Meningitis case raises issue of privacy vs. public health

Annapolis High student, now recovering, wasn't named in note to parents

November 02, 1999|By Jackie Powder | Jackie Powder,SUN STAFF

Issues of privacy and public health came into play last week in a case of life-threatening illness when an Annapolis High School student was hospitalized in critical condition with bacterial meningitis.

Parents of other students were notified of the illness -- which is mostly spread through direct contact -- in a letter that did not identify the victim.

Bacterial meningitis is an infection of the membranes that cover the brain. Symptoms include severe headache, stiff neck, high fever and rash. The disease killed a student at Annapolis High School in April.

A Chesapeake High School student who also contracted the disease that month recovered from the illness. The student involved in the latest case had improved enough over the weekend to be sent home to complete recovery.

The student is in "very good condition," Robert J. Weber, the county's director of community and environmental health, said yesterday.

Based on interviews with the infected student, family members and close friends, Weber said, health officials identified 10 to 12 people who may have been exposed to the dangerous infection through close contact with the student.

The health department advised those individuals -- mostly family members -- to obtain the appropriate antibiotics from their family doctors.

"We follow up and make sure they do it," Weber said. "Everybody we identify as being even possibly at risk, we contact them."

County health officials learned of the latest case Thursday, alerted by the student's family doctor, Weber said.

That day, Annapolis High students and pupils at Mills-Parole Elementary School -- where the infected student has three family members -- took letters home informing parents of the case.

The letter said the disease is not highly contagious -- spread through direct contact with mouth or nose secretions through kissing, sharing cigarettes or using the same eating and drinking utensils. The letter added that routine classroom and school contacts don't usually pose a risk.

Weber said the letter did not name the student because the information is confidential and the student's parents asked that the name not be used. If health officials had identified more people who were at risk for contracting the disease, the situation might have been handled differently, he said.

"The only reason we break confidentiality is if there is some overriding medical reason to do so," he said. "We have to do it on a case-by-case basis; in another situation with many, many contacts, it may be necessary to take a different tack."

Weber acknowledged that someone at risk for the disease might not be identified through interviews with the patient, family members and close friends.

"I guess it's always possible, but it's a very, very low risk to begin with," he said. "You can only do the best you can do, talk to all the people involved and find all the contacts you're able to identify.

"If anyone slips through the cracks it would be unusual, and if you have any symptoms, the letter tells you to go see a doctor right away," Weber said. "If it's caught early on, you can deal with it."

School system officials referred questions about the case and its handling to the county health department yesterday.

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