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Elderly Conn. Woman's Anthrax Death Stumps Officials

Mail suspected, but rural location is baffling

WEDNESDAY, Nov. 21, 2001 (HealthDayNews) -- A 94-year-old woman from rural Connecticut died today of inhalation anthrax, Health and Human Services Secretary Tommy Thompson announced.

Officials openly expressed puzzlement that an elderly woman, living alone in a mill town far away from where other bioterrorism-related anthrax cases were reported, came down with the life-threatening illness.

Thompson said investigators haven't located the "cause or the course" of the woman's infection. "There is mystery to this case," Thompson told reporters.

"This is an extraordinary circumstance," Gov. John Rowland said at a press conference earlier today.

The woman, identified as Ottilie Lundgren of Oxford, died about 10:30 a.m. today at Griffin Hospital in nearby Derby, five days after she was admitted, according to a hospital spokeswoman.

Oxford, a town of 9,800 people, is located in Connecticut's Naugatuck River Valley, about 25 miles northwest of New Haven -- and its geographic location has officials baffled.

"It's pretty extraordinary that a 94-year-old from Oxford could get anthrax," Rowland said. "It's very confusing and puzzling."

The woman was the 11th person to be diagnosed with lung anthrax since the attacks started last month, according to the CDC. Four others -- a hospital worker, two postal workers, and a photo editor -- have died. Lundgren was, by far, the oldest victim, but her lack of obvious connection to most of the other victims set her apart as well.

Nine of the 10 previous cases were traced to anthrax-tainted mail sent to high-profile politicians or media outlets in New York City, Washington, D.C., and Florida. However, the most recent anthrax fatality before Lundgren, a 61-year-old woman in New York City, also remains a mystery -- the CDC says it found no traces of anthrax in her apartment or workplace, and tests of the subway she rode also turned up negative.

The governor kept comparing the Connecticut case to the New York one at the press conference.

"We have no reason to believe that Oxford, Connecticut, or this woman were a target," Rowland said. "We have never been a target of terrorism. I still don't believe we are."

Thus far, no other Connecticut residents have been diagnosed with anthrax, and no one else has anthrax-like symptoms.

Dr. Jeffrey Koplan, director of the CDC, says it's too soon to tell if the new case represents a "second wave" of anthrax. No new cases had been reported since the beginning of the month.

Now the CDC and the FBI plan to retrace Lundgren's steps.

"We're trying to trace the whereabouts of this woman," Rowland said, adding that she didn't go out much. Nothing has been found in her home so far, and her itinerary was largely confined to church and the local hair parlor, he said.

Although Lundgren rarely left her house, she did make weekly trips to nearby Nu Look Hair Salon, says Michele Savoy, a co-owner of the beauty parlor. Lundgren's last appointment was Nov. 10, a Saturday, but Savoy says she didn't appear ill. "She was fine," says Savoy.

Rowland said he "can't speculate" now as to whether Lundgren was sickened naturally simply by gardening -- in its natural state, anthrax lurks in dirt and on animals -- or was hit by microscopic shrapnel from a poisoned package intended for someone else.

The CDC's Koplan said the odds that Lundgren contracted the disease naturally are "very, very low."

But because of the pattern of the previous anthrax attacks, the mail is the chief suspect, the governor said. And because the woman had the inhaled form of anthrax, which is harder to contract naturally through contact with dirt or animals, "we're treating this as a criminal event."

However, a large mail processing facility in Wallingford, which services Oxford, was tested for anthrax on Nov. 11 and "it came back clean," John Steele, a U.S. Postal Service official, said. A smaller post office in Seymour, a town to the south of Oxford, also tested negative.

The Wallingford facility will be tested again, Steele added. Moreover, Rowland said, 1,500 postal workers in Wallingford and another 30 at the Seymour office will be given prophylactic antibiotics if they want.

Savoy says her shop hasn't received any suspicious mail lately. And although Rowland said salon employees were also given antibiotics, Savoy said her only contact with officials so far was a phone call from the FBI hours after the governor's press conference. Nobody had visited her by mid-afternoon, she said.

Lundgren arrived at Griffin Hospital on Friday with symptoms of what doctors initially thought was pneumonia. But Dr. Howard Quentzel, the head of infectious diseases at Griffin, said officials had "a high index of suspicion" about anthrax and ran three tests since Sunday; all came back positive. Samples were then sent to the CDC, which made the confirmation early today. Rowland said he was informed of the woman's illness yesterday.

Lundgren's niece, a caretaker who visits her two or three times a day, is on preventive antibiotics, Rowland said. The postal worker who delivers her mail is also taking drugs as a precaution. Rowland added that anyone who is concerned about contracting anthrax should talk to a doctor about getting preventive drugs.

"We don't want to alarm anyone, but I'm a great believer in precaution," he said.

Dr. Joxel Garcia, commissioner of the state's Department of Health, said Lundgren's age "might be a factor" in predisposing her to catching lung anthrax easily. However, he added, the case -- and the knowledge of anthrax -- is an "evolving science."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Lundgren's age may prove significant in her death from inhalation anthrax. "It is conceivable that as one gets older that the natural host defenses in the lung might" weaken enough to make contact with only a small amount of bacterial spores sufficiently deadly, he said.

If the woman's mail had been cross-contaminated with an anthrax-laced letter, her aged lungs might have been especially vulnerable, Fauci said.

Rowland tried to reassure residents of the Constitution State that this is "an isolated case" of anthrax, so far.

"Let us worry," he said, referring to state and federal officials. "Go on about your business. Go out and enjoy your Thanksgiving."

What To Do

A review of the 10 previous inhaled anthrax cases so far shows that form of the disease almost never causes a runny nose, which is common in flu and similar infection, according to the CDC. Inhaled anthrax is also somewhat less likely than flu or flu-like infections to cause sore throats, headaches and diffuse muscle pain.

However, officials can't say with certainty, since one of the victims did have a runny nose, and the CDC says one person in five with the flu doesn't have one. Officials can't discount the possibility of a co-infection.

For the government's latest news on anthrax, try the Centers for Disease Control and Prevention.

To learn more about the microbe, try the University of Wisconsin.

SOURCES: Televised news conferences with Connecticut Gov. John Rowland, Postal Service official John Steele, and Howard Quentzel, M.D., head of infectious diseases, Griffin Hospital, Derby, Conn.; news teleconference with Tommy Thompson, Secretary of Health and Human Services, Jeffrey Koplan, M.D., director, Centers for Disease Control and Prevention, and Anthony Fauci, M.D., director, National Institute of Allergy and Infectious Diseases; interview with Michele Savoy, co-owner, Nu Look Salon, Oxford, Conn.; CDC, Griffin Hospital news releases
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