CDC Update: Connecticut Anthrax Case Confirmed, New York Subway Samples Negative; MMWR Notice on Minnesota Knee Surgery Cases

Connecticut Inhalation Anthrax Case Confirmed

CDC has confirmed a case of inhalational anthrax in Connecticut. CDC was contacted by the Connecticut Department of Public Health about a respiratory illness in a 94-year-old female which preliminary tests had indicated to be anthrax. CDC conducted PCR (polymerase chain reaction) testing on specimens from the woman and confirmed anthrax. In addition to confirming the anthrax case, CDC has sent a team to Connecticut to assist state health department officials.

Summary of Local, State, and Federal Confirmed Human Cases and Exposures

Case Status Florida New York City New Jersey Washington, DC Connecticut Total

Confirmed 2 5 5 5 1 18

    Cutaneous 0 4 3 0 0  

    Inhalational 2 1 2 5 1  

Suspect 0 3 2 0   5

    Cutaneous 0 3 2 0    

    Inhalational 0 0 0 0    

CDC confirmed cases are based on a rigorous case definition, which was published in CDC’s Morbidity and Mortality Weekly Report (MMWR) on October 19, 2001. The MMWR is available on-line at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5041a1.htm.

CDC defines a confirmed case of anthrax as 1) a clinically compatible case of cutaneous, inhalational, or gastrointestinal illness that is laboratory confirmed by isolation of B. anthracis from an affected tissue or site or 2) other laboratory evidence of B. anthracis infection based on at least two supportive laboratory tests. CDC defines a suspect case as 1) a clinically compatible case of illness without isolation of B. anthracis and no alternative diagnosis, but with laboratory evidence of B. anthracis by one supportive laboratory test or 2) a clinically compatible case of anthrax epidemiologically linked to a confirmed environmental exposure, but without corroborative laboratory evidence of B. anthracis infection.

Cutaneous anthrax is a boil-like skin lesion that eventually forms an ulcer with a black center or crust (similar in appearance to some spider bites).

The cutaneous form of anthrax responds well to antibiotics if treatment is started soon after symptoms appear, such as in this case.

Individuals should, especially in areas that have been directly affected, review and be familiar with advice provided to all postal patrons by the US Postal Service and follow that advice.

New York City Update

Environmental samples taken from subway stations as part of the investigation into the case of inhalation anthrax in New York City have come back negative for anthrax. The samples, taken earlier this month, were sent to CDC for analysis. Environmental tests were conducted in subway stations along the "Number 6" line as part of an investigation into the inhalation anthrax death of a woman who worked at the Manhattan Eye, Ear, and Throat Hospital. No evidence of anthrax has been found in the woman's apartment or in her place of work.

MMWR 11-23-01: 

This week’s Morbidity and Mortality Weekly Report includes the Notice to Readers: “Unexplained Deaths Following Knee Surgery — Minnesota, November 2001.” The MMWR is available online at www.cdc.gov/mmwr.

For the latest update on CDC activities and on-going anthrax investigations visit www.bt.cdc.gov or www.cdc.gov/media.