WASHINGTON -- A New York woman died of inhalation anthrax on Wednesday, the fourth person to perish in a spreading wave of bioterrorism. A co-worker underwent tests for a suspicious skin lesion, heightening concern the disease was spreading outside the mail system.
Despite an intensive four-week investigation by the FBI and health experts, Attorney General John Ashcroft said, ''I have no progress to report'' in identifying the culprits or preventing further attacks.
''I think for the American people it's frightening, it's scary,'' conceded White House spokesperson Ari Fleischer, as authorities also reported a new suspected case of skin anthrax involving a New Jersey postal worker and closed the facility where he works.
President Bush and Ashcroft both employed humor in public appearances during the day -- a rarity in the weeks since the Sept. 11 terrorist attacks and onset of the spread of anthrax. Bush quipped he had been ''icing down my arm'' after pitching the ceremonial first ball at Tuesday night's World Series game, and the attorney general joked about a new haircut that had drawn unflattering reviews.
And there was cause for some optimism in the nation's capital, Dr. Patrick Meehan of the Centers for Disease Control and Prevention said no new cases of the disease had been reported in Washington for several days. Federal officials said some -- but not all -- local residents on medication could discontinue their antibiotics, a recommendation the city was studying.
Authorities expressed particular concern over the early morning death of Kathy T. Nguyen, a 61-year-old Vietnamese immigrant who lived alone in the Bronx and worked in a small Manhattan hospital.
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Doctors sedated her and put her on a ventilator after she checked into a hospital three days ago, and officials said she had been too sick to assist them in their investigation.
The woman worked in a basement supply room that had recently included a mailroom, but there were no reports of suspicious letters or other obvious cause for alarm -- a sharp contrast to other cases in which tainted mail has been linked to the disease.
''So far, all of the environmental tests at the hospital ... all of the environmental tests taken at her home'' have proven to be negative for anthrax, said New York Mayor Rudolph Giuliani. He said a sample taken from her clothing had yielded ''some indications'' of the bacteria and further tests were being completed.
At the White House, Fleischer told reporters that a co-worker of Nguyen at the Manhattan Eye Ear and Throat Hospital had reported a skin lesion that raised concern. ''Tests are being done. The tests were just undertaken, and so there's nothing even preliminary to report,'' he said.
In all, officials have tallied 17 cases of anthrax, including the first confirmed diagnosis on Oct. 4. There have been 10 cases of the inhalation form of the disease -- including all four deaths -- and seven occurrences of the less dangerous skin type. Tens of thousands of other people, many of them postal service workers, are taking antibiotics.
There was evidence of widening concern in occupations and locations where no anthrax has been found. In New Jersey, for example, officials ordered 1,300 toll takers on the state's turnpike to wear rubber gloves as a precaution when collecting money.
Fleischer and Ashcroft both stressed that extraordinary effort was going into the anthrax investigation.
''Specifically, in the case of Ms. Nguyen, they are following all her travels. They are trying to determine if she traveled anywhere domestically or foreign, who she may have come into contact with, any of the people that she's associated with to determine if they have any information about how she could have contracted the anthrax,'' said the White House spokesperson.
Nguyen's case was the second to spark concern among investigators that the anthrax was being spread outside the mail system. A 51-year-old New Jersey woman diagnosed earlier in the week with skin anthrax told authorities she has no recollection of opening suspicious mail at the accounting firm where she works.
Investigators' working theory is that the New Jersey woman contacted the disease through the mail, said Dr. Jeffrey Koplan, CDC director.
''The risk from mail is not zero. It is very low, but it's not zero,'' he said Wednesday. He said the New Jersey case was of concern because there was no known exposure linked to a particular letter or postal facility. ''That low amount of risk may translate into cases occasionally such as this.''
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, noted that these cases do not fit the previous pattern. ''We need to investigate intensely to see if there is another emerging pattern'' beyond anthrax-by-mail, he said. If so, he added, the public health response could change.
The new suspected case of skin anthrax involved a postal employee who works in New Jersey and lives in Delaware. ''He is not hospitalized, he's OK. We are very comfortable the exposure has not occurred in Delaware,'' said Dr. Ulder Tillman, director of the state's Division of Public Health.''
The man, whose name was not disclosed, is a mail processor in the Bellmawr, N.J., regional facility, which delivers mail to 1.1 million locations in southern New Jersey and parts of Delaware. The facility has been shut down.
The Bellmawr office is roughly 35 miles from a Hamilton mail processing center where three anthrax-tainted letters were handled. They were addressed to Senate Majority Leader Tom Daschle of South Dakota, NBC anchor Tom Brokaw and the New York Post.
The letter to Daschle triggered a shutdown of congressional office buildings, and coincided with the spread of contamination widely throughout government buildings in the nation's capital.
There was fresh evidence of anthrax Wednesday in preliminary tests on two of five mailbags sent from the State Department to the U.S. Embassy in Lithuania. Department spokesperson Richard Boucher said final test results would be available by Saturday.
At the same time, three post office facilities in the nation's capital that had been closed for decontamination were reopened during the day.
The city's main Brentwood facility, which tested positive for anthrax at numerous spots, remained shut down.
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