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B 2/75
17 December 2002, 11:33
SAN DIEGO, California -- Physical training has been suspended for 72 hours at the Marine Corps Recruit Depot, while officials investigate whether an 18-year-old recruit who died while being treated for an acute rash may have had Strep A, a rare but very serious bacterial infection.

Officials are still awaiting autopsy results for Pvt. Miguel Zavala, who went to the medical clinic Sunday morning with a rash on his left ankle. Hours later, the rash had spread to the rest of his body, and Zavala died at 1 p.m. (4 p.m. ET) while being treated at the Naval Medical Center San Diego.

Zavala had completed 23 days of training as a Marine.

"Yesterday's sudden death was most certainly a bacterial infection," said Capt. John Malone, the director of medical services at the hospital and an infectious disease doctor. "The streptococcal bacteria that we are aggressively pursuing is a possible cause of this unusual presentation."

Malone said Zavala's case is "very consistent" with Strep A, but doctors are considering other types of infections as well. There is no evidence of meningitis or necrotizing fasciitis -- also known as flesh-eating bacteria -- as a cause of Zavala's death, he said.

Last week, staff members at the Marine Corps Recruit Depot noticed an increase in carriers of Group A streptococcal pneumonia -- more commonly known as Strep A -- as well as a number of recruits showing up with symptoms of it, said Maj. Gen. Jan Huly, the depot's commanding officer.

An investigation revealed a "higher-than-normal incidence" of Strep A at the depot, so Sunday, doctors inoculated all 5,000 of the recruits and their supervisory personnel with a type of penicillin or other antibiotic, Marine Corps spokesmen said.

There is no vaccine for Strep A.

As of Monday, some 50 people were being treated for bacterial infections, and most are improving with antibiotics, Malone said.

The only person so far to have a confirmed case of Strep A is in critical condition in the hospital, Malone said. That person has pneumonia and does not have any problems on his skin, such as a rash, Malone said.

Strep A can cause different types of infections, either in the throat or on the skin.

Malone said streptococcal infections are transmitted with close contact and thrive in the close quarters in which the Marines train and live.

Two other Marine recruits have died at the training base since November 23, but Huly and Malone said those deaths were not related to Strep A.

One collapsed on an obstacle course and died of sudden cardiac arrest, Malone said. The other died after advanced swimming exercises of pulmonary edema, or fluid in the lungs; Malone said the man had recently had a cold which might have been a factor.

Before the recent deaths, the last recruit to have died at the depot was in 1998. Now, with three deaths in the course of a few weeks, Huly said officials are "concerned" but feel they have the situation under control.

"These are the treasure of the United States of America," he said of Marine recruits. "Mothers don't send their sons to the Marine Corps and expect them to become casualties in recruit training. ... We take every one of those deaths personally, as if there was some way we could have prevented it. And we're going to find a way we can prevent it."

Huly said during the suspension of physical training, instead of running obstacle courses or doing swim qualifications, for instance, recruits will have classroom training instead.

TerribleTed
17 December 2002, 21:42
It is not more commonly known as Strep A. If anything it's more commonly known as GAS (group A strep). I think the press is confusing it with Staph A. (staphylococcus aureus).

Yes, GAS can be a killer. It happens on occasion. Start
'em on nafcillin and/or levaquin IV. disclaimer - just my opinion, check your Sanford guide for additional info.

Doctor_Doom
11 February 2003, 02:37
In my experience Strep is referred to clinically according to Litchfield gorups, hence strep A, B, etc. Staph is just staph or staph epi, since only two are commonly seen in hospital and public health settings. I have never seen GAS used as a clinical acronym for strep A.

Perhaps acronyms and conventional notation is different in SOMED clinical practice?

themadmedic
11 February 2003, 19:54
GAS as an abbreviation for Group A Strep is not uncommon in primary care settings.

TerribleTed
11 February 2003, 20:49
Actually, I can't remember where I saw it as GAS. It wasn't at any military special operations school.


Funny story (for me). After I got out of the military, I got a job as an emergency room tech. My military medical education (SOMC, generic Ranger medical training; no medical school yet) prepared me well for that job except some people kept talking about "sonometers", as in an 8 "sonometer" laceration. I remember thinking what the hell are "sonometers"? Finally, after a few months, I asked this dude about the "sonometers". I felt pretty stupid as he explained the whole metric system to me and at the end he added that some people pronounce centimeter as "sonometer". Afterwards I was kind of pissed, I know exactly what a fuckin' centimeter is, I just want to know why some a-holes insist on some foreign pronounciation.

Matter of fact, in a few months, when I'm a doctor, I ain't going to let anyone pronounce centimeter as sonometer around me without correcting them.

themadmedic
11 February 2003, 22:01
Same experience with centimeters in PA school!

Doctor_Doom
11 February 2003, 23:10
That pronunciation pissed me off as well in medical school. I finally started smiling innocently and saying "Um, can you spell that?"

Took me about two weeks to figure out what the hell "skil-lee-tal" muscle was too...