County lives in fear of sore throat bug

WHEN Joan Wood rang her accountant, she expected advice on her financial affairs, not her health. But when he commented on her husky voice and gave her some bad news about a mutual friend, her immediate reaction was to ring her doctor.

The friend is in intensive care at Gloucestershire Royal Hospital with the latest case of a mysterious infection that can kill within hours - an infection caused by a microbe which usually causes little more than a sore throat but which has claimed two lives and possibly a third. Two other victims were saved only by urgent surgery.

Gloucestershire - the county where 98 people contracted meningitis between 1981 and 1987 in Stroud alone - is once again experiencing a medical phenomenon which defies explanation.

Doctors and scientists are baffled by the way in which the streptococcus bacterium appears to have regained the lethal virulence it used to have 50 years ago, before the availability of antibiotics. In the most severe of the Gloucestershire cases, all of which have occurred within a 25-mile radius, the bacterium has caused 'necrotising fasciitis', a condition which can lead to gangrene when the microbe eats quickly through layers of tissue, producing deadly toxins and killing cells as it grows.

While laboratory tests are carried out in an attempt to explain the unusually high incidence of cases in the same area, precautions are being taken to minimise the risk of further outbreaks. Gloucester Health Authority has sent 500 letters to the county's doctors and community health nurses, detailing the possible symptoms, and local TV and newspapers have publicised the dangers of not acting quickly enough when the symptoms - diarrhoea, vomiting and swollen lymph glands - first appear.

However, the measures have come too late for a retired GP from Gloucester, and a woman in her sixties from the Forest of Dean, both of whom died in mid-April at Gloucestershire Royal Hospital. One other patient was successfully treated at that time, as was another earlier at Stroud General Hospital. The Stroud patient was Helen Sackett, 64, who developed the infection after undergoing an operation for varicose veins.

David Hunt, consultant in public health medicine at the Gloucester Health Authority, said it was difficult to make sense of the outbreak to the general public when he and his colleagues were having so much difficulty making sense of it themselves. 'Nobody can be precise about how many cases there might reasonably be among the 530,000 people who live in Gloucestershire. But this should be a very rare disease.'

Initially, it was suggested that the operating theatre at Stroud General might have been to blame, and it was closed for a week for biological cleansing. However a report due to be completed this week is expected to clear the hospital of blame, although Julie Feltham, chief officer of the Community Health Council in Gloucestershire, said she had consulted solicitors on behalf of Ms Sackett and another patient. 'This is not like someone having the wrong leg removed, I know what to do about cases like that. This whole matter has to be investigated very carefully.'

In the meantime, mothers such as Nicola John remain vigilant. Last year, she took her son aged 11 to the doctor after he complained about six of eight possible symptoms associated with meningitis. It was a sensible precaution, living near Stroud where so many cases had occurred during the Eighties. 'We've just about clocked meningitis; now we've got this one to worry about,' she said.

Joan Wood has also been to her GP, Dr Peter Baddeley, and was told to keep him informed if her sore throat gets worse. Dr Baddeley said: 'The profession and the local population are at least aware of the problem. Everyone knows that there is a bug about and that it can get very serious very quickly.'

Mrs Wood knows she has done all she needs to do, something which cannot be said about her friend lying critically ill in hospital. She is believed to have the potentially fatal bacterium, although the hospital says she has not developed necrotising fasciitis.

The woman, who is 36 and has two daughters aged nine and 11, was taken to hospital after she had a fall and an infection set in. Her ex-husband has flown in from South Africa to be at her side.

Mrs Wood said: 'I last saw her three months ago and she was fit and well. I just cannot believe that this has happened to her.'

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