martes, 16 de marzo de 2010
RSOE EDIS

RSOE Emergency and Disaster Information Service


Budapest, Hungary

RSOE EDIS ALERTMAIL

Situation Update No. 1

Ref.no.: EH-20100313-25308-USA

Situation Update No. 1
On 2010-03-16 at 09:48:09 [UTC]

Event: Epidemic Hazard
Location: USA State of Oklahoma Talala

Number of Infected: 7 person(s)

Situation:

Another Oologah-Talala student has contracted meningococcal disease, raising the number of cases in the school system to seven. The Oklahoma State Department of Health confirmed Monday evening that a teenage girl has the disease. Her family said she is 18-year-old Karisa Dene Pales, a senior at Oologah-Talala High School. Officials noted that she is the first Oologah-Talala student outside of the elementary school to be infected. Pales's father, Stephen Pales, said her health is up and down but that she is doing better. He said her symptoms began Thursday at their home near Talala. Initial tests — blood work and a spinal tap — didn't show that she had the disease, he said. Pales said it's a miracle that doctors treated her for the disease anyway. "Thank God they took it serious," he said Monday night. "They could have just treated her for the flu. All I can say is good things about the doctors." Karisa Pales initially was treated at Bailey Medical Center in Owasso and was later taken by helicopter to The Children's Hospital at St. Francis in Tulsa, he said.

The six Oologah-Talala elementary students who contracted meningococcal disease last week were all members of just two classes — one kindergarten and the other second-grade. It is likely that the disease spread between the two classes through a friend or sibling, state epidemiologist Dr. Kristy Bradley said. Pales said the only connection his daughter can think of to other infected students is that one of her classmates' siblings is also in the hospital. Four of the six younger children also remain hospitalized at The Children's Hospital at St. Francis. Andrew Gregory Thomas, 7, and Shuache Moua, 8, died Thursday after short bouts with meningococcal disease. The Rogers County Health Department is hosting a clinic Tuesday to provide antibiotics to family members and close contacts of the high school student. State health officials are contacting those who should attend the clinic.

They stress that the general public is not at risk and that only those who have had close, personal contact with a person with a meningococcal infection have a slightly increased risk of developing the disease. "I don't expect we'll ever figure out how it entered the school," Bradley said. "A lot of times, an asymptomatic carrier has it in the nose and throat. That's how the bacteria is carted around." Only 1 percent of individuals exposed to the bacteria develop an invasive disease, which can be a bloodstream infection or meningitis, she said. Meningococcal disease can be contracted only through direct contact with somebody who harbors the bacteria in their nose or throat. It will develop into an invasive disease only in those who are susceptible to it, Bradley said, explaining that their immune systems might be compromised or they might have recently suffered a viral respiratory infection. Meningococcal disease is rare, with only about 2,000 cases seen in the United States each year. "A lot of it is timing. For a minority of persons, it has the potential for catastrophic consequences," Bradley said. Once it takes hold, the rapidly spreading bacteria can produce toxins that cause a horrible disease, she said.

Oologah-Talala Public Schools officials have said they will be scrubbing down the school facilities during spring break this week as a precautionary measure. But Bradley said that action "will not reduce anybody's risk of exposure" because the bacteria cannot live on surfaces, such as furniture or books. "This is only harbored in people, and it is only spread person-to-person," she said. The first sick child was hospitalized late March 9, according to state records. The Oklahoma State Department of Health was notified by a hospital of the outbreak early Thursday, Bradley said. Cases of meningococcal disease must be reported to the Oklahoma Health Department immediately upon suspicion or diagnosis. A suspected or confirmed case triggers an investigation by personnel at the state and county health departments. Within five hours of notification, state and county health officials were in Oologah and provided hundreds of doses of antibiotics to children, teachers, parents and others in the community. "From our viewpoint, all parties responded quickly and appropriately," Bradley said.

The challenge of meningococcal disease is that its early symptoms are similar to those of any typical viral illness, such as the cold or flu, she said. But "in a matter of hours, an individual can go from feeling fine to being in dire straits," Bradley said. The Centers for Disease Control and Prevention notified the state Health Department that the serotype for this particular strain is C — which is a strain covered by the meningococcal vaccine. The serotype is most frequently associated with explosive outbreaks in institutions or school settings. The meningococcal vaccine is approved for ages 2 to 55 but is recommended for children ages 11 to 18, she said. Only high-risk children ages 2 to 10 are able to get the vaccine through public health departments. It is best for parents who want their children to get the vaccine to consult their pediatricians, she said.

The vaccine isn't routinely recommended for all children because it appears to protect only for one to three years at a time. However, Oklahoma is part of a national study to determine the length of the vaccine's protectiveness and when a booster shot could then be recommended. Under federal guidelines, state and local health officials will offer free meningococcal vaccines to all children who attend Oologah-Talala Public Schools, since it is the site of an outbreak, Bradley said. "We certainly do think the vaccine is a very important part of preventing this disease," she said.

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