Student Cases Not Linked to Fatal Illness

California health officials have investigated the unexplained deaths of two Humboldt State University undergraduates and a severe respiratory illness that struck a third student, but say they have found no link to an outbreak of a mysterious fatal disease in Arizona and New Mexico.

Investigators began looking at the unusual cluster of three cases that developed during the northwestern California school’s winter quarter before they learned last week of the outbreak of unexplained respiratory distress syndrome (URDS) centered on the Navajo reservation in the Four Corners area of Utah, Colorado, Arizona and New Mexico.

Health officials, who are only now releasing the details of the Humboldt State cases, said that two of the three California cases fit the URDS definition. But they stressed that they have found no link between the cases here and the Four Corners outbreak, where there have been 13 deaths, a majority of them American Indians.

“I don’t have any signal on our radar screen that we have this (Navajo-linked epidemic) in California,” said Dr. Richard J. Jackson, chief of the state’s Department of Health Services communicable disease division. “But we do have a large Native American population and we do have people who travel a great deal.”

On Thursday, the state health department asked county public health officials throughout California to begin reporting cases of unexplained respiratory distress in patients ages 5 to 45--a response to growing public concern over the Four Corners outbreak. The results will be forwarded to federal investigators.

The sudden occurrence of three cases of severe illness in healthy students between 20 and 22 years old at Humboldt State continues to baffle health authorities and illustrates the difficulty of tracking an epidemic--or even determining that there has been one.

The first undergraduate to become ill was a woman, who was eventually taken to UC San Francisco Medical Center for treatment. Like the patients in Arizona and New Mexico, she had enormous difficulty breathing and was placed on a respirator. She died in April, three months after the onset of her illness.

A second woman student had a similar illness but recovered after a week on a respirator.

The third undergraduate was a man, who died after reporting to the hospital with some breathing problems, but his main complaint was intestinal.

The two women met the standards for URDS established by the U.S. Centers for Disease Control and Prevention in Atlanta for screening of cases in the Navajo reservation outbreak, but the man did not, Jackson said. None of the three was an American Indian, officials said.

In all three cases, health authorities failed to identify the cause of illness after extensive testing, Jackson said.

After lengthy interviews with the surviving patient and the families and contacts of the other two, public officials could find no thread tying the three cases.

“The cases became a concern to local authorities and a concern to the physicians managing the patients,” Jackson said. “We thought there might be a common exposure, infectious or toxic, but we failed . . . to find either the cause of illnesses or a common pathway.”

The only thing that the three had in common, Jackson said, was that they were students at the same university.

Blood specimens have been sent to the Centers for Disease Control for more detailed analysis.

Investigators have noted that every year a number of people die from respiratory distress without a clear identification of the cause. If there is an epidemic in California--as there is in the Four Corners area--health officials would expect an increase in the number of cases, said Dr. Laurene Mascola, chief of acute communicable disease control for Los Angeles County.

Mascola said that the county is considering whether to review records of patients with unexplained respiratory distress who were discharged or died in county-run hospitals in recent years to see if there has been an increase in such cases. In addition, the county is receiving a number of reports of flu-like illness, but there is no indication that these are similar to those identified near the Navajo reservation.