Published: April 02, 2009 12:15 am      

Antibiotics offered as precaution

Following two bacterial meningitis cases at Lincoln

FAIRMONT — Students at Lincoln High School will have the opportunity today and Friday to receive one of two antibiotics as a precaution after a second student was confirmed to have a case of bacterial meningitis.

Working with the aid of other agencies and county health departments, officials from the Harrison-Clarksburg Health Department will be on hand to administer the antibiotics to any of the 620 ninth- through 12th-graders who attend the Shinnston school as well as faculty members.

“We will probably have 20 to 25 people there tomorrow that will be playing a role,” said Margaret Howe, nurse director of the Harrison-Clarksburg Health Department.

The health officials will be offering either one dose of the antibiotic Cipro, or, in the case someone has allergies, another antibiotic called rifampin, which requires follow-up dosing.

“You take that twice a day for two days,” Howe said. “The reason the Cipro would be preferred is that it’s one dose. You see the person swallow it, and the compliance has been met.”

On Tuesday, a Lincoln student was diagnosed with bacterial meningitis, nearly three weeks after another student was diagnosed on March 11. Following the diagnosis of the first student, many Lincoln students, including the second one, received the Menactra vaccine that helps prevent bacterial meningitis. However, the vaccine is not effective against type B meningitis, the type the first student had.

The serotype of the second student’s illness has yet to be determined, but Dr. Danae Bixler, director of infectious disease epidemiology for the West Virginia Bureau for Public Health, believes there is a good chance the tests will come back that the student also has type B because she had been vaccinated.

“We’ll probably know within a couple of days,” Bixler said.

The decision to offer the entire school population prophylactic antibiotics was not made lightly, Bixler said. An outbreak generally is three cases of a disease in a three-month period in a given population.

“But in a close population such as schools, that’s often lowered to two cases,” she said. “Because of the kind of problem we’re seeing here, do you want to wait before you see a third case before we call it an outbreak? Most people are unwilling to do that. So we’re defining it as two cases in a small population.”

Students at most risk of catching the bacterial meningitis would be close contacts of the two students. However, Bixler noted, people can harbor the bacteria for the disease in their nose and throat and never get sick but still pass on the disease.

“If you went through a population during an outbreak and you did a study to look and see, you might find 10-20 percent carrying the bacteria,” she said. “But most of those individuals are not going to get sick. Most develop antibodies and get better without any problems. But you have a few isolated cases where something goes wrong.”

Brad Underwood, the principal at Lincoln High School, said no direct connection could be found between the two girls who came down with bacterial meningitis, “other than that their boyfriends are friends. They have no classes together, and they are not the same age.”

The first girl was admitted to Ruby Memorial Hospital and, according to Cyndee Kiger, director of nursing at the Marion County Health Department, responded to treatment. Underwood said she now is continuing her recovery at home. The second girl is a patient at United Hospital Center.

Meningitis is an infection of the fluid around the spinal cord and the brain, according to information from the Centers for Disease Control and Prevention (www.cdc.gov). Viral meningitis is generally is less severe than bacterial meningitis, the latter of which can result in brain damage, hearing loss or death.

Common bacterial meningitis symptoms, according to a press release from the Marion County Health Department, include high fever, severe headache, difficulty in breathing, stiff neck and back, painful joints and/or sore muscles, discomfort looking into bright lights and vomiting.

To avoid catching the disease, people should practice good hand washing and not share eating utensils, cigarettes, chewing gum or anything that comes into contact with the mouth, or drink after others.

Students took information packets and permission slips home Tuesday night for their parents to look over and sign in order to receive the antibiotics. Fewer students called off sick Wednesday than Underwood expected considering the circumstances.

“We have 120 students out today,” he said Wednesday. “On a normal day we have 70 to 75. It’s a little more, but it’s not like 200 or 300.”

The calls Underwood had received have been thoughtful, he said.

“People are reacting intelligently,” he said. “They understand that for the most part, this is something they have to be vaccinated for and receive the antibiotic.”

Kiger, who along with fellow health department nurse Donna Riffle and Jamie Moore, the Marion County Health Department’s regional planner for threat preparedness, will be at the school today helping out with the situation.

The Marion County Health Department fielded calls Wednesday from people who wanted to know about the vaccine or prophylactic antibiotics following news reports about the second meningitis case. Wednesday coincidentally was the day for the department’s weekly immunization clinic, and it was well attended, Kiger said.

“At a quarter after 2, it was getting busier than usual,” she said. “We saw an increase in high school-age children.”

E-mail Mary Wade Burnside at mwburnside@timeswv.com.