Slade Ellis '98 remained in critical condition at 1:30 this morning in the intensive care unit at Dartmouth-Hitchcock Medical Center with spinal meningitis, a highly contagious and potentially fatal inflammation of the fluid that covers the brain and the spinal cord.
Ellis's friends found him in a semi-unconscious state yesterday after he had complained of sickness Tuesday night. He was taken to DHMC late yesterday afternoon.
"He is very sick, but we're hopeful," Director of College Health Services Jack Turco said last night. "He's been stable now for four or five hours and has began treatment with antibiotics. We won't know anything for several days."
Last week, a female freshman was identified with the same type of meningitis, Turco said.
The woman lived in a different residence hall than Ellis, Turco said.
"That student was treated with antibiotics and is doing fine and really never got that sick," he said.
Turco said it was "his call" on the first case and he decided not to publicly release the information.
The College is still investigating whether the two cases are linked.
Turco said the College has started treating students who had close contact with Ellis in an effort to prevent any further spread of the illness.
It is still unknown how exactly Ellis contracted the illness. According to Turco, spinal meningitis is carried by air molecules, like chicken pox. But Turco said spinal meningitis is not as easy to catch.
"The outbreak tends to be confined to the college [it infects] and does not spread into the surrounding community," Turco said.
"It is not wildly contagious, but it does have the potential of being spread," Turco said, "The feeling is that you need to have intimate contact for several hours."
Turco said he has consulted with Dr. Jeff Smith, the epidemiologist for the State of New Hampshire, and Dr. Fordham Von Reyn, chief of the infectious disease department at DHMC, to discuss the need for precautionary measures to prevent the possible spread of the illness.
"If you have one of anything, you don't have an outbreak," Turco said. "But if you have two, you just want to make sure you're doing everything to make sure it's not spread any further."
There are two basic types of meningitis. One form of the disease is caused by a virus, the other form by a bacteria. The viral form is not that serious, but the bacterial forms "are serious and can be life threatening," Turco said.
According to Turco, Ellis' spinal fluid clearly shows that his case is bacterial, but the exact kind of bacteria is still not known.
Turco said he is 95% sure it is meningococcus bacteria because, "this type is the most common seen in a young healthy college student."
The case fatality of meningococcus bacteria infection has remained fixed at five to 15 percent for many years, according to Harrison's Principles of Medicine.
Turco said he will be sure of the exact type of bacteria tomorrow.
Ellis could have a rare species of meningococcus bacteria, which responds to antibiotics but not to vaccination, Turco said.
In a press conference last night, Turco, Dean of Freshmen Peter Goldsmith, Assistant Dean of the College Teoby Gomez and College Spokesman Alex Huppe discussed the particulars of the illness and its potential danger to Dartmouth students.
"We don't want to alarm anyone," Huppe said. "We just want people to be aware this is a possibility and if you have the symptoms, seek some attention."
Turco said he feared people would overreact.
"This is nothing to panic about and pack your bags and leave Hanover," Turco said.
Last night, Goldsmith and Turco discussed the illness and attempted to abate any fears that students who live in Brown residence hall in the Choate cluster may have had.
Ellis lived in Brown.
Tim Bruckner '98, Ellis' roommate, said it was "pretty freaky" to see Ellis sick.
Campus police picked up Bruckner and took him to Dick's House so he could be given antibiotics.
"I really appreciate how Dartmouth handled it," Bruckner said. "They were really well informed."
Ellis passed out in his neighbor's room. The occupants of that room, Tony Jurado '98 and Ryan Broderick '98, are currently sleeping in their Undergraduate Advisor's room until their room is cleaned.
The symptoms for meningitis begin much like an upper respiratory infection. Symptoms can begin as non-specific as a sore throat, but other signs of the illness are a high fever, headache, rash and in its most progressive stages, a stiff neck and delirium.
Turco said there is no way of predicting how long the infection will take to materialize. It can begin in the throat and nasal passages and remain there for days or weeks.
People can carry the infection and never get ill from it. Within a matter of hours a person can get sick with the bacteria in their blood and the bacteria could possibly travel to the spinal fluid.
Usually the infected person will get very disoriented and semi-conscious when the bacteria moves into the spinal fluid.
College officials said treatment for the infection is simple, assuming it is caught early on.
"It's very treatable with antibiotics. The question is how sick is the individual when you start treatment?" Turco said.
"The state epidemiologist has recommended that we administer an antibiotic, called Rifampin, which is administered two times daily for two days, that can be given to students who have come into close contact with this individual," Turco said.
The vaccine for the illness is called Menomune and is 90 percent effective. However, it does take 10 to 14 days to take effect and is only effective for three to four years.
The problem, according to Turco, is that the bacteria meningococcus has four different species and the vaccine only covers three.
There is some indication that Ellis has this fourth, uncovered species, Turco said.
According to Huppe, the antibiotics have already been administered to those students who have had close contact with the student. A total of two or three students have received the treatment. Turco said students should self-monitor themselves
Turco said the College has not yet found it necessary to treat the rest of the residents in the hall.
Turco said students who are concerned should call the health services and exams will be given to those who are worried.
"We'll make sure we have extra people on the phones to answer questions and examine people if need be," he said.
"I would say 99.9 people out of a 100 who have a sore throat and headache are not going to have meningitis, but a viral infection," Turco said. "But it is going to be very important for us to be very vigilant and have a low threshold for suspecting the menococcocul infection."
Other students in the dormitory did not seem alarmed at all, simply concerned about Ellis.
"I'm really not scared. I think that things are really well under control. They seem to be taking a really conservative approach," said Jen Constable '98, a hallmate of Ellis's.
"Slade is such a fabulous guy, we're really saddened about his situation. We're really pulling for him," Steve Zerke '98, another hallmate said.
Turco said several outbreaks of this specific bacteria have taken place on other college campuses and military bases, "where people live in close quarters with each other."
One of these outbreaks occurred at the University of Connecticut in May 1993, after three students had been diagnosed with the infection. This prompted the university to offer vaccinations to about 20,000 students and staff members.
There was another epidemic at the University of Illinois in 1992. Three students died of the infection and five others contracted non-fatal cases. This outbreak also prompted school wide immunizations.
The last outbreak of meningitis on the Dartmouth campus was in the mid-1980s. One student was very ill like Ellis and two others had the bacteria in their blood. The student did not die.
