UPDATE: As of Thursday, Oct. 24, the Oregon Health Authority has decided to send a sample to the CDC for futher investigation, according to Columbia County communications manager Karen Kane.
The decision means determining whether bacterial meningitis was actually the cause of the St. Helens High School junior's death could take several more days to a few weeks.
Kane said the county's investigation will continue for at least days past the last possible date of transmission. Since the student died on Oct. 21, if new cases were to appear, Kane said they would probably develop by or before Oct. 31. However, most cases occur within four days of exposure.
"Our Public Health Department has determined that 47 people made close enough contact with the case, although we will continue to investigate others if need be," Kane said. "At least 30 people have received the antibiotic, which is Cipro, as of today."
A 16-year-old junior and wrestling team member at St. Helens High School passed away Monday morning, Oct. 21, and doctors suspect bacterial meningitis caused his death.
According to Public Health Administrator Michael Paul, JD, MPH, the county was contacted by the ER where the teen was treated to alert them to the possible presence of the communicable disease. Test results are expected later this week to pinpoint the boy’s exact cause of death.
Bacterial meningitis “is very serious and can be deadly” according to the Centers for Disease Control and Prevention, and death can occur in as little as a few hours. It is a communicable disease that spreads from person-to-person when there is direct contact with mucus from an infected person’s nose or throat.
However, the disease does not spread through casual contact or by simply being the same room, such as a classroom, as the infected person.
Right now, Paul said, the county is working on an investigation using the Oregon Health Authority’s (OHA) Public Health Division investigative guidelines. Those guidelines can be found on OHA’s website.
“Our main job right now is trying to identify all of the people who had significant exposure to the deceased – those who spent at least four hours in close face-to-face contact with the deceased within the ten days prior to when he developed symptoms,” Paul said.
That ten-day time period covers Oct. 10 to Oct. 20, with Paul adding the dates they are most concerned about for those possibly exposed narrowing from Oct. 16 to Oct. 19.
“The most infectious period is the three days prior to symptoms developing, and he developed symptoms on Sunday (Oct.20),” Paul said, adding the ten-day timeline is a more generous range to be safe and thorough.
At this time, the antibiotic prophylaxis is recommended for: family and household members connected to the deceased, anyone who spent at least four hours in close, face-to-face association with the teen within those ten days, anyone directly exposed to the teen’s cough or nasopharyngeal secretions (via kissing or wrestling with him, for example, within those ten days).
Paul said students who simply sat in the same classroom with the teen or may have touched the same surface he did would not be affected. Those of concern would include wrestling partners, girlfriends or boyfriends, and siblings.
Symptoms to watch for include fever, stiff neck, severe headache, weakness, confusion, irritability, vomiting, and a rash.
“The rash is often red bumps on the skin that appear suddenly. They can look similar to hives initially and could appear in areas such as underwear, socks, and other areas under the clothing or in fingernail beds,” Paul said. “It’s got to be somebody that had significant contact with him and suddenly doesn’t feel well.”
Symptoms can appear two to 10 days after exposure, but usually occur within three to four days. Antibiotic treatment of the disease is usually successful, especially if started early after symptoms begin. Individuals should seek medical care if signs or symptoms develop within the next two weeks. Those who may have been exposed should contact their primary care physician to discuss whether treatment is needed.
“We don’t want to instill panic, but anyone concerned should get the antibiotics,” Paul said. According to the county, Public Health staff is working on directly contacting those who were potentially exposed. “We want to inform them about the signs and symptoms of the illness. The antibiotics will protect them and their family members.”
If you have any questions about this information, please call Columbia County Public Health at 503-397-7247.