Re: USA - Rhode Island mycoplasma pneumonia
Rhode Island news
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?Abundance of caution?
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http://www.projo.com/news/content/bacteria05_01-05-07_FP3O76F.2fecf3d.html
01:00 AM EST on Friday, January 5, 2007
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[SIZE=-1]By Felice J. Freyer
Journal Medical Writer[/SIZE]
More than 20,000 youngsters in Warwick, West Warwick and Coventry were out of school yesterday, after state and school officials, in what they called ?an abundance of caution,? decided overnight to shut schools because a Coventry child had been hospitalized with symptoms of meningitis. Schools in the three communities are closed today as well.
The Health Department recommended the school closures because it would take a few days to determine whether this case had any connection to three unusual and highly publicized illnesses in Warwick and West Warwick last month, one of which resulted in the death of a 7-year-old boy.
Test results on the Coventry child, who was admitted to Hasbro Children?s Hospital on Wednesday, are expected tomorrow. Meanwhile, the child is already on the mend and was headed home yesterday.
At a news conference yesterday afternoon, Governor Carcieri and Health Director David R. Gifford acknowledged that they have no evidence that any unusual infection is circulating in the state right now.
?I don?t think we want to overly alarm people,? Carcieri said. But, especially because a child had died, the governor said, officials did not want children congregating in schools until they knew for sure there was no connection between Wednesday?s case and the unusual cases last month of encephalitis, an inflammation of the brain.
?It?s a fine line here,? Carcieri said. ?We don?t think this [meningitis case] is anything out of the ordinary but we?re trying to be cautious.? About 300 to 400 cases of viral meningitis occur in Rhode Island each year.
Gifford, the health director, said schools will probably open on Monday. No effort will be made to disinfect schools or buses, because the bug that caused the encephalitis cases in December does not last long outside the body and is only transmitted through prolonged, close contact with an infected person, he said.
The infection is not transmitted through casual contact, such as riding an elevator or attending a sporting event. For that reason, the Health Department did not recommend canceling athletic activities or after-school programs, although school and hockey-league officials decided on their own to do so.
Gifford said there was also no reason to close day-care centers, noting that most have good infection-control measures in place. But many day-care centers closed anyway. ?We are trying to cooperate,? said Rita Santilli of Child Care Plus on Tiogue Avenue in Coventry. The day-care center stayed open for a few hours in the morning to give parents a chance to find alternate arrangements, and then closed.
The Roman Catholic Diocese of Providence also closed Catholic schools in the three towns.
Governor Carcieri said he plans to issue an executive order requiring hand-hygiene protocols in the state?s 202 public elementary schools. The state is buying crates of antiseptic gel to distribute to the schools, and will set rules to prevent the spread of many types of infection, such as requiring that all children wash with the gel before lunch.
Meanwhile, the investigation into last month?s illnesses continues, with three additional medical people from the U.S. Centers for Disease Control and Prevention joining five who were already here. The CDC is investigating an unusual outbreak of mycoplasma pneumoniae, commonplace bacteria that normally do not cause serious illness. But mycoplasma has been linked to three cases of encephalitis, a rare and dangerous inflammation of the brain, which occurred in children from Warwick and West Warwick in December.
Two of the children, including the one who died, were second-grade classmates at Warwick?s Greenwood School. Additionally, several cases of pneumonia linked to mycoplasma also occurred at Greenwood. As a preventive measure, the state bought and distributed antibiotics to families of Greenwood students.
The three children who became ill with encephalitis started out with symptoms of meningitis, an infection of the fluid around the spinal cord and brain, which is why the new meningitis case sparked concern. Also, it occurred in a child from the Hopkins Hill Elementary School in Coventry, one of the towns where health investigators are checking to see if mycoplasma was responsible for higher-than-normal school absentee rates late last year.
Dr. Penelope Dennehy, director of pediatric infectious diseases at Hasbro Children?s Hospital, said the Coventry child who was admitted Wednesday had symptoms that were very similar to those of viral meningitis, which is less serious than the bacterial kind. Dennehy said that mycoplasma bacteria primarily affect schoolchildren and young adults, but in her experience mycoplasma infection leads to encephalitis or meningitis only once every few years.
Gifford, the health director, said he had asked for additional manpower from the CDC because the investigation is extremely time-consuming and he would like answers as soon as possible. One possibility under consideration is that a more virulent strain of mycoplasma has developed.
The investigators, most of whom are doctors, are tracking down children who were ill last year, interviewing their parents and doctors, and obtaining throat swabs and blood samples for testing. Additionally, they are working with pediatricians, hospitals and school departments to watch for evidence of any unusual level of mycoplasma infections occurring now.
The decision to close schools involved ?a lengthy discussion? among state, health and school officials, Gifford said.
Coventry Schools Supt. Kenneth R. DiPietro was the first to decide to close schools, ?to err on the side of caution,? he said. He emphasized that there was no mandate. ?We elected to close the schools,? he said.
At 1:30 a.m., West Warwick Schools Supt. David Raiche received a phone call from the Department of Education recommending that schools close because of the Coventry case. He consulted Town Council President Edward A. Giroux, who also serves as a member of the town?s emergency management team, as well as the schools superintendents in Warwick and Coventry, before deciding that West Warwick would close, too.
At 2:30 a.m., a Warwick police officer rang the doorbell at Warwick Mayor Scott Avedisian?s home to tell him that Coventry had canceled schools. For the next three hours, Avedisian said, he was on the phone with Health and Human Services Director Jane Hayward, Schools Supt. Robert J. Shapiro and a host of others as they tried to decide what to do. ?We went back and forth about whether we should close any schools, some schools, all schools. There were a lot of parameters we had to talk about,? he said.
The fact that Coventry and West Warwick had canceled classes ?obviously? influenced Warwick?s decision, the mayor said. (Later yesterday, the mayor also canceled all youth activities affiliated with the city?s Parks and Recreation Department, saying it was ?sending a bad message to say that kids can?t go to school, but they can go to the rink or the pool. We just can?t have mixed messages.?)
Although school departments activated phone trees and other communication systems, many parents learned of the closing only from friends and neighbors.
Sara Hill, a Coventry parent, said she was surprised that families didn?t get an official call from the School Department. Hill and her two children, Jordan, 6, and Lillie, 5, spent the day running errands, going to lunch and going to the library. She said she is relieved that the schools were closed. ?You never know. The more exposure you have to that germ the more likely you can pick it up,? Hill said.
At the Warwick Mall, parents used the day off to catch up on time with their children. Most said they weren?t overly worried. Lori Bollinger, whose daughter, Kelly, is a student at John F. Deering School in West Warwick, said she was glad to see schools closed until the medical mystery is solved. Bollinger is no stranger to serious illnesses. Kelly, now 13, spent almost a week in the hospital with viral meningitis as a young child.
At Thundermist Health Center in downtown West Warwick, phone lines were jammed yesterday. Dr. John Machata, medical director, said he has tried to walk a fine line, acknowledging fears, but quelling undue panic.
?There?s so much anxiety going around, but it is rational anxiety ? rational because there is so much unknown medically,? he said.
Machata said he has received many requests for antibiotics from parents of sick children, and he is prescribing more than usual ?because I have a lower threshold of treatment in the current environment. But am I treating everyone? Absolutely not. That would be irresponsible.?
Instead, he?s handing out lots of business cards and inviting parents to call anytime they are worried. ?We have to be available for these people. I want them to know they have someone to call,? Machata said.
With reports from staff writers Talia Buford, Cynthia Needham and Lisa Vernon-Sparks.
<BQ><BLOCK>?You never know. The more exposure you have to that germ the more likely you can pick it up.?
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Sara Hill, </PERSON>
Coventry parent
