Dr. Mark Hostettler, medical director of Alliance Community Hospital, said a possible vaccination campaign hinges on an analysis of data by the federal Centers for Disease Control and a possible third case of Neisseria meningitis.
Jonathan Stauffer, 15, and Kelly Coblentz, 16, both students at West Branch High School in Beloit, a village near Alliance, died after they were diagnosed with the Neisseria strain.
Christin Van Camp, 18, a student at Marlington High School, about 15 miles from Alliance, has been diagnosed with an undetermined strain of Neisseria meningitis. Ms. Van Camp was in serious condition last night in Children's Hospital Medical Center of Akron.
The cases have sparked widespread anxiety in Alliance, Beloit, and Marlington.
Many students have friends who attend one of the other schools, heightening fears of infection.
News that Ms. Van Camp had been stricken cast a pall over graduation festivities for seniors at the three high schools.
Abby Fox, a junior at Alliance High School, was at her boyfriend's graduation party Saturday night when word spread of the third meningitis case.
Her worried mother showed up at the party and took her, her younger sister, Mary, and a friend to the hospital to try to get short-term antibiotics. After a 20-minute wait, they drove to a pharmacy in Canton, about half an hour away.
They waited for two hours while pharmacists prepared newly received doses for them, Abby said.
Yesterday, Abby and her sister stayed home from school.
“My mom wouldn't let me go,” Abby said. “I was kind of relieved, but at the same time, I was worried about my school work.”
Classes were canceled at West Branch, which is to reopen today, and Marlington, which called off school for the rest of the year.
Doug Hendel, who hosted the party for his son, Mark, went to the hospital Sunday morning and got antibiotics for everyone in his family, including relatives who were visiting for the graduation.
“We had potentially exposed our family and all their friends,” he said. “There were all kinds of rumors flying around. There's a lot of connections in this town. It's a small town.”
Mr. Hendel said he felt secure enough to send Mark, 17, who graduated Sunday night from Alliance High, to a camp near Youngstown, where he'll train this week for his summer job as a camp counselor.
Residents in parts of Stark and adjacent Mahoning County lined up through the weekend to receive the antibiotics. Dr. Hostettler said 21,000 doses were distributed at the hospital, and about 16,000 people received the medicine at Southeast Elementary School in nearby Salem, about 15 miles east of Alliance.
Classes were canceled in Salem, but the high school graduation, postponed on Sunday, was conducted last night in the school auditorium.
Classes also were called off through tomorrow, the end of the school year, at St. Thomas Aquinas High School in Louisville, just west of Alliance.
“Parents are scared,” said Joe Mohra, a special education teacher at the Catholic school. “The fear alone is like a disease. It spreads, and we had no choice but to close the school.”
Mr. Mohra said he understands the anxiety of students and parents but feels medical authorities have the situation under control.
“I haven't taken the antibiotic, and I don't plan to, unless my family doctor tells me to,” he said.
Robin Walker of Alliance kept her daughters, 17-year-old Jennifer and 14-year-old Amanda, home from school just to be safe.
“They were scared, and with it being the end of the school year, I figured they might as well stay home,” she said. “Other than this nagging fear in the back of my head, I'm pretty sure it's going to be OK.”
Dr. Hostettler said a CDC epidemiologist was in Alliance “at our request to provide us with instant background information and recommendations.”
“We're doing anything and everything at the highest speed possible to make sure our community is protected,” he said.
Officials finished distributing antibiotics yesterday morning, an effort they began Saturday and continued almost nonstop through the weekend.
Dr. Hostettler said officials stopped distributing the antibiotics because they are only effective for 24 hours after the course of treatment is finished.
The pills kill bacteria that can spread from nasal and throat fluid. The vaccine, if used, would protect those taking it from infection for seven to 10 days, he said.
Under CDC regulations, three cases of meningitis from the same strain are needed to declare an outbreak, Dr. Hostettler said. Blood and urine samples from Ms. Van Camp were being tested in a CDC lab in Atlanta.
Dr. Hostettler said the size and scope of any vaccination program had not been decided, but that the Ohio Department of Health will pay the $59 cost per dose.
Meningitis is spread by direct, close contact with nose or throat discharges from an infected person. The two students at West Branch High who died reportedly shared a water bottle at a picnic.
Initial symptoms may include fever, headache, body aches, and rash. Later symptoms can include a stiff neck, nausea, vomiting, and exhaustion.
About 3,000 cases of meningitis occur each year in the United States, according to the CDC. Of that number, an estimated 10 to 15 percent die from the disease.