Sweeping probe opens in N.Y. anthrax death

Victim's home, work yield no spores

experts hunt source

War On Terrorism

Anthrax Scare

November 01, 2001|By Heather Dewar, Jonathan Bor and Scott Shane | Heather Dewar, Jonathan Bor and Scott Shane,SUN STAFF

After finding no traces of anthrax in the workplace or home of a New York woman who died of the disease early yesterday, the nation's top medical investigators have launched a sweeping investigation to determine how she got sick.

Kathy T. Nguyen, a Vietnamese refugee who lived alone and had no family here, has become the focus of one of the most intensive medical investigations in U.S. history. Her death captured the attention of President Bush, the FBI and ordinary Americans, who want to know how she contracted deadly inhalation anthrax and whether her case suddenly widens the circle of those at risk.

Nguyen could not help solve the mystery. She was seriously ill when she checked herself into Lenox Hill Hospital three days ago and was diagnosed as New York City's first case of the inhaled form of the disease. Doctors put her on a ventilator, and investigators never had a chance to talk to her.

Preliminary tests showed no traces of anthrax in the basement stockroom at Manhattan Eye, Ear and Throat Hospital, where Nguyen, 61, worked as a supply clerk, or at her Bronx home, according to New York Mayor Rudolph W. Giuliani. A sample taken from her clothing yielded "some indications" of the bacteria, and further tests were under way, he said last night.

The uncertainty about how Nguyen contracted the disease or how large a dose of anthrax spores she inhaled raises new worries that anthrax spores may have been released by means other than the mail.

"We have to be open-minded. We are considering every possibility," said Dr. Jeffrey Koplan, director of the federal Centers for Disease Control and Prevention in Atlanta.

Experts said it was unlikely that Nguyen could have inhaled enough anthrax to fall gravely ill from a letter contaminated by accident. But scientist who oversaw fundamental research into anthrax infection decades ago said a small percentage of people might get sick at very low doses.

"This lady could have been infected with 80 spores," said Edgar Larson, a retired Army scientist who oversaw the animal studies of anthrax at Fort Detrick, in Frederick, on which the human estimates are based.

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, called Nguyen's case "a very puzzling mystery."

"All bets are off, and we need to do ... a full-court press on trying to track this down," he told NBC's Today show. "This is critical."

White House spokesman Ari Fleischer said the FBI has "7,000 investigators working nationwide" to trace Nguyen's infection. "It is an event of concern, and the president is discussing [it] with his team."

Fleischer said a co-worker of Nguyen's has a suspicious lesion, but tests are not complete.

Medical and law enforcement sleuths are also trying to trace the source of infection in the case of a New Jersey accountant who developed the skin form of the disease.

The 51-year-old woman, who was released from the hospital Sunday, lives in Hamilton Township, where a mail-processing center handled anthrax-tainted letters sent to the Washington office of Senate Majority Leader Tom Daschle and to two news organizations in New York. Investigators are trying to determine whether she opened mail that was "cross-contaminated" through contact with a poisoned letter. Mail at her workplace came through the Hamilton Township facility.

With 16 confirmed anthrax cases nationwide, the hospital worker and the accountant are the first victims who neither received a letter intentionally tainted with anthrax nor worked in a contaminated mail facility.

Three other people have died of inhalation anthrax - an editor at a Florida tabloid who opened a letter laced with spores and two workers at the Brentwood mail facility in Washington, which processed the letter to Daschle.

Officials acknowledged yesterday that the mysterious anthrax assault is having an impact on basic services such as mail delivery, and on the American psyche.

"For the American people, it's frightening, it's scary," Fleischer said.

On National Public Radio, Fauci called the threat of anthrax "minor" as a public health menace, saying common diseases kill far more people each day. "It's quite major in the realm of terror, though," Fauci said.

The Nguyen case mystified scientists who have studied anthrax.

"There may be clues in her home, the story of her life, her actions in the past - I don't know," said Dr. Thomas Inglesby, an infectious disease specialist with the Johns Hopkins Center for Civilian Biodefense Studies.

Inglesby said scientists are rethinking theories on how anthrax is spread. "A lot of assumptions about the difficulty of anthrax spores becoming aerosolized in the opening or movement of a letter are being challenged," he said.

Even though investigators can't say how either woman got the disease, the New Jersey accountant's case is less troublesome, Fauci said, because there is "a reasonable possibility ... that there was anthrax contamination on a letter she received."

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