Elderly Connecticut woman dies of inhalational anthrax from unknown source

Nov 21, 2001 (CIDRAP News) – The nation's fifth recent death due to inhalational anthrax—that of a 94-year-old Connecticut woman—was announced today as public health officials were explaining that they don't know how the patient contracted anthrax but don't think it was from a naturally occurring source.

While opening a telephone press briefing on the anthrax case at midday, Health and Human Services Secretary Tommy Thompson was passed a note, and said, "The woman has passed away. We'd like to express our sympathy to the family. The FBI and the CDC [Centers for Disease Control and Prevention] are pursuing the case very aggressively." The woman has been identified in the general media as Ottilie Lundgren of Oxford, Conn.

CDC Director Jeffrey Koplan, MD, said the woman's diagnosis of anthrax had just been confirmed early this morning. He said the CDC has a five-member team investigating the case, but there were no clues as to the source of the anthrax spores. "We will not eliminate natural occurrence as a possibility, but I think it is a very, very low possibility," he said, implying that the case stemmed from anthrax spread deliberately.

Thompson said that postal workers at two facilities have been put on antibiotics as a precaution, though there were no indications so far of contaminated mail. "We're simply erring on the side of caution; we do not know the source or the cause of the case of anthrax," he said. "All possibilities are being investigated."

CDC officials said the woman had been in good health before her fatal illness. According to other media reports, she had been admitted to Griffin Hospital in Derby, Conn., Nov 16 and had been treated with antibiotics but had not responded.

Koplan said the CDC has not yet identified the anthrax strain involved in the case to see if it resembles the strains in other recent cases. Tests of the organism's antibiotic susceptibility and genetic characteristics were just getting underway, he indicated.

The woman was intubated while in the hospital and hence could not give a history that might suggest how she contracted anthrax, Koplan said. Hence, investigators have to rely on interviews with relatives, friends, and acquaintances, but no obvious clues have been turned up, he said.

The woman's advanced age could have made her vulnerable to a level of anthrax exposure that would not have harmed a younger person, said Anthony Fauci, MD, director of the CDC's National Center for Infectious Diseases. Noting that the ability to clear or inactivate spores that enter the lungs declines with age, he said, "Age may be highly significant as to why she got infected and someone else might have brushed it off or never noticed it."

The Connecticut woman's death is the first US anthrax death since Kathy Nguyen, a New York City hospital worker, died Oct 31. Others who died recently of inhalational anthrax were a 63-year-old photo editor in Florida and two postal workers in Washington, DC, aged 55 and 47. The Florida and Washington, DC, cases were apparently related to contaminated mail. Six other people who contracted inhalational anthrax this fall have recovered or are recovering.

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