Bacterial meningitis in the National Forest: Tracking contacts at the Rainbow Family Gathering, Arknasas 2007

The Rainbow Family of Living Light meets annually around the Fourth of July on U.S. Forest Service land for a communal experience. Attendance has numbered as many as 25,000 persons from around the world. The gatherings utilize slit trenches, rudimentary “kitchens,” and stream water, causing potential for diseases. In 2007, 6,000 gathered in the Ozark National Forest in remote, northwest Arkansas. A Forest Service National Incident Management Team deployed to Arkansas, included Bob Beckley, Health and Safety Officer, who coordinated with the Arkansas Department of Health through Lee Clark, Environmental Health. ADH notified the officer when a case of Neisseria meningitides type B was diagnosed -- symptom onset June 29, hospitalized July 1. Case contact investigation was complicated by the culture of anonymity and skepticism prevalent at the Rainbow Family Gatherings. With cooperation of event participants close contacts from 18 states and Israel were identified and treated. In a gathering of non-traditional persons, seeking anonymity and leery of government, politics and policy were strained in working a meningitis case. The “rainbows,” often go by pseudonyms (i.e. “Seven Song” “Dr. Z” “622”), and have a history of animosity and distrust of the Forest Service. Many are reluctant to be identified in any way making public health response difficult. Before personnel were dispatched to the site, the Forest Service agreed to provide transportation/escort, to facilitate contact with gathering participants (healthcare professionals) who enabled CD nurses to interview contacts and treat them.