More People Exposed to Anthrax; Investigation Continues

As investigators continue to examine the anthrax incidents in Florida, at least five people in New York and five additional people in Florida may have been exposed to the bacteria, bringing the total number of possible exposures to 13, the Wall Street Journal reports (Fong et al., Wall Street Journal, 10/15). Only two of those people have developed anthrax disease (Hutcheson, Philadelphia Inquirer, 10/15). The following is a summary of the most recent events:

• New York: Erin O'Connor, an assistant to NBC anchor Tom Brokaw, tested positive for anthrax infection about two weeks after she handled threatening letters addressed to Brokaw. Unlike the cases in Florida, which involve inhaled anthrax, O'Connor has a less lethal form of the infection, cutaneous anthrax, which is contracted through the skin (Barstow, New York Times, 10/13). Symptoms of cutaneous anthrax -- swelling around where the bacteria entered the body and a skin ulcer within a few days of the infection -- are "easier" to recognize than inhaled anthrax (Johannes, Wall Street Journal, 10/15). The mortality rate for untreated cutaneous anthrax is 20%, compared with 90% to 100% for untreated inhaled anthrax (Fan/Borenstein, Philadelphia Inquirer, 10/13). Besides O'Connor, an unidentified clerical employee, has "symptoms consistent with anthrax exposure" and is being treated with antibiotics (Lipton/Rutenberg, New York Times, 10/14). Further, because of "flaws" in New York City officials' "initial response" to the anthrax exposures, a police detective and two laboratory technicians have been exposed to the bacteria. The New York Times reports that the detective "improperly handled" the letter thought to contain anthrax, and the lab technicians' protective clothing was not "secure enough to prevent exposure." In the future, a firefighter trained in hazardous materials and two police officers -- wearing protective gear -- will initially respond to bioterrorism threats, city officials said. Further, city Health Department staff members who handle materials for anthrax testing will work with the material only after it is placed in a sealed glove box or will wear protective gear that completely covers their faces and shoulders. The New York Times reports that all those exposed to anthrax or infected with it as part of the NBC case are expected to fully recover (Lipton, New York Times, 10/15).
  
• Nevada: Of six people tested for anthrax exposure after a letter sent from Malaysia to a Reno, Nevada-based Microsoft office, four have "received clean bills of health." Preliminary tests on two others are negative (Nieves, New York Times, 10/15). The letter had been sent from the Reno office to Malaysia, but was returned to the Reno office with "added material," at which point Microsoft employees alerted authorities (Fan/Borenstein, Philadelphia Inquirer, 10/14). Although anthrax was in powder or granulated form in the NBC case, there was no powder inside the envelope sent to the Microsoft office. Instead, the envelope contained five pornographic pictures that "looked as if they had been dipped in liquid and dried." CDC Deputy Director Dr. David Fleming said, "In theory, it would be possible if you had something that was liquid that had anthrax in it, to dip something in it and then have the anthrax bacteria on it when it dried." But he added that the risk of infection from using such a method would be lower than using a powder (Nieves, New York Times, 10/15). Investigators have determined that the letter had anthrax after performing three tests (Powell/Blum, Washington Post, 10/14).
  
• Florida: Preliminary blood tests indicate that five more American Media Inc. employees have been exposed to anthrax. Two other employees have tested positive for anthrax exposure; one other died Oct. 5. The CDC warned that the blood tests, which will be repeated this week, should be interpreted "cautious[ly]" (Slevin/Powell, Washington Post, 10/15). Authorities still are waiting for test results on 35 more employees (Canedy/Yardley, New York Times, 10/14).
  
• New Jersey: Test results on a 58-year-old man who had a rash on his body similar to symptoms associated with cutaneous anthrax, are "ambiguous" and the man will undergo additional tests to determine whether he was exposed to anthrax (Powell/Blum, Washington Post, 10/14).