posted on wed, mar. 05, 2003
5th meningitis case spurs meeting
area in 'outbreak,' iu expert says
by andy gammill and ryan werbeck
the journal gazette (ft. wayne, in)
the number of bacterial meningitis cases in northeast indiana rose to five this week, prompting school and health officials from around the area to meet tuesday.
the fifth and most recent case is a female new haven high school student, said dr. deborah mcmahan, allen county health commissioner. lab tests could not confirm that the student has meningitis, but it is presumed she does, mcmahan said.
indiana state epidemiologist dr. james howell attended the meeting, and a spokeswoman for the federal centers for disease control and prevention said the cdc is assisting in the response.
state officials didn't make recommendations at the meeting, the purpose of which was simply to open lines of communication, howell said.
mcmahan called the meeting to ensure everyone is using the same criteria in their decision-making, she said.
"when dealing with something communicable, you need to get everyone on the same page," she said. "the schools have been working very closely with us."
the new haven case follows three cases that forced a huntington county elementary school to close for several days and a fourth in whitley county this week.
meningitis causes swelling and inflammation of the brain or spinal cord and can be fatal.
health officials have been unable to determine whether the cases in northeast indiana are related, and it's too early to tell whether there's cause for concern, howell said.
"it may all be connected," he said. "we just don't know yet."
an indianapolis-based meningitis expert, however, said it's suspicious to have five cases in a concentrated area.
"in adjacent counties i would be very worried about this," said dr. karen roos, a neurology professor at the indiana university school of medicine. "that is an outbreak, definitely."
the type of meningitis involved locally can be spread by kissing, coughing, sneezing or sharing drinks or food utensils. it cannot be spread by casual contact.
symptoms include fever, severe headache, stiff neck, vomiting and confusion. meningitis in isolated cases is not uncommon; six people were diagnosed with it in allen county alone last year.
although everyone agrees meningitis is a serious health risk, the doctors are at odds as to how schools should respond.
mcmahan will not close allen county schools or order them cleansed, as has been done in huntington and whitley counties, she said. the bacteria don't live long outside the human body, making the cleaning unnecessary, she said.
closing school puts additional people at risk because it takes a relatively small group that has already been exposed to the bacteria and puts them into the community at large where they could pass it on to others, mcmahan said.
but roos, who works with meningitis patients, said she would close the schools for a week during an outbreak.
"normally after someone is sick in your school, the incidence would be in the first five to seven days," she said. "i would close schools for a week."
howell's office will help communities work through that decision but can't make it for them, he said.
smith-green community schools superintendent david martin canceled classes tuesday after learning a high school student had contracted bacterial meningitis.
the health department advised him that was unnecessary, but he said he felt safer canceling classes for a day.
"would i be willing to send my children into that situation without cleaning the school?" martin asked. "the answer is no."
the district's schools are expected to be open today.
the high school student, who also attends anthis career center in fort wayne on a part-time basis, became ill friday, and his diagnosis was confirmed late monday.
the student remained hospitalized tuesday, martin said.
"had we had more time (monday), we could've had some things taken care of and had school today," martin said.
whitley county's health department didn't see the need for the schools to close, nurse heather reed said.
"we didn't feel the school should be closed because there was just one case," reed said. "it's rare that you should close a school, but that's at the discretion of the superintendent and school board."
reed said the school's decision may have been influenced by the closing of northwest elementary in huntington county last week. three students in eight days were diagnosed with bacterial meningitis. two are home recuperating, while the third remains hospitalized.
martin said he based his decision partly on what happened in huntington county but considered other factors as well.
among those was whether the school had enough time to start cleaning and to communicate with parents about what was happening. because of the late developments monday, martin said, accomplishing those goals wasn't possible.
crews spent tuesday disinfecting the schools, martin said.
"we are cleaning every surface kids would touch," martin said. "we're cleaning the buses, the cafeteria tables - we're even washing the dishes again."
the student's classroom at anthis career center was disinfected tuesday, and parents of students in that class have been contacted, said deborah morgan, a fort wayne community schools spokeswoman.
smith-green officials also have contacted parents of students who had close contact with the student, martin said.
a meningitis outbreak means parents in the area should be on high alert, roos said.
part of her work at iu has included modeling how meningitis moves through a community. although outbreaks are usually short, they can have devastating effects, she said.
that means parents should seek immediate medical treatment when children have symptoms that would seem mild under other circumstances, she said.
"if your child gets a fever and a headache and a stiff neck, it's a medical emergency," roos said. "you have minutes, maybe hours. you can't screw around with it. i wouldn't assume these kids have the flu."
meningitis is particularly dangerous because people can carry it without knowing they have it, roos said.
"people are carriers but don't get sick," she said. "what determines if you get sick with this is your own immune system, subtle characteristics in your immune system."
people can protect themselves by washing their hands thoroughly and can protect others by covering their mouths when they cough or sneeze, mcmahan said.
anyone other communities experiencing outbreaks? we had a case of aseptic meningitis at our facility. kid is doing well....
Mar 5, '03
We had an outbreak about two years ago at the UMD med school. Two friends of mine were attending at the time, and one of the striken students was the friend of my friend's boyfriend's roommate. Not exactly a close relationship to her, but still, she was spending a lot of time at her boyfriend's house, and one of the people living there may have been exposed to it.