Anthrax Suspected in Two Washington, D.C. Postal Workers’ Deaths

Two Washington, D.C.-area postal workers have died in local hospitals of suspected inhaled anthrax infection, the Boston Globe reports. Homeland Security Director Tom Ridge said, "It is very clear that their symptoms are suspicious, and their deaths are likely due to anthrax." The first man, Thomas Morris, died on Sunday, and the second man, Joseph Curseen, died yesterday (Milligan, Boston Globe, 10/23). Both men had experienced "severe respiratory problems before becoming critically ill and dying" (Lichtblau/Rosenblatt, Los Angeles Times, 10/23). A blood culture smear on Curseen showed bacteria that is suggestive of anthrax infection, but doctors will not be certain if he or Morris died of anthrax until a culture is completed today. The two men worked in a D.C. mail processing facility that handled an anthrax-laced letter sent to Senate Majority Leader Tom Daschle (D-S.D.). If the two deaths are "conclusively tied" to anthrax, it would bring the number of fatalities from anthrax to three (Boston Globe, 10/23). Bob Stevens, an editor at the Boca Raton, Fla-based American Media Inc. died in early October from inhalation anthrax, the most deadly form of the disease (California Healthline, 10/11). Officials also announced yesterday that two other unidentified men who worked in the postal facility with Morris and Curseen are being treated for inhalation anthrax (Boston Globe, 10/23). One of the men, Leroy Richmond, was diagnosed with inhalation anthrax Sunday morning and remains in serious but stable condition. Both men are being treated "aggressively" with antibiotics (Sorokin, Washington Times, 10/23). Dr. Ivan Walks, D.C.'s chief health official, said nine other cases have raised anthrax concerns and are under investigation. It is unknown whether the nine are all postal workers (AP/Investors Business Daily, 10/23). Walks has urged all 2,000 employees who worked in the back room of the mail processing plant -- where the four men with suspected anthrax worked -- to get tested and begin taking antibiotics (Boston Globe, 10/23). As a precaution, the CDC also has recommended that about 2,000 workers in 36 D.C. post offices that receive mail from the processing facility receive antibiotics (Roylance, Baltimore Sun, 10/23). Including the two new confirmed cases, three people are being treated for inhalation anthrax, six others have cutaneous anthrax and at least 37 people have tested positive for anthrax exposure but have not developed the infection. Several thousand people are taking antibiotics as a precaution (Twomey/Goldstein, Washington Post, 10/23).

Ridge said that investigators are assuming that "all the contamination" in the District of Columbia originated from the letter that was sent to Daschle (Rosenbaum/Stolberg, New York Times, 10/23). However, investigators have found "wide exposure" at the processing facility and anthrax spores in the Ford House Office Building, leading them to presume "that at least one other tainted letter ... is involved," the Post reports (Twomey/Goldstein, Washington Post, 10/23). The two suspected deaths and new illnesses "have forced health and law enforcement officials to reevaluate their understanding of" anthrax, the Los Angeles Times reports. The CDC's Dr. Mitchell Cohen said, "At first we had no evidence that any of the mail handlers were at risk" (Los Angeles Times, 10/23). Based on the incidents in New York -- where several tainted letters resulted in cases of cutaneous anthrax -- CDC epidemiologists had expected at the most to find cutaneous infection, not inhalation anthrax, among D.C. postal workers. CDC Deputy Director David Fleming said, "Clearly something different happened here than happened previously." He added that the agency "is considering ways to change its testing procedures."

The new developments suggest that officials had "miscalculated" by assuming that inhaled anthrax could not be contracted from sealed envelopes (Lueck, Wall Street Journal, 10/23). Anthrax spores cannot pass through intact paper. However, workers could have inhaled anthrax spores from a letter if "a puncture or gap in the seal allowed some of the finely milled spores to escape into the air," the Post reports. Further, blowers used to clean mail-sorting equipment of dust and debris could have "provided sufficient energy to suspend" anthrax spores in the air (Okie, Washington Post, 10/23). Cohen said, "Part of our epidemiological investigation is to track down what are those kind of exposures and eliminate them, so that we can make things safer" (Stolberg, New York Times, 10/23). Postmaster General John Potter said the postal service is considering the purchase of equipment similar to ultraviolet machines used to treat food and medical supplies to "sanitize" mail. The devices would kill anthrax spores on external surfaces, but it is unclear whether the machines would be able to kill spores inside mail (Wall Street Journal, 10/23).