When 17-year-old Steven Quarry died, it was as if the soul of the Quarry family died with him.
Thirteen months later, his father, Jim, is numb and angry. His mother, Lynne, is mired in sadness. His 25-year-old brother, Mike, gropes for the joy he's lost.And John, 18, who feels a continuing connection to his twin brother, is trying to pull the family together again.
The Quarrys are living the devastation of one of the most frightening contagions of our time: meningococcal disease.
Spread by a cough, a sneeze, a kiss or a shared drink, it can kill a healthy teenager within hours.
"It's kind of like a tornado touching down periodically," said Dr. Zell McGee, head of the infectious diseases center at the University of Utah School of Medicine. "And now it's touching down here."
McGee said a handful of recent cases could be the beginning of another burst of meningococcal disease in Utah. Craig Nichols, the state epidemiologist, said that's unlikely, because different bacteria are at work in the new cases.
In the last Utah outbreak, from October 1993 to March 1994, 29 people were afflicted and six, including Quarry, died.
Moreover, sporadic cases of the disease have rocketed. Altogether, 43 Utahns fell ill to meningococcal disease in 1993 and 1994, and 13 died. In the previous five years combined, there were only 35 cases.
This meningococcal season, which stretches from late fall to early spring, has seen outbreaks in Wyoming, Minnesota, Texas, New Mexico and New Hampshire, and it's the second year of outbreak in parts of Washington and Oregon.
In the unlucky few who lack immunity, the meningicoccus bacteria infects the lining of the brain as a form of meningitis or the bloodstream as meningococcemia.
Steven Quarry was one of those whose blood was attacked.
After school on Friday, March 11, 1994, the center for the state champion Skyline High School football team, shot hoops with a friend. He was weary, though, and after a nap began showing classic flu symptoms.
His mother, a teacher at Decker Lake Youth Center, had just that day made photocopies of a health department warning on the outbreak. Skyline High, too, had just sent home a notice on meningococcal disease.
A 17-year-old Wellington boy and a 17-year-old Granger High School student had both died the previous month, and a Skyline sophomore had narrowly survived what doctors believed was meningococcemia.
So Lynne and Jim Quarry didn't hesitate to take Steven to St. Mark's Hospital, suggesting nurses and physicians consider meningococcal disease.
After several hours in the emergency room, Steven was sent home with what they were told was probably a nasty case of flu.
"We shed a few tears of relief and went to bed exhausted," Lynne recalls.
Overnight, though, Steven's condition worsened. He ached all over and had diarrhea. By 5:30 a.m., he struggled to breathe and had blue streaks on his face and arms. His parents dressed and rushed him to St. Mark's.
"He was squeezing my hand and I was squeezing his and he said, `I'm dying, Mom.' He was thrashing around. `I'm dying, Mom,' " Lynne Quarry remembers.
Steven Quarry did die soon after reaching the hospital.
The physicians who treated Steven at St. Mark's were not available to consult Friday, said Shauna Abbatiello, St. Mark's director of quality management. However, she said, "It's our position that we did nothing wrong. We treated Steven appropriately."
Panic over a disease that could strike so fast swept the east side of Salt Lake City after Steven's death. Dozens of prescriptions for the antibiotic rifampin were written for Skyline students and their families.
But overshadowing the panic was the grief, for Steven Quarry was an unusually loved boy.
More than 2,000 attended his funeral, and the day before he was buried fellow students, using flour, changed the "S" in the foothills above the Skyline neighborhoods into a "Q." They made a smaller Q again last month on the anniversary.
On trails in the Wasatch range, small Qs were painted on rocks.
"He crossed all the lines, whether you were the kid out in the bushes smoking pot or the president of the school," said his dad.
"Steven wasn't an Eagle Scout or a Sterling Scholar, but he had all these attachments," said Lynne Quarry.
Jim and his sons were fixtures as football coaches and players from the time the boys were big enough to don shoulder pads.
Even then, Steven was the "bridge," recalls his father. Jim Quarry would yell at a young player. Steven would be there to soothe the hurt.
"Sometimes I was so ashamed because I could see what damage he was having to repair," said the father.
The Quarrys remain in a limbo of grief.
Jim Quarry, a U.S. probation and parole officer, gets angrier as time passes - angry that the hospital didn't detect the disease, angry that he didn't follow his instincts and press for quicker, serious treatment.
"His role in the family . . . as a part of my heart, I've lost some of that strength," said Jim Quarry. "There's too much emptiness. Most of the time, I'm pretending."
For brother Mike, there are glimmers of healing. After months of numbness, he latched onto the game of football last season with the tenacity of an obsessed fan. "I gave myself this feeling that . . . I can feel again." Even so, he said, "I haven't regained a great deal of my passion."
Only John, Steven's twin, feels a measure of peace.
John, who is deaf, regrets the times he lashed out at Steven in frustration or anger. But mostly he feels that Steven wants family members to get on with their lives.
"I've always had this feeling that he's still around. I know him so well, it's kind of a spiritual feeling. Maybe he's my guardian angel."
At graduation from Skyline last spring, John led the procession with his brother's mortar board and robe in hand. He believes Steven has bolstered him in death as in life, helping him thrive in a social world inhospitable to a handicapped youngster.
"I'm a nicer person, helping people. I understand relationships better," he said. Small annoyances no longer matter.
Lynne Quarry visits Steven's grave each day after work, and thinks that she should be fixing him dinner instead.
She's sorry she is unable to help her own mother, who cared for the twins daily as children, deal with her grief. And she regrets not giving much to her husband or other sons.
She has changed from a woman with a myriad of planned projects into a woman who is fumbling for a future.
"This tunnel cloud just touches down and takes everything. There's just massive destruction. I wonder if the healing will ever come."
Incidence is rare but can be deadly
Selected facts about meningococcal disease:
- What It Is - Caused by bacteria common in 12 percent to 15 percent of population. Transmitted by coughing, sneezing, kissing, sharing a drink or cigarette. If it passes through tissue at back of throat, it can infect the blood as meningococcemia or lining of the brain as a form of meningitis.
- Incidence - One case per 100,000 population per year. About 2,600 cases per year in United States. Deadly in fewer than 10 percent.
- Utah Cases - Two cases and one death in 1995, two possible cases under investigation; 19 cases and five deaths in 1994; 24 cases and eight deaths in 1993; 35 cases 1988-1992. In October 1993-March 1994 outbreak, 29 cases and six deaths. Majority caused by Group C meningococcal bacteria.
- Symptoms - Preceded by upper respiratory irritation, then severe headache, fever, vomiting, diarrhea, confusion, stiff neck with meningitis and red spots turning to purple blotches with meningococcemia.
- Timing - Most show symptoms two to three days after exposure. Death can occur within 24 hours of first symptom.
- Treatment - Antibiotics, primarily rifampin, for victim and those in close contact. Vaccine available in outbreaks of all but Group B meningococcal disease.