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New Jersey Health Commissioner Holds Press Conference

Aired October 25, 2001 - 14:59   ET


AARON BROWN, CNN ANCHOR: A New Jersey health commissioner, among others, is talking to reporters about the situation there, so we'll listen in for a bit.


DR. GEORGE DIFERDINANDO, N.J. HEALTH COMMISSIONER: ... Hamilton site. A few days ago we went from seven to 10 days. Now we're going to extend it to 60 days, the full course. That's based on further evaluation of our environmental sampling, which has shown positive cultures at various sites with in the facility.

We're also going to recommend that 60-day treatment for the people at West Trenton, although our data isn't as firm for that facility. But we feel that that's the best thing to do. This will not require people to come back a third time, or a fourth time if we do have to keep them on for 60 days. If we don't have to keep them on, recommend they stay on it for 60 days, we'll announce that to them and to the press, and then they'll be able to stop their treatment.

There was a rumor yesterday and another rumor today -- this is about the inhalational case from Mount Holly. There were several rumors going around about her condition. I can tell you that just within the hour I was on the phone with the vice president for medical affairs in Mount Holly. He informed me that she is in stable, but improving condition. So I would just urge you, if you do hear these rumors -- I know people have come back to me -- we didn't mind tracking them down, but as far as we all know, she has maintained her stable and gradual improvement. And we hope to continue to see that.

Now Dr. Bresens (ph) will talk to you about a suspect case that we have, as well as update you on the environmental evaluation of Hamilton that's leading to this recommendation for extension of therapy.

UNIDENTIFIED MALE: Good afternoon. As you know, at the last time we met we talked about our active surveillance system developed with the Centers for Disease Control and Prevention. We were reaching out to the medical community, including hospitals and medical practitioners, asking them to be on the lookout for suspected cases of anthrax, either cutaneous or inhalational.

As part of that active surveillance system, we have been evaluating an individual who potentially has inhalational anthrax. She has been hospitalized at a local hospital, and in addition, she has symptoms that are compatible and similar to two of the other inhalational cases, namely the individual in Boca who is still alive, as well as the most recent case that Dr. DiFerdinando mentioned.

She's an individual who worked in the Hamilton Township facility over the time period since September 18. And as Dr. DiFerdinando mentioned, that facility has demonstrated to have environmental contamination at various locations throughout the facility. So with that particular pattern, she meets the definition of someone who possibly may have inhalation anthrax.

Today we sent samples to the Center for Disease Control for testing. As I mentioned, we continue to reach out to the medical community on a daily basis. Finally, I'd like to report that to date we've had a little over 1,100 nasal swabs done on individuals who worked at the Hamilton Township facility. So far, a little over 800 of those are negative. We have no positive nasal samples to date. The rest of the samples are still pending.

I think this underscores our previous statements that nasal testing in fact is not a terribly useful test for either diagnosis or even evaluation of contamination facility. Thank you.

DIFERDINANDO: And I turned off my cell. Let's all turn off our cells. I don't know about you. I've got two or three cell phones.

There were some -- we are working very closely with the United States Postal Service, as well as with the Department of Health and Human Services in Washington, the Social Security administration. Many different organizations have been -- that we've been chatting with over the past few days, as well as the departments of health of New York City, New York state, Pennsylvania.

All of us are working to make our various recommendations as consistent as possible to deal with some of the issues that all of us have been struggling with, certainly in the press, and those of us who are giving out these messages. But the people who are listening to these messages, we are all trying to make these messages as consistent as possible, in the light of changing science.

I think we've seen very clearly over the past several days, both in my statements and in statements that have been made across the country, that we continue to learn about this situation. And so while it is absolutely valid for people to ask various questions and to point out the differences, I think the differences, to me, are clearly coming from the fact that we have extremely complicated, as they say, fact patterns. These fact patterns continue to be analyzed.

We are working with the postal service to decide whether other testing might be necessary, or other treatment might be necessary. We have nothing to announce for on you that right now, other than what was announced by the postal service yesterday. And that was that environmental testing was done at the Carteret facility.

That facility, for those of you who aren't aware of it, is a -- I don't know the exact term -- a staging facility, where the boxed mail from Hamilton goes. And the boxes really are then secondarily transported to other parts of the country, either New York City, Washington, in the cases that we're talking about, or other places around the country.

Our consideration that at least one contaminated letter, specifically the Daschle letter, and potentially more than one of the letters that we've been talking about went through the Carteret facility -- led us to recommend preventive prescriptions for the approximately 125 people at that Carteret facility, as well as doing some environmental testing.

We don't believe that there's a high likelihood that there's contamination there, but we thought it was the prudent thing to do. Other than that, I think we're ready to take questions, unless Dr. Bresens (ph) has anything else.

QUESTION: The case in Mount Holly is still considered suspected. Have the other cases that are pending -- can you just again describe exactly how are those turned, that seemed like anthrax, and what does it take for you to be sure?

UNIDENTIFIED FEMALE: We developed very specific criteria for what we would consider a confirmed case. And there's a reference for that, which was actually in our publication last Friday morning, the MMWR, you can get it off of our Web site. And essentially, for a case to meet the criteria for a confirmed case, we have to have essentially isolated organism from some part of the body, or have more than one, what we have defined as supportive laboratory results.

And as I say, I think it's important to focus the specific wording so that you understand exactly what I'm talking about. In the case of the patient in Mount Holly, she's currently classified as suspected, because she has clinical symptoms which are compatible. She has exposure which is compatible, but she has only one type of positive laboratory test, which is considered to be supportive, and not a sort of confirmed laboratory test.

We are doing additional types of laboratory tests, and if we find one of those additional types of laboratory tests to be positive, we would then -- she would then meet the definition for a confirmed case. And these definitions are definitions that we're applying in a consistent fashion across all of the cases that we're investigating.

QUESTION: When will you know, Doctor?

UNIDENTIFIED FEMALE: When will we know? It's hard to say. The laboratory at CDC is extremely busy, stressed. And there are a number of different kinds of tests that we're working on simultaneously. And I really can't tell you when we will know for sure.

QUESTION: The new case, is that considered a suspected case?

UNIDENTIFIED FEMALE: No, it is not. The new case is not a suspected case. The new case has a clinical picture which is not inconsistent with inhalational anthrax. We have no laboratory data at the moment to support such a diagnosis. This person is not a suspected case.

DIFERDINANDO: The reason -- just to clarify. We're giving this information with the idea that you want the information earlier, rather than later. So we're actually pushing back behind the definition of the Centers for Disease Control definition, to give you information prior to the lab results even being ready.

So you're getting this information we will get you. So for all the questions about when it will be available, we'll share that information with you as soon as we have it.

QUESTION: Can you give us some more details, as far as when they were hospitalized (OFF-MIKE) when was she hospitalized.

UNIDENTIFIED MALE: I think that -- and I've given you limited information. She clearly had respiratory symptoms, because it's considered an inhalational case.



QUESTION: ... but the CDC is saying it's not, if I understand it right.

UNIDENTIFIED MALE: Well, I believe that when I presented -- yes.

Right. As I described this, this was a possible case of inhalational anthrax. That was the terminology that I used. And since I used that terminology, you can assume that the individual has respiratory symptoms. There were a number of tests that were done when she was admitted. Specifically, what's of most importance are cultures -- cultures of whatever fluids are available: blood cultures, cultures from the respiratory system, and others.

Those tests, to date, have been negative. They've been negative for anthrax. So right now we have no laboratory evidence that she has anthrax. However, because of the fact that she was a postal worker who worked in the Hamilton Township facility, she worked in the time frame where we have already had other cases. And she worked in a facility that we know to have environmental contamination with anthrax.

And she has a clinical picture that is similar to other cases, suspected cases in New Jersey, and the other one in Florida. So our mind, this is a person that could have inhalation anthrax. But I'll reinforce that it's still considered a possible case, as opposed to suspected. And the definition of "suspected" was basically described by Dr. Bell.

QUESTION: And her age?

BROWN: New Jersey health officials trying to sort out what is -- and we are enormously sympathetic to them. We've struggled with this often, as they try and explain the distinctions that they're drawing here. The headline, it would seem to me, is this: they have a patient who is showing the symptoms that would suggest inhalation anthrax. They don't have a single test that confirms that. And they are running a number of them.

And so what they're trying to do is say, look, we know you -- that would be us -- want to know this stuff. We're getting it to you as quickly as we can, but we're not sure yet what we have. I think that's a fair characterization of it.

There is a woman who is exhibiting the signs of inhalation anthrax who worked near the facility that is in question in Trenton, and they are continuing to check her, but that is a possible other case. We have another case of anthrax in the Washington, D.C. area, State Department mail facility there. So this thing continues to expand, in terms of the number of people affected.

At the same time, we want to say it's not broadening. And what we mean by that is it's not showing up in Omaha or Detroit or Cleveland or anywhere else -- now. It still seems to be Trenton, New York, Washington, that axis.

Gary Tuchman is at the Trenton, New Jersey mail facility where this all seemed to begin -- Gary.

GARY TUCHMAN, CNN NATIONAL CORRESPONDENT: Aaron, one thing you note, when you listen to news conferences like this, is we are hearing terms and words that we never imagined we'd hear before -- "possible anthrax, suspected anthrax, confirmed anthrax" -- it's all very new to us. What we know now is that there's a woman who works here who has a possible case of anthrax. That's a step below a suspected case.

We also know a few days ago that there's a woman who works here who has a suspected case of inhaled anthrax. Two women here who may have anthrax that work in this processing facility in Hamilton Township, New Jersey. We said just a short time ago, we'll say it again. After this news conference now, it's still -- this is the only facility in New Jersey that has tested positive for anthrax spores.

There's a post office a few minutes away from here that has not tested positive for anthrax spores. However, a letter carrier...

BROWN: Gary, I'm going to interrupt you. This is one of those cases where the wind won out. And the wind was blowing so hard through the microphone that we couldn't hear it. But I think the essential information there has been passed along. There's a case that they are looking at very carefully now in New Jersey, because there are symptoms in another postal worker that suggest the possibility -- how many disclaimers can I put in one sentence? -- suggests the possibility of an inhalation anthrax case.




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