N.J. Anthrax Case Poses a Mystery

Health officials announced Monday they have identified the first case of anthrax in a person who is not a mail worker and has no apparent connection to an office targeted with a contaminated letter.

The case--involving a 51-year-old Hamilton Township, N.J., bookkeeper who contracted skin anthrax on her forehead--raises the prospect that more Americans, especially on the East Coast, could be at risk from opening their mail and that the deadly bacteria can spread more easily than previously believed.

The Centers for Disease Control and Prevention said late Monday that they have launched an “active and intense” investigation to determine how the woman, the 14th person to contract the disease, was infected. They are taking environmental samples at both her home and workplace, but there was no indication that she or her company was targeted, authorities said.

The woman’s office receives its mail from the Hamilton postal facility, which is a few miles away. The facility also processed three anthrax-laced letters to Senate Majority Leader Tom Daschle (D-S.D.), NBC news anchor Tom Brokaw and the New York Post.

“This would be to my knowledge the first instance of [cross-contamination] exposure if that ends up being the case,” said Linda Rosenstock, dean of the UCLA School of Public Health. “We’re going to have to talk differently. We need to revisit the assurances.”

Said Thomas Milne, executive director of the National Assn. of County and City Health Officials: “The best science, the best information everybody had is that even cutaneous anthrax isn’t spread that way.”

Late Monday night, New York Mayor Rudolph W. Giuliani announced that a 61-year-old hospital worker had tested positive for inhalation anthrax and was in serious condition. If the preliminary tests are confirmed, she is the first person in New York City to contract the inhaled form of the disease.

The source of her infection was not immediately known, officials said. Antibiotics have been issued to 25 other employees at the Manhattan Eye, Ear and Throat Hospital where the woman, who was not identified, works in a stockroom.

Officials said the woman works near the mail room but normally did not handle mail as part of her job, which includes making deliveries throughout the hospital.

The woman, who lives in the Bronx, went to Lenox Hill Hospital’s emergency room Sunday evening with a severe respiratory infection, said Dr. Neil Cohen, the city’s health commissioner.

Meanwhile, the search for undiscovered anthrax-laced letters intensified Monday as the trail of contamination crept closer to major power centers in Washington, including new “hot spots” found inside the U.S. Supreme Court building, the State Department and possibly the government office building that houses the Department of Health and Human Services and the Voice of America.

At the State Department, where one mail worker is battling the often-fatal inhaled form of anthrax, traces of the bacteria were apparently carried as far as Lima, Peru, on a contaminated mailbag shipped from Washington to the U.S. Embassy there.

The State Department last week warned more than 220 embassies and consulates not to open mail pouches from Washington after anthrax contamination was discovered at their mail facilities. Tests were conducted on the mail, all of which went through the Brentwood facility, officials said.

“All our mail rooms have been closed off,’ said State Department spokesman Richard Boucher. “Mail distribution has been shut down. It’s all locked up and it won’t be opened up until it’s cleaned up.”

The developments, particularly the new case in New Jersey, raise questions about the past reassurances from the CDC and other health officials that it would be highly unlikely for someone to contract anthrax if they did not handle a tainted letter.

“We clearly felt that the nation and certainly the people of New Jersey needed to know this information as soon as possible,” said Dr. George T. DiFerdinando, the state’s acting health commissioner.

DiFerdinando said the latest anthrax victim saw no mail either at her job or at home that seemed unusual or dangerous.

But CDC officials Monday reiterated their belief that the risk to the general public of cross-contamination from the three letters is low.

Officials said it was too soon to speculate about how the woman was infected, but they are examining a range of possibilities, including possible links to the Hamilton facility. The developments also increased concerns that there may be other contaminated letters that have not yet surfaced.

The woman first noticed what she thought was a pimple on her forehead on Oct. 17. She went to a local doctor the next day and was given a prescription for the antibiotic Cipro as a precaution, although a preliminary test came back negative.

When the swelling continued the woman was admitted to Robert Wood Johnson University Hospital in Hamilton, the same facility that swabbed and handed out antibiotics for thousands of local postal workers, and received an intravenous Cipro drip. She was released from the hospital Saturday and is recovering, DiFerdinando said.

The CDC confirmed her case Monday.

The woman works in a single-story suburban office park just a few doors away from a district office of Rep. Christopher H. Smith (R-N.J.). That office has not yet been tested for anthrax contamination.

Nick Manetto, a congressional aide to Smith, said he has been working from the New Jersey district office ever since the anthrax threat closed down much of Capitol Hill.

“It was shocking, very surprising,” Manetto said.

Manetto did not know whether any mail headed to Smith might have been contaminated and then come into contact with the accounting firm’s mail. He noted that his office has not received any suspicious mail and no one was sick.

Authorities said Monday they are still sorting through tens of thousands of letters from various government offices and from the Capitol in an attempt to find additional letters that might explain the spreading contamination, which has also been discovered in mail facilities serving the White House, Justice Department and CIA.

“That mail is being recalled and intensively evaluated by [the] FBI,” said Dr. Bradley Perkins, who led the CDC’s investigation in Florida, where the first anthrax fatality occurred at the tabloid publisher American Media.

The FBI is searching through mail that had been sequestered after Oct. 15, when the Daschle letter was opened, according to Homeland Security Chief Thomas J. Ridge. That letter is believed to have killed two postal employees who worked at the Brentwood facility, which processes most government mail.

“The belief within the administration is that we need to isolate all the mail that was on the Hill to determine whether there was more than one letter,” Ridge said Monday.

FBI Team Checks Mail, Phone Tips

About 12 FBI agents specially trained in identifying germ warfare are poring over mail, checking hot spots and responding to dozens of calls a day about contaminated letters, according to an official at the FBI’s National Capital Response Squad who asked not to be identified. He said the members wear “moon suits” that protect them from contaminants, and use high-tech tools to detect any anthrax and to decontaminate areas where it is found.

Rep. Mike Pence (R-Ind.), whose office in the Longworth building tested positive for anthrax, said Capitol Hill security officials told him they do not believe the Daschle letter was the source of the Longworth contamination. He said investigators have told him that they believe there is at least one additional letter that was mailed to someone in the House.

On Oct. 17, he and other lawmakers were instructed to return all unopened mail, resulting in what he said must be “truckloads” of letters and packages to be examined.

Pence expressed confidence that investigators would find any additional letters mailed to the House.

“I think we’ll all breathe easier when we can identify a source of the material that can be traced to the mail bin our office mail came from,” he said.

Dan Mihalko, a spokesman for the U.S. Postal Inspection Service, said his inspectors are working closely with the FBI and health officials to determine if there were any other anthrax-laced letters, and that more than 30 tons of mail from Washington had been sent to Lima, Ohio, so it could be decontaminated by a private contractor.

“Clearly, they are going to have to go through the mail,” Mihalko said. “But the mail hasn’t even come back yet from being sanitized. It is now being sent back to Washington.”

The anthrax threat presents an unusual challenge for law enforcement agencies. Searching for new letters could put investigators at risk, but sanitizing the mail could kill evidence of the anthrax that might provide additional clues.

And CDC officials said they still believe that many of the anthrax traces being detected around Washington stem from cross-contamination with the Daschle letter.

On Monday, traces of anthrax were also found at the mail rooms inside the Supreme Court, the State Department and the Cohen building, which houses the Health and Human Services agency and other government offices. Those facilities get mail from the Brentwood facility.

“We think probably in most cases it’s mail that was processed at the same time as the Daschle letter that was cross-contaminated by it,” said Dr. Pat Meehan, the CDC’s director of emergency environmental services.

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Times staff writers Marlene Cimons, Josh Meyer, Robin Wright in Washington, and John J. Goldman and P.J. Huffstutter in New York contributed to this report.