- Concern about meningitis reached a crescendo
in Rhode Island yesterday, as the major health insurers agreed to cover
the cost of vaccinating all children and news of a 5-year-old's death prompted
worried parents to jam pediatricians' phone lines and flock to walk-in
clinics in quest of vaccine.
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- The state Health Department, in a departure
from federal policy, recommended that anyone aged 2 to 22 be vaccinated
against meningitis, but stressed that there was no emergency. Such a mass
vaccination is expected to cost health insurers a total of $7 million;
it will prevent 8 to 10 cases of meningococcal infection and perhaps one
death.
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- Because the vaccine has many limitations,
however, meningococcal infections will continue to occur in Rhode Island
even if all 221,000 children are vaccinated. Some 15 to 20 out of every
100 children vaccinated will have no protection, and the vaccine does not
work at all in babies under 2.
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- ``The hearts of all Rhode Islanders go
out to the families that lost loved ones,'' Governor Almond said at a news
conference last night inside the T.F. Green Airport terminal. A 9-year-old
from Woonsocket died on Feb. 12, and a 5-year-old from North Providence
on Monday night. Almond said the state plans to kick in $1.5 million toward
the vaccination effort but expects to recover most of it from the insurers.
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- The state will also work with communities
to establish clinics, as soon as possible in North Providence and the northern
part of the state. North Providence Mayor A. Ralph Mollis said last night
that he plans to institute an inoculation program in his town.
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- Dr. David Chronley, a South Kingstown
pediatrician who was among four doctors at Almond's news conference, urged
parents to be patient while the vaccine is being shipped and distributed,
and not to tie up doctors' phone lines with inquiries.
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- With help from the federal Centers for
Disease Control, health officials will monitor the efficacy of the vaccination
program. One question to be decided is whether the vaccine, which wears
off in three years, should be administered again in such an organized way
in 2001.
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- THE HEALTH DEPARTMENT began negotiating
with health insurers on Monday, hours before Steve Tella, son of Robert
and Cheryl Tella of 88 Merchant St., North Providence, was rushed to Hasbro
Children's Hospital with symptoms of meningococcal infection. He died within
an hour. The Health Department expects test results today that will disclose
whether the child did have meningococcal disease -- an infection with meningococci,
bacteria that cause meningitis and the blood infection called meningococcemia.
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- Neither Steve Tella nor his sibling attend
North Providence public schools. The boy, who attended preschool at Friends'
House in Warwick, had not been at the school for the past week. Several
people who had close contact with the boy were given antibiotics, a standard
procedure. Meningococcal infections are spread through saliva -- by kissing,
sharing drinks and such -- but the bug does not live long outside the body.
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- ``It is important for people to realize
that although we had a death last night, that does not represent a change
in what's going on in our state,'' Health Director Patricia A. Nolan said
at Almond's news conference. ``It's not an emergency to get immunized.''
Parents should remain ``vigilant,'' she said, and report headaches, stiff
necks, vomiting, fevers and other flu-like symptoms to a doctor.
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- The Health Department's recommendation
for widespread immunization was developed in response to an unusual increase
in meningitis cases in Rhode Island, and the latest death did not affect
decision-making, said Dr. Utpala Bandy, the Health Department's director
of disease control.
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- It did affect public mood, however. Phone
lines were busy at the Health Department all day. Eight to 10 nurses were
moved from other duties to answer questions from the public about meningitis.
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- Pediatricians' offices were similarly
stressed; one mother with a sick child said she had to redial 22 times
to reach the child's doctor.
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- And both the Fogarty Unit of Landmark
Medical Center in North Smithfield and Kent Hospital in Warwick got so
many calls they had to set up hot lines to handle questions.
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- Many doctors' offices and clinics had
little or no vaccine on hand, and told patients to come back later.
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- At Coastal/Waterman Pediatrics, parents
seeking vaccines were asked to sign up for a clinic that would be held
as soon as the vaccine arrived; 305 registered within four hours yesterday,
said medical secretary Anna Mansolillo. They will be called as soon as
the drug arrives.
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- A spokesman for Pasteur Merieux Connaught,
the vaccine's manufacturer, said the drug was in ample supply. Doctors
placing orders can receive the vials via United Parcel Service within 48
hours. The vaccine comes in powder form which doctors reconstitute. The
powder lasts three years; once reconstituted the vaccine lasts five days.
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- WOONSOCKET'S EFFORT to vaccinate all
schoolchildren as well as the Health Department's move to encourage vaccinations
are unique in the country. Although meningococcal illnesses are increasing
nationwide, no other state or community has taken such steps. The vaccine
is not recommended for mass use because it is believed to be effective
only in stanching outbreaks.
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- But Bandy said that because of Rhode
Island's small size, high public anxiety, and the strong feelings by political
leaders that more had to be done, the Health Department decided to take
action.
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- ``This is not an emergency,'' Bandy said,
recommending that parents have their children vaccinated sometime within
the next six to nine months. Bandy, who previously said she wouldn't vaccinate
her own children, has changed her mind and plans to do it, but not in any
hurry.
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- Bandy said that parents should watch
feverish children ``like a hawk.'' When one of her own children goes to
bed with a fever, Bandy said, she sleeps on the child's floor with a flashlight
and checks for the telltale meningitis rash every half-hour. ``I'm paranoid
about this,'' she said. ``I'm a pediatrician and a mother.''
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- Bandy, who recently presented the state's
data to a group of Brown University infectious disease experts, said that
the doctors in the group could not remember ever seeing such a high rate
of meningococcal disease. Even so, the numbers are low: 12 cases in 1995,
23 in 1996, 24 in 1997, and 12 so far this year.
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- ``I know it's a horrible disease and
people are panicking,'' said Dr. Rana Hajjeh, a medical epidemiologist
with the U.S. Centers for Disease Control and Prevention. ``But the data
we have so far [from Rhode Island] is not that outstanding. It's a really
small number.''
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- ``When you look at the overall attack
rate, it is still very low,'' agreed Dr. Georges Peter, chief of pediatric
infectious diseases at Rhode Island Hospital. ``There are going to be children
who unfortunately die in car accidents; people are still going to continue
to drive cars. Parents should be reassured that this is not an emergency,
and the chances are overwhelmingly in favor of not developing the disease.''
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- Asked about the $7 million cost of widespread
vaccinations, Peter said: ``Any investment that prevents death is a good
one . . . If you talk to the parents of the kids that died, they will tell
you that amount of money is a good investment.
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- ``There's a lot of public anxiety,''
Peter added. ``The more the Health Department does to demonstrate that
they're doing everything possible, the more reassured the public will be.''
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- ANXIETY SURELY ran high at a meeting
of the House Health Education and Welfare Committee, which heard more than
three hours of emotional testimony on legislation that would require all
Rhode Island children to be vaccinated for meningitis before enrolling
in any school.
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- No vote was taken yesterday on the legislation,
sponsored by Reps. Rene Menard and John Barr, both Lincoln Democrats. ``This
legislation is born of heartbreak,'' said Barr.
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- ``Kids are dying as we're not taking
preventative steps,'' said Barr. ``The state mandates bus monitors on school
buses to protect our kids. The state should mandate vaccinations for meningitis.''
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- Menard, an emergency medical technician,
told of having a child die in his arms.
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- Gail DeGuilio of Cumberland, whose daughter
survived meningitis and is now doing well, told the committee a harrowing
story of a night at Hasbro Children's Hospital when she was not sure that
her very sick 14-year-old was going to live. Her fevered and confused daughter
teetered near death in the intensive care unit of the hospital for hours
as doctors performed a spinal tap and gave her massive doses of antibiotics.
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- ``That night will live with me until
I die,'' said DeGuilio. ``It was an unbelievable thing.''
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- But Nolan, the state health director,
told committee members that the scientific and medical evidence is not
definitive on vaccination. ``There is no good science to tell us whether
increasing use of vaccine will help us or not.''
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- Meningitis is a ``very unpredictable''
disease that cannot be wiped out with mass vaccinations, Nolan said.
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- While there was widespread support on
the committee for the legislation, the measure was held so that Barr and
Menard could draft some amendments to cover younger children who attend
day care and nursery schools.
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- In Lincoln yesterday, town and school
leaders clamored to address residents' concerns about meningitis .
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- School Committee Chairwoman Linda Resnevic
called an emergency School Committee Meeting for 6:30 p.m. tomorrow at
the school administration building.
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- Supt. Robert A. DeRobbio said the committee
will decide on an action plan in response to calls from parents for a meningitis
inoculation program. On Monday, the state rejected DeRobbio's request for
vaccination clinics.
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