Case 10 SUSPECTED (BUT LATER REMOVED)

On October 13, a 54-year-old Delaware resident who worked as a mail sorter at a New Jersey postal processing and distributing center developed a painless lesion on the dorsum of his left hand. The lesion began as an erythematous "knot" several millimeters in size that developed a crusted scale during the next few days. No associated edema, eschar, or lymphadenopathy was observed. The patient had elevated levels of serum antibody (IgG) to the protective antigen component of the anthrax toxin using enzyme-linked immunosorbant assay.

On December 7, 2001 CDC removed this case with the following explanation: "A 54-year-old man who lived in Delaware and who worked at a postal facility in New Jersey (NJ) previously had been classified as having a suspected case of cutaneous anthrax. Additional laboratory findings indicate that the patient's illness no longer meets the CDC surveillance case definition for anthrax. Initially, he was classified as having a suspected case because of a lesion on his left hand and elevated levels of antibody (IgG) to the protective antigen component of anthrax toxin. Subsequent biopsies of the skin lesion did not reveal Bacillus anthracis in the tissue, and additional confirmatory antibody tests on serum specimens were negative.

Click for news account of un-named case (10/31/01)

Click for follow-up of postal facility and mention of suspected case (3/1/02)