By GEOFF CUMMING and AGENCIES
For more than 20 years, Vietnamese immigrant Kathy Nguyen walked unnoticed through the streets of her decrepit Bronx neighbourhood - walls painted with graffiti, broken glass on the street and guys hanging around the liquor store.
She wore nice hats on her neatly cropped hair, was softly spoken and would not have left a lasting impression if she had not died yesterday of inhalation anthrax.
Her death, the fourth in a month, has baffled investigators because it is the first not directly linked to the postal service or the news media.
Nguyen's infection, and the case of a New Jersey accountant with the less serious skin anthrax, has heightened American anxiety that anthrax-laced letters could "cross-contaminate" other mail. Experts say the spores could be infecting people by other, unknown, means.
Nguyen, who lived alone and had no family, commuted by subway every day to her job in a storage supply room in the basement of the Manhattan Eye, Ear and Throat Hospital. Until recently the space included a mailroom, but she had no direct contact with the mail and there is no evidence of any suspicious letter.
Her death will make it even more difficult for investigators to track the source of her disease and to trace the last days of her life, which letters she opened, where she visited and whether she noticed anything suspicious.
Neighbours told local television that the woman, who went to the US in the 1970s, lived a quiet life. She had owned a bar in Vietnam, but lost most of her family in the Vietnam War and left with little more than the clothes on her back.
She married an American and had a son. The marriage ended in divorce and the son died several years ago in a car crash.
This week as she lay gravely ill in hospital, biohazard workers poured into her neighbourhood for environmental testing as they tried to solve the puzzle of her infection.
A worker at the local grocery store said: "If she could die from anthrax, then it could be anybody."
Nguyen worked late and spent her free time shopping, often visiting New York department stores.
Late last week she complained to her neighbours about respiratory problems that she believed were just a cold. But Nguyen had become the first person in New York to contract the more dangerous inhalation form of the disease.
White House spokesman Ari Fleischer said her death was a cause for concern and that preliminary tests of her home and workplace showed no indication of the anthrax bacteria.
An autopsy would be conducted to discover whether the bacteria that infected her was related to those involved in other anthrax deaths.
Thomas Rich, a colleague of Nguyen, said "almost everyone in the hospital came in contact with her" because she delivered supplies to departments and offices.
Up to 2000 hospital workers, patients and visitors who have been to the hospital since October 11 are being offered antibiotics and the hospital is closed.
Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the case was more perplexing than others.
"To have a situation where she gets inhalation anthrax and no evidence thus far in the place where she worked of there being anthrax makes this a very puzzling mystery," he told NBC.
He would make every effort to track the source of the disease.
Another case in New Jersey, where a female accountant has the skin form of the disease, has further heightened fears of "cross-contamination".
The woman works in Hamilton township, where several postal facilities have been contaminated.
Dr Fauci said it was "not far-fetched at all" that the woman, who was organising her daughter's wedding, had received a cross-contaminated letter.
In a fresh case yesterday, an employee at a regional mail facility in Bellmawr, New Jersey, was confirmed with skin anthrax. The plant is about 55km from the Hamilton sorting centre that processed letters sent to Senator Tom Daschle's office in Washington, NBC News in New York and the New York Post.
The 54-year-old man was said to be doing well enough on antibiotics to return soon to his job.
The number of confirmed cases now stands at 17.
Ten have the inhaled form, including the four who died.
One victim from Washington's main mail sorting house, Joseph Curseen jun, 47, died within hours of admission to a Maryland hospital.
The others have less severe skin infections.
The inspector in charge of the US Postal Inspection Service's main forensic laboratory told Associated Press that investigators were confident only three anthrax-tainted letters had been sent through the mail, despite concerns from medical experts that not all envelopes containing anthrax had been found.
"I still think we're dealing with three letters," said Roy W. Geffen, who runs the laboratory in suburban Virginia.
"That's the best information we have."
Story archives:
Links: Bioterrorism
Timeline: Major events since the Sept 11 attacks
New death deepens mystery of anthrax
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