Griffith Kevin S, Mead Paul, Armstrong Gregory L, Painter John, Kelley Katherine A, Hoffmaster Alex R, Mayo Donald, Barden Diane, Ridzon Renee, Parashar Umesh, Teshale Eyasu Habtu, Williams Jennifer, Noviello Stephanie, Perz Joseph F, Mast Eric E, Swerdlow David L, Hadler James L
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Emerg Infect Dis. 2003 Jun;9(6):681-8. doi: 10.3201/eid0906.020728.
On November 20, 2001, inhalational anthrax was confirmed in an elderly woman from rural Connecticut. To determine her exposure source, we conducted an extensive epidemiologic, environmental, and laboratory investigation. Molecular subtyping showed that her isolate was indistinguishable from isolates associated with intentionally contaminated letters. No samples from her home or community yielded Bacillus anthracis, and she received no first-class letters from facilities known to have processed intentionally contaminated letters. Environmental sampling in the regional Connecticut postal facility yielded B. anthracis spores from 4 (31%) of 13 sorting machines. One extensively contaminated machine primarily processes bulk mail. A second machine that does final sorting of bulk mail for her zip code yielded B. anthracis on the column of bins for her carrier route. The evidence suggests she was exposed through a cross-contaminated bulk mail letter. Such cross-contamination of letters and postal facilities has implications for managing the response to future B. anthracis-contaminated mailings.
2001年11月20日，康涅狄格州农村的一名老年妇女被确诊感染吸入性炭疽。为确定其感染源，我们开展了广泛的流行病学、环境和实验室调查。分子亚型分析显示，她的分离株与故意污染信件相关的分离株无法区分。在她家中或社区采集的样本均未检测出炭疽芽孢杆菌，她也未收到来自已知处理过故意污染信件机构的一类信件。在康涅狄格州地区邮政设施进行的环境采样中，13台分拣机中的4台（31%）检测出炭疽芽孢杆菌孢子。一台严重污染的机器主要处理大宗邮件。另一台为她所在邮政编码进行大宗邮件最终分拣的机器，在其投递路线的邮袋列上检测出炭疽芽孢杆菌。证据表明，她是通过一封交叉污染的大宗邮件感染的。信件和邮政设施的这种交叉污染对管理未来应对受炭疽芽孢杆菌污染邮件的工作具有重要意义。
