December 15, 2010

Death of child prompts Maine meningitis alert

By John Richardson jrichardson@pressherald.com
Staff Writer

The death last week of a 2-year-old Westbrook girl from what appears to be meningitis prompted a statewide health alert and notices this week to parents of schoolchildren in the area.

BACTERIAL INFECTION CAN KILL, CAUSE LONG-TERM ISSUES

Bacterial meningitis, also known as meningococcal disease, is a potentially fatal bacterial infection that strikes an average of 1,500 Americans a year. Adolescents and young adults are at increased risk. More than 10 percent of patients die, and many survivors suffer long-term problems such as brain damage or kidney disease.

The disease is transmitted through direct contact with an infected person's saliva (e.g., by coughing or kissing). The bacteria cannot live outside the body for very long, so the disease is not as easily transmitted as a cold virus. The disease occurs most often in late winter and early spring.

Early symptoms include sudden fever, headache, stiff neck, nausea, vomiting, sensitivity to light, altered mental status and seizures. After the disease has taken hold, a rash may appear.

Adolescents and young adults are urged to seek medical care immediately if they have two or more of the symptoms concurrently, or if the symptoms are unusually sudden or severe. Vaccination is the only way to guard against meningococcal disease, although the vaccine does not protect against every strain of bacteria.

The U.S. Centers for Disease Control and Prevention recommends meningococcal disease immunization for everyone 11 to 18 years of age and for some younger children, such as those who travel to areas with the disease.

For more information, go to www.nmaus.org

Source: The National Meningitis Association

The Maine Center for Disease Control and Prevention issued a high-priority alert Friday evening to health care providers and school officials, citing a "bacterial blood infection in Cumberland County."

Superintendents sent out letters Monday to parents in Westbrook, Windham and Raymond, explaining the illness and the precautions taken by the state to prevent its spread.

"The people who are at risk are those who have had very close face-to-face contact with the individual," said Dr. Stephen Sears, Maine's state epidemiologist. Officials have already identified those people -- about a dozen family members and playmates -- and suggested they take antibiotics as a precaution.

People who may have had less direct contact with the toddler are not at high risk of becoming ill, Sears said. "It is not spread in a casual way," he said.

Meningitis is spread through saliva, not through the air or on surfaces, according to the Maine CDC. It is "highly unusual" to have a second case of the illness at any one time, according to the state.

The cause of the girl's death has not been confirmed by laboratory tests, but the symptoms and circumstances were consistent with the bacteria -- meningococcal -- that causes meningitis, officials said.

"When it first starts, it doesn't look that different from a severe flu, but it progresses very rapidly," Sears said. "She was seen (by a health care provider) originally and then felt OK, but came back within 24 hours to the hospital by ambulance."

Maine has recorded 15 cases of bacterial meningitis in the past three years, Sears said. Four of those patients died.

It's unknown why the bacteria causes severe illness in some people and not in others.

"It's a devastating bacteria. It happens like a lightning strike," said Dr. Dora Anne Mills, director of the Maine CDC. "You can have a lot of people walking around -- normal, healthy people -- in a carrier state, doing fine, and suddenly it strikes somebody and kills them."

The state's alerts urge health care providers to consider testing for bacterial meningitis "in persons with recent onset of symptoms, including high fever, headache, stiff neck, vomiting and rash."

It says parents should seek medical attention for a child who has "sudden onset of high fever with a headache and/or rash."

The alerts refer only to a case of bacterial blood infection in a 2-year-old child in Cumberland County. State officials confirmed Tuesday that the girl died and that she lived in Westbrook, but they would not identify her.

The lack of specific information caused problems for Westbrook school officials, said Superintendent Reza Namin.

Namin and school administrators received the notice Saturday and prepared a letter for parents before they learned Monday morning that the child was a Westbrook resident. Namin said a media representative called him after Windham and Raymond school officials circulated a letter that identified the girl as a Westbrook girl.

Namin said he then tried to contact the Maine CDC but couldn't immediately get any more information. He eventually sent a letter to Westbrook parents explaining the circumstances and making clear that the child was in a private day-care center and not in a public school.

"Even though it wasn't a school, I would have preferred the CDC contact me personally and say, 'These are the facts,' " Namin said. "The bottom line is, it's really sad and we really feel for the family."

Sears said the school department would have been contacted if the child had been enrolled in a school. The state does not publicly identify hometowns, to protect the identity of individuals and families, and because it wants the message heard in the larger community, Sears said.

"We try to maintain confidentiality." Sears said, but "we make sure the people who need to know (the details) know."

 

Staff Writer John Richardson can be contacted at 791-6324 or at:

jrichardson@pressherald.com

 

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