WATERLOO - A 5-year-old boy from Buchanan County's Amish community is the fourth person in Northeast Iowa to be diagnosed with bacterial meningitis.

Tricia Kitzmann, a regional epidemiologist with the Buchanan County Health Center community care department, said the boy was taken to the hospital Thursday. Kitzmann said he was improving Friday but "he is still a very sick little boy."

Test results determining the type and strain of the bacteria were not available Friday afternoon.

"We have two nurses out doing the contact tracing and working on the follow up with the community," Kitzmann said.

The young boy was not in school and Kitzmann said others in the community should not worry.

"Almost all family members and those in the Amish community have already been contacted," she said. "They have been very cooperative and are providing us with accurate and important information."

A story in Friday's paper about the new case of meningitis incorrectly stated who said the boy was not from Black Hawk County. Tom O'Rourke, director of the county health department, said the boy was not from Black Hawk County, but did not say what county the boy resided in.

Three Black Hawk County residents were diagnosed with meningitis during the last two weeks. Elizabeth Huddleson, a 20-year-old University of Northern Iowa student, and Wendy Wyant, a 29-year-old inmate at the Black Hawk County Jail, died from disease last Monday. Caleb Twito, a 20-year-old Hawkeye Community College student, is recovering at University of Iowa Hospitals in Iowa City.

The women were diagnosed with a type C bacterial meningitis. However, the strains of the bacteria were different. Twito is recovering from a type B meningitis.

The recent outbreak has forced public health officials to take a closer look at plans they began developing in August for a mass meningitis vaccination.

"This looked to be much closer and more imminent Monday morning, but now on Friday, we have a much clearer picture of what is out there," O'Rourke said. "It is also true we have three cases very early in the season. I think we need to move forward with these tabletop exercises."

On Friday, O'Rourke said the meningitis vaccination is not recommended for everyone, but persons 18-29 should consider the meningococcal and influenza vaccinations as a preventative measure. He said neither the current situation or planning efforts show the need for a public clinic at this time.

Additional cases will be evaluated if they arise, however, any more cases, specifically with identical strains, could prompt the Center for Disease Control to recommend the county hold mass vaccination clinics for any number of people at the county's expense.

The CDC has mandated similar clinics in Iowa in the past. Jane Sherman, vice president of community services with the Regional Medical Center of Northeast Iowa, headed a mass vaccination clinic in Delaware County in June 2000.

In that case, the county vaccinated about 2,400 high school students in one day. Another 300 to 400 later received shots.

"We are only a county of 18,000 so that is a substantial quantity for us," Sherman said.

In Delaware, the CDC "strongly recommended" a vaccination clinic on a Friday and by the following Monday health officials were ready to start. Like Black Hawk County officials, they had started planning for the possibility earlier in the week.

"Our difficulty was we had parents of students that were not in the parameters that wanted their children to be vaccinated," Sherman said

And getting those required to take the shot to the school wasn't difficult because parents made sure their children attended.

"It went very smoothly. Not that I would want to do it again, but it went much smoother than I thought," Sherman said.