PMC3000148_01
Bioterrorism-related inhalational anthrax cases by week of symptom onset:United States, 2001.The first two cases of inhalational anthrax occurred in Florida. Though no direct exposure source was found, environmental samples of the media company in which these two patients worked and the postal facilities serving the media company yielded Bacillus anthracis spores specifically implicating a B. anthracis-containing letter or package:  , the letters to Senators Thomas Daschle and Patraick Leahy were postmarked in the Trenton, New Jersey, processing and distribution center on October 9, 2001; black bars indicate cases of inhalational anthrax in persons with direct exposure to a B. anthracis-containing letter; gray bars indicate cases of inhalational anthrax persons with no known B. anthracis exposure.
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Trenton, New Jersey (Figure 1).The patient in Connecticut was not in the known categories of intentionally contaminated letter recipients and was not a postal worker or a mailhandler. This report describes the epidemiologic and environmental investigation conducted to determine whether her case was related to the other bioterrorism-related cases; whether she was the only case in Connecticut or a sentinel of a larger outbreak; and the source, place, and time of her exposure. The clinical aspects of the case have been described.