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Mass preventive treatment planned at Folsom High on Friday
Updated: Feb. 8, 2001 - 5:29 p.m.
The Sacramento County Health Department is asking students and staff at Folsom High School to agree to take preventive medicine for a meningitis-related disease after it was found two recent deaths are connected, according to information released Thursday.
The action follows the second death this year of a Folsom High student from a meningococcal disease.
A third student is suspected of having the disease, but the case was not reported in time to verify the ailment. The third student recovered.
Health officials are asking parents to give signed permission for students to take the drug Cipro in one oral dose on Friday, according to a news release from the county and a note sent home with students.
The note was sent home before health officials confirmed the two deaths are connected.
The mass treatment is necessary to “avoid ‘ping-ponging’ of the organism between people who might take" the drug at different times, the note to parents said.
Health officials said tests show both students died from the same type of the disease.
The note also said the antibiotics are only effective for a few days so “100 percent participation” is needed for maximum effectiveness.
A 17-year-old girl who attended the school died Wednesday from meningococcal disease.
Tanya Edsall’s death prompted a full-fledged investigation by county health officials.
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.
-- Bee Metro Staff
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Bacterial disease kills Folsom girl -- Death is second in area in 2001
By Dorsey Griffith and Pamela Martineau
Bee Staff Writers
(Published Feb. 8, 2001)
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.
Bee staff writer Aurelio Rojas contributed to this report.
This is sad and freaky stuff she was eating my chips on monday.