Visiting a Western-style dance club somewhere in Salt Lake County - possibly in Salt Lake City - is the key connection that links six Utahns who were stricken by bacterial meningitis.
State epidemiologist Craig Nichols refuses to identify the club or its location, other than the county. But five of six people who contracted the potentially deadly disease were at the club over the Thanksgiving weekend, and the sixth had close contact to someone who was there.None of the victims died. All six were hospitalized, and "most of them are recovering," Nichols said.
Two of them had dated and kissed, but the other three in the club did not even know each other. One of them didn't dance during the visit to the club.
It was "just an ordinary weekend at a club," not a special concert. Most people were "just there to dance."
Nichols admits it may be coincidence that the five went to the same dance club. But with only 21 cases of bacterial meningitis in Utah this year, counting these six, the odds of that are extremely low.
"We do not think there's any continuing transmission at the club, and there's no need for people to stop patronizing dance clubs," he said Thursday.
"But there are a couple of recommendations that we'd make to anyone who goes out this time of year:
- "They ought to cover their mouths when coughing. This helps reduce the spread of the meningococcus (bacteria) as well as other organisms.
- "You should not share cigarettes or drinks.
- "Avoid kissing strangers, because saliva is a major transmitter (of disease), and it also makes it difficult for us to trace individuals who might have been exposed."
The 21 cases as of Wednesday makes 1993 "a record year for us over the past 10 years," Nichols said. "We generally are one of the lower states of the country for meningitis disease, and this brings us up to the average."
Nichols said the State Health Department has asked all major hospitals in Salt Lake, Davis and Utah counties to quickly report to their local health departments if they see any more possible cases of the disease.
Meanwhile, he said, the club has not been closed.
"There's really no reason to believe that there's anything wrong with the club itself. But we will do a total inspection just as a precaution, to make sure that there's nothing unusual."
Bacterial meningitis usually is spread by close contact. But with the flu outbreak that Utah is experiencing, many people are coughing.
Meningitis bacteria can be spread through coughs. And the bacteria aren't rare.
"It's not unusual to find even 25 percent of the population carrying this organism but not having any symptoms," he said.
"It's a common throat organism."
But in some circumstances - not well-understood - the bacteria might spread to the lining of the spinal cord and the lining of the brain. There, the infection causes meningitis.
Some of the symptoms are like those of flu in that the victim suddenly has a high fever and a severe headache. But it differs in that with teens and adults, nausea and vomiting also occurs.
Also, a meningitis patient will have a stiff, painful neck. Commonly, a pink rash covers the body.
"As the disease progresses, delirium and coma are common," Nichols said. Sometimes this stage is reached within 48 hours, or even in one day.
Tracing the outbreak was a puzzle.
"It was just by good investigation that we were able to find out that they had this weekend in common," Nichols said.