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Health

String of area E. coli cases stirs concern

By ASJYLYN LODER
Published December 21, 2006


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When Kim Lapi's 9-year-old twins were hospitalized with E. coli in early November, state health officials told her there were no other cases in Florida. Her children weren't part of an outbreak, they assured her.

Then Lapi met Tampa mom Bonnie Villella, whose 14-year-old daughter had near-fatal complications of E. coli in the hospital room next door. Then she found Christil Perez in Pasco County, whose 4-year-old son also had the dangerous infection in mid October. Finally, health officials told Lapi last week of a case that matched her twins: a 20-year-old man in Lake County, who went to an emergency room on Oct. 30.

State health officials said Wednesday these are isolated cases and not an outbreak.

"We don't notify the public on sporadic cases, single cases, of any disease unless there's a public health threat," said Roberta Hammond, food and waterborne disease coordinator for the Florida Department of Health.

But the three moms said the department failed to investigate aggressively enough, especially in light of recent outbreaks throughout the country. Their stories highlight the frustration of parents trying to protect their children from a harrowing disease, and the difficulties faced by "disease detectives" trying to protect the public.

Their stories also underscore several frightening lapses by medical professionals -- including lost lab samples, failure to report one case for two weeks, and the misdiagnosis of 14-year-old Victoria Villella's near-fatal illness.

Bad diagnosis?

Alex Perez, 4, was the first. His mother, Christil Perez, took him to a Tampa clinic Oct. 14. Four days later, clinic workers told her that Alex had E. coli.

A health department investigator told Perez it was an isolated case. He recovered without hospitalization.

Perez doesn't know what strain Alex had, or if his case matches any others in Florida. Laboratories are supposed to send samples to the state. But when health investigators went looking for it, Perez said she was told it had been thrown out.

The department counted three cases in September, five in October and four in November, according to health department spokesman Fernando Senra.

Bonnie Villella said her daughter's doctors should have known about Alex Perez on Oct. 24. That's when Villella took Victoria to University Community Hospital in Tampa.

If the doctors had known, Villella said, perhaps they would have tested Victoria for E. coli - before removing her healthy appendix.

Escherichia coli can cause cramps, bloody diarrhea and nausea. Some people have mild symptoms while others develop potentially fatal kidney failure. It can be transmitted a number of different ways, such as handling raw beef, changing diapers, eating contaminated food. Last year, a Plant City petting zoo was implicated in an outbreak. An outbreak in September was thought to be caused by packaged spinach.

Late notification

After Victoria was diagnosed, a Hillsborough County health investigator took a case history. The investigator told Villella that Victoria was the only current case.

In the meantime, Victoria's kidneys started to fail. She was put on dialysis, and later eased into a drug-induced coma.

"They said, 'We've done all we can for her,' " Villella said. "I said, 'What does that mean, you've done all you can?' And the only response was, 'Your daughter is a very, very sick girl.' "

On Oct. 30, Victoria was moved to All Children's Hospital in St. Petersburg.

Also on Oct. 30, an unidentified 20-year-old man went to a Lake County emergency room with what turned out to be E. coli, according to Kevin Lenhart, spokesman for Lake County's health department. By law, the hospital was supposed to notify the county health department immediately.

It didn't.

The hospital - which Lenhart declined to identify because of privacy rules - didn't notify the health department until Nov. 16. "I'm not sure why they didn't tell us," Lenhart said, "but we pointed out to them that the length of time wasn't appropriate."

A medical puzzle

In early November, with Victoria Villella still at All Children's, Kim Lapi, a nurse, tried to puzzle out what sickened her 9-year-old twins. Both children worsened, and on Nov. 13, Alexa Lapi was admitted to Spring Hill Regional Hospital with E. coli. Her brother Michael followed a day later.

Both children remained in the hospital until Nov. 18. But Michael didn't get better, said Lapi. Tests showed signs of kidney failure, and he was taken to All Children's Hospital.

Lapi, like Villella, was told there were no other current cases - even though both had been in touch with their county investigators, and Lake County was three days into its own investigation.

Villella said, "When I finally met Kim Lapi, I said, 'You can't say that to me anymore. There's a case next door.' "

In a Dec. 6 interview with the Times about the Lapi twins, Hammond said the children were the only case in the previous three weeks, exactly 21 days after the Lake County case was reported.

Hammond said Wednesday she didn't remember that conversation. It's possible she hadn't been made aware of the case yet, she said.

In mid December, health investigators found a match to the twins. Lenhart confirmed Tuesday that the Lake County case was the match. It's unclear where the man contracted E. coli.

"I know it's frustrating, but you may not find an answer," Lenhart said. "But we're not going to stop looking."

Victoria Villella was released from the hospital on Thanksgiving. Michael Lapi went home a day later, and is recovering. Victoria has lasting vision problems, her mother said. The freshman hasn't been to Wharton High School since Oct. 20.

Angie Drobnic Holan contributed to this report. Asjylyn Loder can be reached at aloder@sptimes.com or 352754-6127.

[Last modified December 21, 2006, 05:33:49]


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