The death of Ottilie Lundgren is the second puzzling case for law enforcement and health officials, because like a similar anthrax death in New York City, it offers few clues as to where the woman might have come into contact with anthrax spores.
Initial testing on an envelope brought to Griffin Hospital in Derby by a woman because it contained a suspicious powder showed it did not contain any anthrax, Derby Mayor Marc Garofalo said. He said the hospital, where lundgren was treated and died, would return to normal operations based on the tests. n He said the hospital would return to normal operations based on the initial tests.
Health and Human Services Secretary Tommy Thompson confirmed Lundgren's death during an afternoon call with reporters.
"Our prayers are certainly with her and her family," Thompson said, initially indicating Lundgren was hospitalized in critical condition. He then paused, rejoined the conference and said while he had been told earlier the woman had died, he could now release the information publicly.
Gov. John G. Rowland, R-Conn., urged Connecticut residents to remain calm despite the fact investigators so far have no idea how the woman, who lived alone in rural Oxford and rarely went out, came in contact with the anthrax. She was hospitalized last Friday and treated with antibiotics for anthrax infection immediately after symptoms appeared.
Rowland told residents the FBI and experts from the Centers for Disease Control and Prevention in Atlanta were retracing the woman's activities over the past two weeks to try to determine the source of infection.
The governor called the infection an "isolated case" and in a news conference said people should go about their holiday plans and "let us worry."
Investigators were focusing on the mail as the most probable source. Postal workers and others who had come in contact with Lundgren were being offered antibiotics.
CDC Director Dr. Jeffrey Koplan said all avenues are being explored as sources of the anthrax, including the woman's mail, places she may have visited and the fact she lived in a rural area, where anthrax among animals is not all that uncommon.
"It behooves us to keep as open a mind as possible as to the cause," Koplan said. "Initial readings in this 94-year-old woman, who had no occupational exposure, who did not engage in the variety of pastimes associated with anthrax ... have so far not led us down that path."
Koplan said there is no way of determining whether this case represents the beginning of a new wave of anthrax attacks or if Lundgren may have come into contact with cross-contaminated mail sent to her from the office of Sen. Christopher Dodd, D-Conn., where trace anthrax has been found.
This is the second mysterious inhalation anthrax death among the five total since early October. Investigators in New York also have no idea where Manhattan hospital worker Kathy Nguyen, 61, came into contact with anthrax that ultimately killed her on Oct. 31. Over the weekend, New York officials said another clue trail, the New York subway, dried up as no anthrax was found during extensive environmental testing.
Nguyen and Lundgren do not match up with other victims of inhalation anthrax infection, who either were postal or media employees. They have no direct connection to the U.S. Postal Service, media in New York or Florida or Congress in Washington, where the other anthrax cases can be traced.
The one common point they share is that neither woman was able to provide investigators any details on their lives and activities before they died. Koplan said Wednesday that as in the Nguyen case, the details of Lundgren's life will have to be provided by relatives and friends as the FBI and CDC try to trace a path back to anthrax spores.
Dr. Anthony Fauci, of the National Institutes of Health, said from a clinical standpoint, the woman's age could be a key factor in why she succumbed to anthrax infection. He suggested that at her age -- even though she was believed to be in relatively good health -- the threshold number of anthrax spores required for infection may be lower than for a younger person and that her body's defense against such infection may not be as strong.
Since the CDC does not know the minimum number of spores required for either inhalation or cutaneous -- the less serious skin form of anthrax -- infections, it raises the question of whether an older person may be susceptible to inhalation anthrax from a smaller number of spores that may otherwise cause only cutaneous infection in a younger person.
"It is conceivable that as one gets older, that natural host defenses in the lungs may be weaker, a critical threshold that brings out an increased susceptibility for anthrax," he said.
Rowland said law enforcement officials are investigating to see if Lundgren's death is in any linked to the case of a Derby man, Amir Omerovic, 27, charged last week with sending letters threatening anthrax exposure to several state and federal offices.
Lundgren was the 11th person reported with the inhalation form of the disease. Of the 10 people previously identified as infected -- in Florida, New York, New Jersey and the District of Columbia -- four others have died.
In Washington on Wednesday, the congressional offices of Dodd and Sen. Edward Kennedy, D-Mass., were closed for anthrax decontamination purposes. Trace amounts of anthrax, believed caused by cross contamination via an anthrax letter sent to another member of Congress, were confirmed in the mailrooms for each senator.
(Dave Haskell in Boston contributed to this story)