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Saturday, April 10, 2004



Leptospirosis blamed
in student’s death

His Big Island family contends
that dengue may have had a role


Laboratory tests concluded that the bacterial disease leptospirosis -- and not dengue fever -- caused the Jan. 26 death of a Big Island college student, state officials said yesterday.

But the tests, performed by the federal Centers for Disease Control and Prevention, also reveal that 22-year-old Simon Hultman had a trace amount of dengue antibodies in his system. And Hultman's family says the virus should also be considered as a factor in the Pahoa resident's death.

"We're not saying it (dengue) is the cause of death," said Hultman's sister, Sharon Beauchan. "But we do want them to acknowledge that they did have a recent exposure, and I don't see how it couldn't have contributed to his (Hultman's) death."

State chief epidemiologist Paul Effler said the CDC tests show Hultman was indeed exposed to dengue before his death, a reading that has kept officials alert to the possibility that the virus is present on the Big Island.

Preliminary tests released earlier this year said dengue likely killed Hultman, who died in Maryland where he attended Washington College.

In response to the results, the Health Department asked Big Island doctors to look out for residents with symptoms of the virus and report any cases. No one has been diagnosed with dengue in the months before Hultman's death or since.

Even during the state's outbreak two years ago, in which 199 confirmed cases of dengue were reported, the Big Island had no cases of the fever.

Effler said that despite the CDC's finding on Hultman, physicians throughout the state will continue to be on the alert for dengue cases.

"To me it isn't a shocker that dengue might return to Hawaii," he said. "If it does, we need to respond appropriately."

Hultman is believed to have contracted leptospirosis while vacationing with his family on the Big Island during his school's winter break, Effler said.

The student took at least one hiking trip to Waipio Valley, which has been identified as a hot spot for the bacterial disease.

Family members say Hultman was in good health when he returned to school in January but went briefly to the hospital Jan. 18 and was found seriously ill in his dormitory the next day. He was readmitted to the hospital and died six days later.

Beauchan said her family is puzzled by the CDC's test results. Hultman, she said, was "treated for leptospirosis from the first day in the hospital," and hospital officials attributed Hultman's death to dengue.

"We still have a lot of questions," Beauchan said.

Hultman's family will meet with state Health Department officials Friday -- on what would have been Hultman's 23rd birthday -- to discuss the results of the CDC tests and "bring closure" to the case.

Hultman's is the seventh reported leptospirosis death in the past decade, Effler said. Every year, between 30 and 70 people in the islands are diagnosed with the disease.

Exposure to leptospirosis, which is usually transmitted through infected animal urine, can come from contact with animals, taro farming, swimming in freshwater streams and using water catchment systems.

The bacteria can get into the bloodstream through broken skin, or membranes in the eyes, nose and mouth. Two to 21 days after exposure, those with the disease usually develop flulike symptoms such as fevers, chills, muscle aches and nausea, according to the Health Department.

Leptospirosis can be treated with antibiotics, which are most effective when administered early in the disease.

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