Meningitis victim was sent home by hospital
N.H. teen lacked 'classic' symptoms
The mother of an 18-year-old New Hampshire woman who died Saturday of meningitis said she took her ill daughter to a Peterborough, N.H., hospital on Christmas Eve, the same day the state issued a meningitis warning, but the emergency room doctor diagnosed the teenager with the flu and sent them home.
The next morning, when the teenager's father went to check on her, Rachael Perry of Bennington had stopped breathing, her mother said yesterday. Perry was rushed to another hospital, where she was eventually declared brain dead. Two days later, she was taken off life support and died.
The death was the first caused by meningitis this year in New Hampshire, officials said, but there are four other reported cases of the contagious disease throughout the state.
Although a Massachusetts man died from the disease on Christmas Eve, officials said the number of cases in the Bay State were well within the norm and stressed that there was no cause for panic.
Susan Perry described her daughter yesterday as an unfailingly optimistic young woman who planned on becoming a kindergarten teacher. She graduated from high school last spring and had been working in a grocery store to save money to pay for college. She complained to her parents that "she didn't feel right" last Wednesday.
Perry said the doctor at Monadnock Community Hospital in Peterborough gave her daughter a throat culture but never performed a blood test or discussed the possibility of meningitis. She said her family plans a lawsuit.
"I want to punish him, to make him realize that you just can't rush with this disease going around," Perry said. "You've got to take some time, take blood work so nothing like this will happen to anyone else."
Yesterday, the hospital released a statement saying that when Perry came in on Dec. 24, she did not have a "fever or other classic symptoms of meningitis" and that "all patients that come to our Emergency Room are treated in a clinically appropriate manner based on the symptoms presented."
The hospital has been handling a high number of flu cases this season, officials said.
State officials issued a meningitis warning to area health care providers on Christmas Eve. Perry came in for treatment at 12:20 p.m. that day, but it was not clear yesterday what time the hospital received the state's warning.
Bacterial meningitis is a contagious infection of the spinal cord and the membranes that surround the brain. Meningitis is transmitted primarily through direct contact with saliva or nose secretions and produces symptoms that include fever, neck pain, sensitivity to light, seizures, excessive sleepiness, or a rash. It can usually be cured by antibiotics if detected early, doctors say.
New Hampshire averages between 15 and 25 cases of bacterial meningitis a year and one to two deaths, said Dr. Jesse Greenblatt, the state's epidemiologist. The state has recorded 11 cases this year.
Two days before Perry was taken to the hospital, two sophomores at Monadnock Regional High School in Swanzey -- Brady Ells and Louis Gilman -- were diagnosed with the disease. As a result of those diagnoses, on Dec. 24, New Hampshire health officials issued a warning to the southwest portion of the state -- including Monadnock Community Hospital -- urging health care providers to be on the alert for meningitis, Greenblatt said yesterday. The state broadened that warning to include the entire state two days later, on Dec. 26.
Yesterday, a 13-year-old Colebrook, N.H., boy also appeared to have contracted meningitis. The teenager, who became sick on Friday, was listed in critical condition yesterday at Dartmouth-Hitchcock Medical Center. Three other teens -- the two 15-year-old classmates at Monadnock Regional High School, and a 14-year-old from the Concord area -- were in fair condition yesterday.
Greenblatt said the 15-year-olds appear to have spread the disease to one another, but health officials had found no links between the other cases. Ells, Gilman, and Perry all contracted a strain of the disease that cannot be prevented by vaccination. Health officials were testing to determine whether the Colebrook boy had the same strain, and suspect the Concord-area boy did, as well.
"If all of the strains of the bacteria match, and certainly if there are more cases, that would be more concerning," Greenblatt said. "It would mean that there is potentially more risk from a new strain that has entered the area."
He said officials hoped to know more about the strain in the next day or two.
In Massachusetts, a 52-year-old New Bedford man died on Christmas Eve at St. Luke's Hospital in that city, but Dr. Alfred DeMaria, the Massachusetts director of communicable disease control, said there was no spike in the number of cases in the Commonwealth.
Typically, DeMaria said, about 60 people contract meningitis every year in Massachusetts and about 10 percent die of the disease.
He stressed that Perry's death in New Hampshire should not frighten anyone.
"There's nothing to indicate that the circumstances in New Hampshire reduce or increase the risk in Massachusetts," DeMaria said. "This is something we deal with all the time."
Perry's immediate family as well as her boyfriend have been tested for the disease, and do not have it, Susan Perry said.
As a precaution, about 40 of Perry's co-workers were put on antibiotics and nearly all of the 1,100 students and approximately 100 teachers at Monadnock Regional High School were put on antibiotics to prevent the disease.
Greenblatt said the state plans to hold a teleconference today with hospital emergency room departments throughout the state to help raise awareness of the issue and "to increase the level of suspicion and to increase lab testing."
For the general public, he said, the most important thing was to be aware of the symptoms and to seek a health care provider's attention if an individual or family member develops any of them.
"And do it sooner rather than later," Greenblatt said. "A disease like this can strike quickly."
The Associated Press contributed to this report.
