http://www.washingtonpost.com/wp-dyn/articles/A36077-2001Nov29.html

 

Rash Has Officials Scratching Their Heads
Mysterious Outbreak Afflicts Manassas Middle School

 

Katie Hedrick with RashMarsteller Middle School students are coming down with a mysterious rash that still has medical officals looking for answers. (Larry Kobelka - For The Washington Post)


_____From The Post_____

Manassas School Closed by Rash to Reopen (The Washington Post, Nov 29, 2001)
Manassas School Closes Again as Rash Spreads (The Washington Post, Nov 28, 2001)

 


_____From the CDC_____

Enterovirus Information
Fifth Disease Information

 


 


 

By Christina A. Samuels and Leef Smith
Washington Post Staff Writers
Friday, November 30, 2001; Page B01

Three nurses sit in the Marsteller Middle School library, taking the temperature of dozens of students complaining of a red, itchy rash on their arms, legs, chests or backs. A steady trickle of parents arrives at the Manassas school, picking up sick kids in the middle of the day.

In the last 10 days, one-third of the 940-member student body has been ill, and the biggest number yet in one day -- 161 -- got sick yesterday.

And still, no one knows what's causing the illness, or how to stop it. Viral syndromes, allergic reactions or contact dermatitis from something in the air are all theories from the medical experts, said Principal Karen Poindexter. But as health officials, doctors and school staff members scour the information they have gathered, there's no evidence yet that proves one theory over another.

"There are answers the parents want, and we just cannot give it to them," Poindexter said. "We don't have enough information."

School officials plan to open Marsteller today. Unlike previous days, children were not sent home yesterday if they had a temperature under 100, though some parents chose to pick their children up anyway, Poindexter said.

"I think they're trying," said parent Sandy Hedrick, who took her 14-year-old daughter, Katie, home early. "It's been a week now, so you think they'd know what it is by now."

Katie, an eighth-grader, said she can't figure it out either.

"I don't know. Some people are saying that people put itching powder in the vents," she said. "There's a lot of people talking in the halls."

The outbreak, even with its mild symptoms, is occurring at a time when parents are already on edge about possible environmental dangers or contaminants.

More serious illnesses were quickly ruled out, said Superintendent Edward L. Kelly. Anthrax, for instance, "has never been considered, simply because you don't have any kind of anthrax symptoms at all."

The illness first appeared in about 40 students two days before Thanksgiving, prompting the first unscheduled closure Nov. 21 while school officials brought in a company to conduct environmental testing. The school was cleaned, the tests came back negative, and the Health Department declared the school safe to reopen.

However, on Monday, 20 more students came down with the unexplained illness. On Tuesday, 114 students and four staff members got sick. Administrators closed the school again Wednesday to allow additional tests and, some hoped, to allow the outbreak to run its course.

The halls, showers and lockers have been disinfected by custodial workers. Air filters have been replaced. Health officials have checked with janitors to see whether anything new is being used in the cleaning supplies. Nothing suspicious has turned up. And although the school was again declared fit to open, yesterday was the worst day so far.

A working theory in the early days of the outbreak was that the rash and fever were caused by a mild childhood illness called fifth disease, which starts with a low fever and produces a red rash, most often on the cheeks. One child is known to have tested positive for the illness.

"I think we may have fifth disease, but we may have something else" viral, said Jared Florance, Prince William County's health director. "Or it could be an allergic reaction. We have one kid with poison ivy. We just don't have the information to say what it is or isn't."

Prince William Health Department officials said they have not called on the U.S. Centers for Disease Control and Prevention for help in identifying the illness. Rather, Florance's office has asked the state's regional epidemiology expert to help it sort through the clues.

Health officials said it's not uncommon for viruses to spread quickly among dense student populations. That's because viruses such as fifth disease are so easily transmitted. Last winter, scarlet fever spread across the Washington region in just two weeks in January, with cases in 38 schools in Prince George's County alone.

Marsteller, which is part of the Prince William school system, was built in 1963. Earl Tester, environmental health supervisor for the Prince William County health district, said his staff is evaluating janitorial supplies and anything else that might have been a contact agent for the rash.

"We went through all of that," Tester said. "Nothing had changed. No work was being done on the building or equipment. The chemicals, cleaners, polishes and washes are all the same that they've used before."

One twist is that the rash appears to flare up when students are actually in Marsteller, then subsides when they go home.

Ariel Taylor, 13, an eighth-grader, had the rash on her back Tuesday. On Thursday, it was on her arms, and she left school early.

"Most kids, they don't want to be touched by someone else who has the rash because they're afraid they're going to get it," she said. "I just think it's kind of gross."

Mary Schmidt, a pediatric and adult infectious disease specialist at Inova Fairfax Hospital for Children, said that the problem sounds viral but that she's not convinced that fifth disease is to blame.

That's because fifth disease is known for producing a flat, lacy rash. What doctors are seeing on many of the Marsteller students is a rash made up of little red bumps.

Schmidt said the symptoms more closely resemble those of an enterovirus, the second most common virus that infects humans, behind rhinoviruses, which are the "common cold" viruses.

"I look forward to seeing what they finally come up with," Schmidt said. So does Terri Taylor, Ariel's mother.

"The kids were out of school five days, and you come back to school and they still have the problem," Taylor said. "They really need to get to the bottom of this."

© 2001 The Washington Post Company


ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.