RARE BACTERIAL INFECTION SUSPECTED IN NURSE'S DEATH NORFOLK GENERAL TAKES CARE TO PREVENT SPREAD.(LOCAL) - The Virginian-Pilot (Norfolk, VA)

Byline: LIZ SZABO THE VIRGINIAN-PILOT

NORFOLK -- A nurse who worked at Sentara Norfolk General Hospital died early Friday morning of a bacterial infection that can cause meningitis, hospital officials have announced.

Although the cause of death has not been confirmed by laboratory tests, hospital executives said the preliminary diagnosis was meningococcemia, a rare ailment that can kill previously healthy people in a matter of hours.

To control infection, Sentara staff members have contacted 110 patients, co-workers, visitors and others who might have had close contact with the nurse, who worked in Norfolk General's labor and delivery unit, said Dr. Rodney Hochman, the hospital's chief medical officer and administrator.

People at risk typically are given a single dose of antibiotics, Hochman said.

``This is not something that the public has to worry about,'' Hochman said. ``We have tried to err on the side of caution.''

Sentara has set up a hot line, 668-5800, to answer questions about the infection. Health professionals will screen callers for potential exposure and will offer antibiotics for those at risk.

The disease is spread through the exchange of respiratory or throat secretions. Those most at risk are people who have prolonged or close personal contact with an infected person such as by coughing, kissing or sharing drinks.

Yet the risk even for exposed household members is low: Only about four in 1,000 come down with the disease, according to the federal Centers for Disease Control and Prevention.

Hospital officials have contacted state and local health departments, as well as the CDC.

Hochman said Sentara has taken aggressive steps to control the disease.

``We have gone a couple steps beyond the CDC recommendations,'' he said.

Doctors worry about meningococcemia, however, because it can cause death only a few hours after a person falls ill, Hochman said.

In fact, meningococcemia can kill more rapidly than any other infectious disease. Up to 20 percent of patients die.

The Sentara nurse, a Virginia Beach resident whose name has not been released, recently had returned from a trip to Puerto Rico and began feeling slightly ill Tuesday, said Dr. Gary Yates, Sentara Healthcare's vice president for clinical effectiveness.

She worked from 7 p.m. Wednesday to 7 a.m. Thursday. She reported to work again Thursday night at 7 p.m. After only an hour on the job, however, she went home sick with fever and respiratory symptoms.

The nurse sought help at the Sentara Leigh Hospital emergency department at 9 p.m. Thursday and died just over six hours later, Yates said.

``This can take people very quickly,'' Hochman said.

Meningococcemia is caused when the bacteria Neisseria meningitidis invades the blood. Blood vessels begin to leak and can quickly collapse, leading to shock, Hochman said. Patients also can develop meningitis, an inflammation of the lining around the brain.

The CDC recommends vaccination against some strains of meningitis for college freshmen and military personnel because the bacteria spreads more easily in the close quarters of dormitories or barracks.

There were 46 cases of bacterial meningitis reported in the state last year, with 12 of those in the eastern region, which includes Hampton Roads, said Michelle Stoll, spokeswoman for the Virginia Department of Health.

Four people in Virginia died of the infection last year.

This year, 20 cases have been reported statewide, aside from the Sentara nurse, with three in the eastern region. The one person in Virginia who is confirmed to have died from the infection this year was from the northern part of the state.

The military recently diagnosed a case of bacterial meningitis in a barracks at the Naval Support Activity Norfolk, Northwest Annex, in Chesapeake.

After a physician reported one case, the military gave preventive treatment to other Marines who had been in contact with the meningitis patient, said Lt. Cmdr. Sharon Wright, head of the preventive medicine department at the Portsmouth Naval Medical Center.

Betty Rouse, regional epidemiologist for the state health department, said two local health districts are monitoring this week's case. The Norfolk Health Department is working with Sentara in following up with the nurse's work contacts.

And because the nurse was a Virginia Beach resident, that health district will investigate whether the woman's family, friends and others need preventive treatment.

The CDC will decide whether any of the people on the nurse's plane need to be contacted, Rouse said.

Reach Liz Szabo at 446-2286 or at lszabo@pilotonline.com.

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