2nd Death Rings No Alarm on Meningitis

The deaths from bacterial meningitis of two Orange County schoolchildren within a week are apparently unrelated and not the sign of an epidemic or disease outbreak, state and county public health officials said Monday.

“The bottom line is, there is nothing different going on this year than last year, so there is no reason for extraordinary precautions,” Hildy Meyers, county epidemiologist, said.

The latest death occurred Saturday when a Santa Ana third-grader, who had an earache midweek, died at Children’s Hospital of Orange County in Orange.

The 8-year-old boy, Felipe Carrillo, complained at Pio Pico Elementary School of a problem on Thursday, said Al Mijares, superintendent of the Santa Ana Unified School District. The boy did not attend school Friday but was taken by family members to the emergency room at CHOC, where he was given intensive treatment.

“It is extremely rare” to see such a rapid fatal development of the disease despite aggressive treatment, said James Cappon, a critical-care pediatrician at CHOC who treated the boy.

In the other fatal Orange County case, Ashley Williams, 13, a Cypress junior high school student, died Wednesday of bacterial meningitis and a blood infection, officials said.

In a coincidence Monday, physicians at CHOC were treating a second student from Felipe’s class for viral meningitis. But the two illnesses--one bacterial and the other viral--are not related, Meyers said. That child is in very good condition, hospital officials said. The viral strain of the disease is considered less serious, doctors say.

Health and school officials said they are unaware of any other cases at the Santa Ana school.

School officials took the precaution Sunday of phoning parents and spoke with the families of each of the 17 children in Felipe’s class. Several youngsters were evaluated after complaining of health problems, Meyers said.

Midmorning Monday at the school, two children were in the office complaining of either an earache or a stiff neck. Parents were contacted. School officials also were besieged with phone calls from parents, news organizations and public officials.

Also on Monday, the school staff distributed cautionary letters in English and Spanish to be taken home by students. About 900 children attend the K-5 school.

“It is a very, very tough situation,” Principal Judith Magsaysay said. “We are trying to reassure parents. It is very difficult to contract this.”

Health officials said parents should observe their children for symptoms of meningitis, which may include fever, vomiting, headache, stiff neck and a rash. If such symptoms appear, the child should get immediate medical attention.

Typically, the early symptoms can be flu-like but quickly “climb the symptom ladder” to high fever, stiff neck, excruciating headache and disorientation, Cappon said.

The district had a psychologist and a nurse, both bilingual, at the school Monday to speak with parents or children who needed counseling or reassurance. In the office, teachers and other staffers were contributing money to help Felipe’s family cover the funeral expense.

“Students seemed to be in a kind of state of shock and denial,” Mijares said. “We can’t neglect the grief of the family or the students.”

This year in Orange County, Meyers said, there have been four deaths among 53 cases of bacterial meningitis, which physicians and hospitals are required to report to the county. There have been 380 cases of viral meningitis, which is not life-threatening.

“There is no indication we are having an abnormal number of cases of meningitis,” Meyers said. Officials expect more cases, peaking in the winter or spring, she said.

Typically, the disease is transmitted by saliva, through kissing or sharing food among family members or intimates, health officials said.

Dr. Janey Mohle-Boetani, medical epidemiologist in Sacramento with the California Department of Health Services, said there is “no cause for alarm at this time.”

There would be a problem, she said, if there were “two or more cases of the exact same strain of one particular organism occurring within a [brief] time period in the same school.”

Perhaps 5% to 10% of the population carry in their nostrils the organism that causes bacterial meningitis, she said, and they do not have symptoms and are not causing illness in others. If there were several such cases, however, it “would suggest a particularly contagious or virulent strain was being transmitted in that school.”