenton, NJ to the local postal processing center in Wallingford, CT on October 11, where anthrax spores were found on sorting machines. At least one anthrax-contaminated letter was reported to have been sent from Wallingford to Seymour, nearby to Oxford, showing that cross-contamination was both possible and likely. She became ill on November 14 and on November 16 was taken to 160-bed Griffin Hospital in Derby, Connecticut with symptoms corresponding to pneumonia. On November 17, the hospital tested four vials of blood for the presence of bacteria. When those came back positive, the hospital conducted additional tests that showed the bacteria matched the properties of anthrax. On November 19, the Connecticut Department of Public Health (CDPH) was notified by the hospital of the positive blood culture results. On November 20, the isolate was identified as B. anthracis at the CDPH laboratory with confirmation at CDC the following day. The B. anthracis isolate was indistinguishable by molecular typing and antibiotic susceptibility patterns when compared with the strain from recently identified cases of bioterrorism-related anthrax. An autopsy revealed hemorrhagic mediastinal lymphadenitis with positive immunohistochemical staining for B. anthracis on spleen and mediastinal lymph node tissue. The patient died at 10:32 AM (EST) on Wednesday, November 21, 2001, five days after being hospitalized. 

Click for initial clinical details (MMWR) (11/30/01)

Click for complete clinical details (JAMA) (2/20/02)

Click for news account of Ottilie Lundgren (11/21/01)

Click for medical and news account of case (11/22/01)

Click for news account of negative test results (11/26/01)

Click for news account of CDC's test of anthrax type (11/27/01)

Click for news account of new FBI investigation team (11/28/01)

Click for epidemiologic reflection on case by CDC (11/30/01)

Click for possible source of exposure in nearby Seymour (12/1/01)

Click for source of exposure via Wallingford, Conn. (12/02/01)

Click for news account of envelop-opening method of Ms. Lundgren (12/26/01)

Click for news account of Ottilie Lundgren's life (12/30/01)

Click for news account of clinical details and treatment (2/20/02)

Click for news account of speculation on source of exposure (3/27/02)

Click for additional spores found in Wallingford, Conn. (4/26/01)

Click for further details on likely Wallingford, Conn. cross-contamination (5/1/01)

Click for cross-contamination theory of 10-100 spores (5/14/02)

Click for news of final clean-up in Wallingford postal facility (6/8/02)

Click for news account of environmental and epidemiological details (9/18/02)

Click for news of follow-up one year later (11/17/02)

Click for reflections and remembrances of Ottilie Lundgren's niece (11/21/02)

Click summary of past three years (11/21/04)

Click for follow-up of Lundgren's death nearly seven years later (8/02/08)