More than 50 cases of a form of meningitis from which children almost always recover without any lasting effects have been reported in the Washington area in the past two months.
Although the intial symtoms of aseptic, or viral, meningitis - fever of about 104, vomiting, headache and general discomfort - are the same as those of the far mote serious bacterial meningitis, aseptic eminigitis usually runs its course within a week, the child is usually none the worse for the experience.
Meningitis is a term describing a set of symptons, rather than the name given to a particular disease, such as measles of chicken pox. It refers to an inflamation, or swelling of the meninges, or linings, of the brain of spinal cord or both.
Bacterial meningitis, which can be cured with antibiotics if caught in time, can lead to permanent brain damage paralysis, coma and deaths.
Viral meningitis, which is caused by various types of viruses, is not sucpetible to any treatment. All that can be done for the patient - most usually a child under 3 years of age - is to make him comfortable, provide fluids and help in breathing if that becomes necessary, until the disease runs its brief if uncomfortable course.
"Usually this type of meningistis is fairly self-limited," said Dr. William Rodriquez, a fellow in infections diseases at the Children's Hospital National Medical Center. "The patients recover with minimal problems. Usually by the third to fifth day they are better.
"Polio used to cause this type of meningitis," said Rodriquez, "but it had other complications. This is not polio."
"We had 30 cases thus far (since the beginning of June)." he said. "We've had one case of transitory paralysis of an arm, but it improved markedly as the child left the hospital. We've had two cases of encephalitis - " a swelling of the brain itself - and one of the children has recovered and the other is recovering. Those children were under three months of age.
"If a child has symptoms the parents should contact their private physician or seek help ar one of the clinics." he said. "Most of these things are very benign."
At Greater Southeast Community Hospital, which has seen 21 cases since May 4. Dr. Meechai Sriprasert said, "we have to admit them and do a spinal tap and observe them quite closely to rule out bacterial meningitis. There are six cases (of viral meningitis) in the hospital right now.
"I believe it is an epidemic," said Sriprasert, director of pediatrics at the hospital. "We usually might get a few cases in a year."
Rodriquez hestitated to call the outbreak an epidemic, saying instead that it is "an increased incidence of the disease. In 1972 we had an epidemic. We had close to 104 cases in children less than 15 years old. Of those, 84 occured in the early summer."
According to Rodriquez, the virus itself is highly contagious, but the appearance of the symptoms is relatively rare. This indicates that in most persons the body manages to successfully fight off the virus before it can cause the symptoms.
Although no one yet knows that particular virus has caused this outbreak. Dr. John Sullivan-Bolyai, a medical epidemiologist with the federal Center for Disease Control in Atlanta, said such outbreaks are "almost always due to the enteroviruses. They're both respiratory and fecal-oral," spread through through the air and by children touching and then ingesting traces of fecal material.
Suilivan-Bolyai said that the outbreak in the District, as well as outbreak in Albama and Connecticut are now under investigation by the CDC.
Not including the Washington cases, there were only 995 cases of viral meningitis in the nation during the first 25 weeks of this year. However, CDC official said now is the time of year when viral meningitis outbreaks usually appear.
Dr. George J. Glasso, chief of the development and applications branch of the National Institute of Allergies and Infectious Disease, said "I think we have a problem but I wouldn't call it an epidemic. Although there are a fairly large number of cases, they are spread out in time. Epidemic to me means something explosive," a large number of cases appearing within a very short period of time, said Glasso.