PHILADELPHIA -- Five children have died in the last 11 days in a measles outbreak here, all of them from families that belong to two fundamentalist churches that preach a reliance on prayer, not medical care, to cure disease.
The churches -- the Faith Tabernacle Congregation and the First Century Gospel Church -- run their own schools, which together have about 350 students who have never been inoculated against measles or other diseases.
Since the death of 9-year-old Caryn Still on Feb. 7, health officials say they have uncovered 134 cases of measles among the 201 students that attend the Faith Tabernacle school in North Philadelphia.
The school closed voluntarily last week.
Health workers are now going to the homes of all students in a frantic effort to monitor their conditions to prevent further deaths.
Officials say they are prepared to seek court orders to force the families to accept medical care if the children are in serious condition.
"This is very bad," said Dr. Robert Ross, the city's deputy health commissioner. "I think 'nightmare' would not be too strong a term."
Although measles is usually fatal in only 1 of every 300 cases, Philadelphia health officials said the outbreak here probably caused an unusual number of deaths because the children received no treatment for pneumonia or encephalitis, which can result from measles.
Health officials said the epidemic among church members was particularly distressing since it might take constant surveillance to ensure that a child who seemed to be recovering when a nurse visited the home did not suddenly develop life-threatening complications.
"What seems to be happening is that the children are doing fine and
then they take a turn for the worse very quickly," said Robert Levenson, director of the Philadelphia Health Department's division of disease control.
Indeed, after 9-year-old Monica Johnson died last Sunday, a health department doctor visited the other 11 children in the family and, while not permitted to conduct an actual physical exam, found no cause for alarm.
But early Friday morning, Monica's 13-year-old sister, Tina-Louise, died.
The Johnson girls and Caryn Still both attended the Faith Tabernacle school.
Linnette Milnes, a 14-year-old sister of another student at the school, died Thursday.
Students at the school come from many neighborhoods. Some, like the Johnsons, are from poor inner-city areas. Others, like Linnette Milnes, are from more affluent areas.
Dr. Ross said Friday that all the families with children in the two schools would be visited in the next two days by a nurse or doctor.
Mr. Levenson said the church members "have been entirely cooperative, providing us with names and addresses of the members and agreeing that we could visit the homes."