Meningitis-stricken teens attended same concert.

Byline: Tim Christie The Register-Guard

A Eugene teen-ager killed by bacterial meningitis and a second one made critically ill by the same virulent disease attended the same punk rock show at the WOW Hall during the Eugene Celebration, public health investigators said Monday.

Both 16-year-old Mani Shimada, who died last Thursday, and 15-year-old Christina Norton, who fell ill Sunday and is listed in critical condition, were sickened by bacterial meningitis. Also known as meningococcal disease, the illness can progress at a frightening pace and lead to death if not quickly treated.

Both attended the Sept. 20 "Bloodstains Across Eugene" music show at the WOW Hall, which featured such local bands as Monkee Torture, Capgun Suicide and Blasphemous Abnormality.

Lane County public health officials don't know if Shimada and Norton - who didn't know each other - had any contact during the show, or even if they were there at the same time. It's possible one exposed the other or that both were exposed by a third party. But the concert is the one known common thread that links their illnesses.

"It's the only link we know so far," said Dr. Sarah Hendrickson, the county public health officer.

As a result, public health officials are advising anyone who attended the show - and particularly those mixing it up in the mosh pit - to contact their doctor to determine their risk of contracting the disease and possible preventive treatment.

Public health officials have been busy working the phones, calling friends and friends of friends of Norton and Shimada, searching for a connection. They learned of the WOW Hall link Monday morning.

The WOW Hall, at 291 W. Eighth Ave., holds about 300 people but was never filled to capacity during the concert in question, said publicist Bob Fennessy. Anyone who had a wrist band to get into the Eugene Celebration could wander in and out of the venue, he said.

Still, a crowded mosh pit filled with aggressive, colliding dancers could provide a setting for disease transmission, public health officials said.

"We know the WOW Hall is an enclosed area and the mosh pit activities can be pretty intense and pretty close together," said Betsy Meredith, the communicable disease nursing supervisor for Lane County Public Health.

Norton is a sophomore at South Eugene International High School. She fell ill Sunday afternoon and was taken to Sacred Heart Medical Center. She was being treated in the intensive care unit and still listed in critical condition late Monday.

School officials distributed fliers to students Monday with information about Norton and about the disease. Norton's case was the talk of campus Monday, said senior David Cao, student body president.

"It's very alarming to know that a person who goes to your school ... is possibly going to die," he said. And students suffering from seemingly routine illness were suddenly a lot more concerned, he said. "Everyone is scared."

County health officials provided doses of the antibiotic Rifampin to the South Eugene Health Clinic for students who may have been exposed and didn't have access to medical care.

Norton attended an hourlong International High School assembly at South Eugene High on Friday afternoon along with about 650 other students from the city's four high schools. It's possible other students were exposed at the assembly, said Laurie Moses, South Eugene principal, but the students were together for only one hour and they weren't engaged in face-to-face contact, she said.

Health officials say people are not considered at high risk for contracting the disease unless they've had four hours of face-to-face contact with a contagious person over a weeklong period.

Student leaders were preparing a package of cards and well wishes for Norton. Her classmates at International High School signed a large placard with the message, "Get Well Soon Chris - Our Thoughts Are With You."

Moses, who is in her first year as principal, said Norton has good attendance, takes challenging classes and has a regular group of friends she eats lunch with.

"She seems to be a very fine person from a loving family," Moses said.

Shimada was a 16-year-old junior at Wellsprings Friends School. He got sick Thursday and died later the same day. A memorial service is planned for this Thursday at 1 p.m. at the school.

The rapid onset of the disease is similar to what happened to Jill Dieringer, a University of Oregon freshman who died from meningococcal disease in 2001. Symptoms can include high fever, rash, headaches and vomiting.

"It's the only thing I know that takes a perfectly healthy person and kills them in 12 hours," said Dr. Kenneth Bromberg, an infectious disease specialist who directs the Vaccine Study Center at the State University of New York in Brooklyn.

In Oregon, 919 cases of meningococcal disease were reported between 1993 and 2002, an average of 92 cases per year. The number of cases has declined each year since a high of 136 in 1994.

In Lane County, 90 cases were reported during the same 10-year period, for a rate of 2.9 cases per 100,000 population, about the same as the statewide rate.

A vaccine for meningococcal disease is available. The CDC and pediatricians recommend that parents of incoming college freshmen talk with their doctors about getting their children vaccinated because college freshmen are at higher risk for getting the disease.

But the vaccine that's available does not protect against the strain of meningococcal disease that's most prevalent in Oregon. The Type B strain accounted for 57 percent of Oregon cases from 1993 to 2002.

Lab tests have confirmed Norton has Type B. Public health officials are still awaiting lab tests for Shimada.

Still, parents of high school students and college freshmen should learn more about the vaccine by talking to their doctors so they can make their own choice, said Lynn Bozof, executive director of the National Meningitis Foundation.

"My advice is to find out about the disease," said Bozof, who lost her college-age son to meningococcal disease. "At least have that information to make an educated decision."

The vaccine costs $70 to $80 and lasts three to five years.

"To me it's a small price to pay for what comfort and protection you can get," she said.

BACTERIAL MENINGITIS

Symptoms: Can include high fever, rash, headache, stiff neck, vomiting, irritability and lethargy. Typically appear three to four days after exposure, but can take as long as 10 days.

How it spreads: By droplets or direct exposure with discharges from the nose or mouth - for instance, by coughing, sneezing, kissing, or sharing a drink or cigarette. Not as contagious as common cold or influenza, and cannot be spread simply by breathing the same air where a person with the disease has been.

How to reduce risk: Stop smoking; don't let children in rooms where people are smoking; get a flu shot and avoid close contact with people who have coughs and colds; get pneumococcal vaccine if you're in the group for whom it's recommended.

More information: Visit Web sites of state Department of Human Services (www.dhs.state.or.us/publichealth/acd/nmenin/facts.cfm) or Centers for Disease Control and Prevention (www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm)

MENINGITIS FACTS

Mortality: Sickens 3,000 people a year in the United States and kills 300. About 10 percent of the population may carry the bacteria at any given time, but the vast majority do not become ill.

Antibiotic: Rifampin is recommended treatment for anyone exposed to bacterial meningitis. Rifampin should not be taken by anyone who is pregnant and it may reduce the effectiveness of birth control pills and patches. It will temporarily turn the urine orange and may discolor contact lenses.

Vaccine: One exists, but it does not protect against a strain of disease known as Type B, which accounts for more than half the cases in Oregon. It remains effective three to five years.