Case Rise in Nonfatal Meningitis Strain Puzzling : Health: County officials stumped by near tripling of aseptic form. Symptoms include severe headaches.

Orange County this year has seen cases of a nonfatal form of meningitis nearly triple over the previous year, health officials said Tuesday.

The ailment, aseptic meningitis, is caused by a virus, and the symptoms include severe headaches, stiff necks, muscle aches and fatigue. Aseptic meningitis is an inflammation of the membranes surrounding the spinal cord. Victims frequently need hospitalization because of excruciating headaches, but the infection rarely causes long-term damage.

From Jan. 1 to the start of this week, Orange County had 310 cases of aseptic meningitis reported, a 189% increase over the 107 cases during the same period in 1991, officials of the Orange County Health Care Agency said. Health officials said it is the biggest outbreak of the ailment since 1987.

Health officials in Sacramento acknowledged that there has been “an upward trend” this year in the number of aseptic meningitis cases statewide, but nothing so remarkable as in Orange County.

Scott Lewis, spokesman for the state Department of Health Services, said there were 589 cases reported statewide as of June 30, compared to 389 for the same period in 1991. Lewis said there had been 459 aseptic meningitis cases for the first six months of 1990. “It’s cyclical in that it goes up and down (statewide),” he said.

But Orange County health officials said the outbreak of aseptic meningitis is beyond normal cyclical swings and is a cause for concern.

“The county usually averages about six to eight cases (of aseptic meningitis) per 100,000 (residents), and this year we’re showing about 12 cases per 100,000,” said Dr. Hildy Meyers, Orange County’s medical director of communicable disease control.

The virus that causes aseptic meningitis survives for long times in fecal matter, and babies, because of diaper contact, are frequent victims of the malady.

“About 40% of all cases affect children under the age of one year,” said Meyers. While the infection disproportionately affects children, many Orange County adults are suffering in the current upsurge of the infection. Meyers, however, said the health department did not have an age-group breakdown of the 310 cases of aseptic meningitis reported so far this year.

Rosalie DeSantis, nurse epidemiologist for Hoag Hospital in Newport Beach said that Hoag has mainly seen an increase in aseptic meningitis cases among young adults--people between 25 and 39.

“Adults can get the virus by coughing and oral secretions,” DeSantis said. “Adults that come to our emergency room (with the ailment) usually are seeking relief for the severe headaches. They say they could get no relief from their usual medications (for headaches).”

DeSantis said patients have been averaging a hospital stay of two to five days. “Most are hospitalized for pain management,” she said, referring to the severe headaches.

Children’s Hospital of Orange County and UCI Medical Center, both in the city of Orange, on Tuesday reported significant increases in aseptic meningitis cases.

Dr. Mitch G. Flores, associate director of ambulatory care services at CHOC, said the hospital had 100 cases in the last two months, compared to a normal ratio of about 80 cases every six months.

Patricia Hamm-Hayden, manager for infection control at UCI Medical Center, said the hospital has had 15 aseptic meningitis cases so far this year, compared to only 13 for all of 1991.

Meyers and other health officials said that people with the symptoms of aseptic meningitis should always see a doctor because the same symptoms could be signs of meningitis caused by a bacteria. Bacterial meningitis can cause brain damage or death.

Health officials said cleanliness, especially the washing of hands after bowel movements or handling of diapers, can help prevent the spread of the infection.