Officials Alert O.C. After Illness Kills 2 Children

Twelve-year-old Kori Emer came home from school Wednesday with a headache. By noon the next day, she was dead.

Authorities said Friday that she was the second child in Orange County in the last three weeks to die of meningococcus, a rare but highly aggressive disease. A seventh-grade classmate of hers at Costa Mesa High School is in critical condition with the disease at Children’s Hospital of Orange County and another patient was treated last month. An 8-year-old girl also died in January. The doctor overseeing all four cases declined to release information about the 8-year-old or the child who recovered.

The disease is treatable with antibiotics but can kill quickly if it is not diagnosed.

Public health officials and pediatric doctors on Friday cautioned parents and others not to panic, but to be alert.

“There is no outbreak. There is no epidemic,” said Dr. Hildy Meyers, Orange County Health Care Agency epidemiologist. “The number of cases is not unusual, especially in winter or early spring.”

In 1996, Orange County recorded 33 cases of meningococcus, with three deaths. Los Angeles saw its lowest levels of the disease in 20 years in 1995, but experienced some deaths last January during an especially virulent flu season. At any given time, up to 15% of the population is carrying the bacteria in their throats, Meyers said. Nationally, an average 3,000 cases are reported each year, with a 10% to 15% mortality rate.

“It is easily treated with antibiotics,” said Tom Skinner, a spokesman for the Centers for Disease Control in Atlanta.

But the disease, which is spread through sharing food or drink or prolonged exposure to an infected person’s coughing or sneezing, can rapidly ravage a body’s organs and immune system if not treated promptly. Those especially at risk include babies and young children in group settings, such as day care, people with compromised immune systems, and people with no spleens.

“Most kids will survive this, but for the one kid whose body can’t handle it, it is like setting off a nuclear bomb,,” said Dr. Antonio Arrieta, a pediatric infectious disease specialist at CHOC who treated Kori and is handling her classmate’s case. The bacteria spread through both girls’ bloodstreams, causing meningoccoxemia, rather than to their brain or spinal cords, which is called meningitis.

Kori Emer was a healthy child, an avid soccer player and reader, eager and worried all at once about her future, according to her mother, Gloria.

Kori came home from school with a headache Wednesday, took an aspirin, ate some food and then lay down, her mother said. By 6:30, she was hurting all over. Later she began vomiting, and her condition deteriorated through the night. Her parents took her to St. Joseph Hospital in Orange early Thursday morning and watched in horror as her breathing slowed, and a rash spread over her body.

“That’s the unfortunate part, it spreads so rapidly,” said her mother, who with her husband, Joseph, stayed at her daughter’s hospital bed. “In three hours, it was over.”

Kori’s younger sister, other family members, and closest friends were promptly vaccinated with the antibiotic rifampin. Wide-scale vaccinations are not used because the immunization wears off quickly, because resistance can build up to the drug, and because it would not be cost-effective to treat large numbers of people for a rare disease, doctors said.

Still, health officials urged anyone who had been in close contact with Kori and who has not seen a doctor to do so. Students were not at Costa Mesa junior and senior high schools Friday because they had already been given the day off to prepare for final exams.

“Thursday was Kori’s math exam,” her mother said. “She was so worried she was not going to be well enough to go when she first was getting sick. She was a good student, a high achiever . . . and she really loved her math class.”

Kori also was on the school’s all-star soccer team.

“Soccer and reading, those were her passions. Lately Danielle Steel was her favorite,” Emer said.

Kori’s aunt, Faith Cosatine, said her niece “was just a real special person, on the inside and outside.”

Her hospitalized schoolmate was in some of the same classes with her, and is on the volleyball team. The incubation period for the disease can be as long as 10 days, but usually lasts about three. School officials plan to have classes as usual Monday.

Orange County Public Health Officer Hugh Stallworth warned parents not to panic: “There is not a lot to fear. Just by being in the same school with someone doesn’t mean you need to be worried about getting bacterial meningitis.

“Ordinarily, in very young kids--kindergarten or first grade, the age group where kids are touchy feely--if a child develops a bacterial meningitis, then we recommend that everyone in the class get [preventive] treatment.”

Because older children do not typically touch each other as much, the Health Care Agency has only recommended that family members and people who may have had close contact with the sick students see a doctor.

“The symptoms are very similar to the flu: You feel bad; you have a fever, maybe a cough and a headache. Then the headache becomes more severe and the neck becomes painful,” Stallworth said. ‘Someone who has had a severe headache and has been noticing a stiff neck should contact their physician to let them know of the symptoms.”

Meyers said that if a rash is noticed in conjunction with a high fever or other symptoms, medical treatment should be sought promptly.

“If I saw those rapidly spreading bruises, I would take the person to the emergency room myself,” she said.

A public health official will be available to answer questions from 8 a.m. to noon today at (714) 834-8180.

Also contributing to this report were Times staff writers Tina Nguyen, Scott Martelle and Ken Ellingwood.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

A Fast-Moving Threat

Two Orange County children have died in the last three weeks and two others are sick with the rare, life-threatening bacterial infection called meningococcus. About 3,000 cases occur nationwide each year, with a 10% to 15% mortality rate.

Who’s Most at Risk

* Babies and young children, especially in day-care settings

* Those with a compromised immune system or no spleen

Symptoms

* Sudden high fever, nausea, vomiting

* Intense headache

* Stiff neck

* Sensitivity to bright light

* High, shrill cry in infants, children

* Spreading pink rash or rapidly spreading bruises

How It Spreads

* Contact with infected person’s saliva or nasal fluids

* Sharing food and drinks

* Kissing

* Direct, hours-long contact with someone coughing or sneezing

What to Do

If rash and bruises appear, contact doctor at once and go to emergency room

Source: Children’s Hospital of Orange County