Nguyen Anthrax Strain ‘Indistinguishable’ from Others
The strain of anthrax that killed 61-year-old Kathy Nguyen, a Manhattan Eye, Ear and Throat Hospital supply clerk, is "indistinguishable" from that sent to Senate Majority Leader Tom Daschle (D-S.D.), the New York Post and NBC News, the New York Times reports. Stephen Ostroff, a CDC epidemiologist, said, "As far as the organism itself, we did have a number of cultures from [Nguyen] and it is what we call indistinguishable from all of the others." The similarity in strains could indicate that the anthrax came from the same source, but the finding "neither illuminates much about who has been spreading the anthrax nor discounts the possibility that there may be more than one person or groups involved," the New York Times reports (Steinhauer, New York Times, 11/2). That was the "only clue made public" yesterday in the investigation of Nguyen's death, the Washington Post reports. Investigators, who have interviewed 250 of Nguyen's co-workers and "close contacts," remain "frustrated in their attempts to discover the source of the attacks" (Connolly, Washington Post, 11/2). In addition, although preliminary tests on some of Nguyen's clothing were positive for anthrax contamination, later tests indicate that those items did not contain any anthrax bacteria. Further, tests on 28 people "who worked in close proximity to ... Nguyen" have come back negative for anthrax exposure. Authorities have determined that one employee who had a "suspicious lesion" does not have anthrax (Steinhauer, New York Times, 11/2).
Investigators also have been unable to link Nguyen's infection with the mail, which is believed to be the source of disease in several other people (Washington Post, 11/2). In other infections, there is a pattern suggesting that "most, perhaps all" are the result of two mailings, one mailed on or around Sept. 18 and another on Oct. 9. So far, investigators have only been able to identify and locate three letters (Wade, New York Times, 11/2). In Nguyen's case, the CDC's Julie Gerberding said, "We are reviewing the routes that mail might have traveled to reach her. So far we have found no clues to suggest that the mail or the mail handling was the cause of her exposure" (Steinhauer, New York Times, 11/2). HHS Secretary Tommy Thompson said, "We have no conclusive evidence at this time [concerning the anthrax source]. I wish we did, but we don't" (Kaplan/Donnelly, Boston Globe, 11/2). Addressing why there has been "little progress" made in the anthrax investigation, White House Press Secretary Ari Fleischer said, "Investigations can take time ... they need to be done in a methodological way, and they need to be thorough" (Fatsis/Fields, Wall Street Journal, 11/2).
Although health officials initially were concerned that Nguyen had inhaled a different, more dangerous type of anthrax because she did not respond to antibiotics that have been successful in other cases, they now say the reason she died is because she "sought treatment too late" (Garvey et al., Los Angeles Times, 11/1). Gerberding said, "She arrived in the hospital late in the course of her illness. It's probably early treatment that accounts for survival." Nguyen's first symptoms -- malaise and muscle pain -- emerged Oct. 25; over the next few days, she developed chest discomfort and shortness of breath. However, she did not seek medical help until Oct. 28, when she went to the emergency room (Merzer/Moritsugu, Philadelphia Inquirer, 11/2). Health officials now are speculating that older age could be a risk factor in contracting inhalation anthrax. The 10 people with confirmed inhaled anthrax infections range in age from 43 to 73. Ostroff said, "Right now, it's an interesting epidemiological observation. We don't know if this has any meaning. Historically, anybody who gets sufficient exposure through the aerosol route should be able to develop inhalation anthrax." The best indicator of the risk of infection, epidemiologists say, is exposure to an anthrax-contaminated item (Regalado, Wall Street Journal, 11/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.