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http://www.washingtonpost.com/ac2/wp-dyn/A45315-2003Feb21?language=printer

washingtonpost.com

5 Who Died Had Flu-Like Symptoms
Children's Deaths In Southeast Va. Appear Unrelated

By Michael D. Shear and Maria Glod
Washington Post Staff Writers
Saturday, February 22, 2003; Page B03

RICHMOND, Feb. 21 -- Five children who died in southeast Virginia in the past week had no contact with each other and did not attend the same schools or take similar medicines, according to state health officials, who also dismissed bioterrorism as a cause of the mysterious deaths.

The five boys and girls -- from Richmond, Hampton, Virginia Beach and Portsmouth -- had one thing in common before their unexpected deaths: an apparent viral infection that caused flu-like symptoms, including sore throat, wheezing, coughing, ear infections, and low-grade fevers.

John S. Marr, the state's director of epidemiology, said the lack of an obvious commonality -- the children were not the same age or sex -- is making it difficult to pinpoint a single cause. "There's nothing that ties them together in time, place or person," he said.

Marr said one child died after being sick for five to six days, while others were sick only a couple of days before getting progressively worse. He said none of the children had been admitted to a hospital, though some had been treated by doctors.

"We don't have an epidemic here at all. We do have an unusual cluster," Marr said. "I'm a parent, and I'm concerned. But I wouldn't be overly concerned."

Officials said they consider an influenza virus to be the most likely cause of the children's symptoms, though they acknowledged that it is rare for otherwise healthy children to die from that disease. Two to four children die annually from flu-related ailments, officials said.

Parents in the Tidewater area of southeastern Virginia swamped physicians and local health departments with calls today.

"It's difficult because we can't give them a direct answer," said Elaine Perry, director of the Peninsula Health District. "Every parent whose child has a cold is concerned, and they really shouldn't be." Perry said she's urging parents to take the usual precautions against illness and contact their doctor if they become concerned.

Some local health departments in Northern Virginia and other parts of the state urged hospitals and physicians to be particularly watchful when caring for children with respiratory problems.

"It's just to give them a heads-up and to tell them they should be extra suspicious if they see a child around that age with respiratory complaints," said David Goodfriend, director of the Loudoun County Health Department, who sent an e-mail to local physicians and alerted Loudoun Hospital Center. "Even though it's far removed from us geographically, it's important that we get the word out."

State health officials would not identify any of the children who died. But one child who died this week in Virginia Beach after such symptoms was 7-year-old Rachel Broome, a second-grader at Trantwood Elementary School, said Principal Patricia C. Slaughter.

Slaughter said Rachel went to see the school nurse on Monday with a cough. Her mother picked her up that day and later told the school that Rachel had been taken to a hospital and then to a Norfolk pediatrics center. On Wednesday, Slaughter learned that Rachel had died.

Another child who died was 2-year-old Maria Carter of Portsmouth, whose death occurred Sunday.

Officials said they "could not rule out anything," but stressed that they do not believe the deaths were caused by a biological attack. Out of 100 possible explanations, one state doctor said, bioterrorism would be the 101st reason he would examine.

Marr said he suspects the outcome of the state inquiry may find the deaths to be unrelated and coincidental. "You drop 100 marbles on the floor, and eight of them are going to be next to each other even though they are not otherwise related," he said.

Glod reported from Washington. Metro researcher Bobbye Pratt contributed to this report.

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