Hospital worker becomes fourth anthrax fatality

A hospital worker with a mysterious case of inhalation anthrax died early today, the fourth fatality from the disease in the United States.

Kathy Nguyen, 61, died three days after checking herself into the hospital and being diagnosed as the city's first case of the inhaled form of the disease.

Lenox Hill Hospital spokeswoman Ann Silverman said Ms Nguyen died early Wednesday. She would not provide any other details.

Ms Nguyen had been sedated and put on a ventilator and was too sick to help the health and criminal investigators who are trying to find the source of her infection by reconstructing her social life, her commute and her job routines at the Manhattan Eye, Ear and Throat Hospital.

Her illness and that of a New Jersey woman who contracted the less serious skin form of the disease, complicated the investigation by raising the possibility that anthrax letters are contaminating other mail or that people are being infected by means other than the mail.

The latest victims raised the number of confirmed anthrax cases to 17 nationwide since the outbreak began in the first week of October. Ten of the victims have the inhaled form, and four have now died. Seven others have less–severe skin infections.

Four of those skin–anthrax cases – and two more suspected cases – are linked to city media outlets.

Ms Nguyen, who lived alone and commuted to the hospital by subway from the Bronx, worked in a basement supply room. Until recently, the space had included a mailroom, but there was no evidence of any suspicious letter and the first environmental samples from the hospital were negative.

"Almost everyone in the hospital came in contact with her," because she delivered supplies to various departments and offices, said Thomas Rich, a coworker.

As many as 2,000 hospital workers patients and visitors who have been to the hospital since Oct. 11 are being offered antibiotics, officials said Tuesday.The hospital was closed and other hospitals in the city were alerted to take precautions and report any suspicions.

Dr Anthony Fauci of the National Institutes of Health said worries about "cross–contamination" – anthrax spores sticking to pieces of mail at postal facilities – have grown with the new cases.

Dr Fauci said preliminary tests show no anthrax at the hospital where she works and "that's part of the mystery."

Contamination of postal facilities in Washington, New Jersey and Florida has altered investigators' assumptions about how easily the spores can be spread. Postal Service equipment and procedures, too, are under re–examination.

Officials at the federal Centers for Disease Control and Prevention are now keeping an "open mind" about cross–contamination, a spokesman said – a stark change from a week earlier.