By Dorsey Griffith and Pamela Martineau
The Sacramento Bee Staff Writers
A 17-year-old girl
at Folsom High School died Wednesday of meningococcal disease, the second student
at the school to succumb to the illness in the past month.
Tanya Edsall's
death has prompted a full-fledged investigation by Sacramento County health officials
looking for a possible outbreak.
"I am not prepared to say we have no public
health emergency," said Health Officer Glennah Trochet. "We need to do a more
thorough investigation. It will take several days to figure this out."
Edsall
died early Wednesday at Mercy Folsom Hospital of meningococcemia, a bacterial
blood infection related to meningitis. Her death follows the Jan. 7 death of Folsom
High student Robert Karle, 18. Health officials have not linked the two deaths.
Two
other area students also have contracted the disease in recent days. Zach Fodge,
a student at Oak Ridge High School in El Dorado Hills, was diagnosed with meningococcal
meningitis in late January and is recovering. Another student from Center High
School in Antelope, who has not been identified, appears to have contracted meningococcemia,
Sacramento County health officials said.
News of a second teen death has
panicked families throughout the region, Trochet said. However, only the family
members and those who may have kissed or shared eating utensils, lipstick, drinks
or cigarettes with the affected teens are being asked to take preventive antibiotics.
"Giving
antibiotics to everybody will only guarantee we produce a resistent bacteria,"
Trochet said. "We want to be sure we give antibiotics responsibly."
Officials
at Folsom and Oak Ridge high schools sent students home with warnings about potential
risks of the potentially deadly disease.
"Kids tend to think they are immortal,"
said Jill Solberg, principal of Folsom High School. "We have talked and talked
about not sharing pop and not sharing water. But we just had some kids come in
awhile ago who said they shared Chap Stick with Tanya. We told them they have
to go get treated."
Aside from the two deaths, a third Folsom High School
student became sick last month with meningococcemia, but that case was never confirmed
by a laboratory test, said Pamela Bradley, a Sacramento County nurse-epidemiologist.
In
that case, the student was treated with antibiotics and fully recovered, but the
student's doctor did not alert county health officials until after Karle's death,
Bradley said.
Sacramento County has nine confirmed cases of meningococcal
disease this year, including both meningococcemia -- an infection of the bloodstream
-- and meningitis, an infection of the fluid that surrounds the brain and spinal
fluid. The Folsom students are the only deaths; Karle's mother also contracted
the disease but survived.
Last year, the county had 21 cases of meningococcal
disease with two fatalities, which also happened very close together. None of
the cases were linked, Trochet said.
Trochet said she is in contact with
the state Department of Health Services, which will assist in the investigation,
particularly because of the proximity of the cases in Sacramento and El Dorado
counties.
The recent cases were enough to prompt one area physician to
alert the media Wednesday morning. Dr. Randy W. Martin, a Roseville infectious-disease
specialist who treated Karle's mother, said it appears there are more cases in
the area than normal.
"There is a need for public awareness," he said.
"Whether there can be anything else done -- that is a question open for debate."
He
said if there is a higher concentration of bacterial meningitis in the Folsom
area, there may be a reservoir of the bacteria that has yet to be identified,
a process that is both time-consuming and costly.
"We are not hearing about
meningitis down in the Elk Grove area, for example," he said.
Meningococcus,
the organism that causes meningococcal meningitis and meningococcemia, is not
uncommon. Ten percent to 20 percent of the population carry the bacteria in their
nose and throat and never suffer an illness. Why a healthy adolescent succumbs
to a serious infection is still not understood.
About 3,000 cases of meningococcal
disease occur each year in the United States; 10 percent to 13 percent of those
patients die. Bradley said the Centers for Disease Control and Prevention considers
10 meningitis cases out of 100,000 people an epidemic. In Sacramento County, the
rate so far this year is less than 1 in 100,000.
Neighboring Placer County
has no reported cases of meningococcal disease this year, according to Mark Miller,
director of communicable disease control. The county had six in 2000, including
one death. Those six cases included one in Roseville and another in Auburn, both
reported in December.
"We consider those to be single, sporadic cases,"
Miller said. "They all concern us, because they can be very serious, especially
in otherwise healthy young people."
In El Dorado County, the Oak Ridge
High student appears to be the only case of meningococcal meningitis, said Health
Officer Dr. Stephen G. Drogan. Two non-fatal, unrelated cases -- one of viral
meningitis and one of pneumococcal meningitis -- also have been reported this
year, he said.
Bradley said the Sacramento County health department has
contacted the mayor and city manger of Folsom about the deaths at the high school.
"We
wanted to let them know what is going on because there is so much concern in that
community," she said.
Donna Nichols, parent of a Folsom High School student,
said the most recent death has terrified her family.
"I am freaking out,"
she said. "It's to the point where I'm wondering whether I should keep my daughter
home."
Trochet said parents should not do that, but should stress practicing
prevention.
"We really can't predict who is going to get this disease,"
she said. "If kids do not share personal items such as lipstick and drinks, and
if they cover their mouth when they cough, their risk of getting this disease
is small. Kids tend to share their saliva. That is what puts them at risk."
Complicating
the diagnosis of bacterial meningitis is the fact that its symptoms mirror those
of the flu. They include fever, headache, neck pain, confusion and sleepiness.
Meningococcemia victims typically get a dark red rash.
There is a vaccine
against some types of bacterial meningitis, but it does not work against Type
B, which represents about half the cases seen in the area and is most likely what
killed Robert Karle, Trochet said.
The American Association of College
Physicians has recommended that all entering college freshmen who live in dormitories
get the vaccine. The CDC and Prevention has recommended that health care providers
give college-age students and their parents information about the disease and
the benefits of vaccination.
Dr. Martin said Edsell was admitted to the
intensive care unit early Wednesday morning with mental confusion and a rash.
"She
was on life support," he said. "They had a blood pressure problem and her kidneys
didn't want to work. Within an hour, she had passed away."
Edsell moved
to Folsom last year from Oregon and last attended school Monday. Solberg said
the young woman particularly loved art classes and worked as an assistant in the
school office.
"Her art teacher was just talking about what a wonderful
kid she was ... who gave 105 percent of herself all the time," Solberg said. |
