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Rash outbreaks at schools a mystery

ATLANTA, Georgia (CNN) -- Federal authorities are working with state and local health officials to determine the cause of mysterious rashes among schoolchildren in 14 widespread states.

It is not clear whether a single cause is behind the rashes, which tend to be mild and go away by themselves.

The first outbreak happened in October in Indiana. Subsequent cases have occurred as recently as February 21, the Centers for Disease Control and Prevention said Thursday in its Morbidity and Mortality Weekly Report.

The rashes have been reported primarily among elementary school students, though a few middle and high schoolers have been affected as well, the report said.

The rashes are itchy and tend to appear suddenly on the face, neck, hands or arms. They are not associated with any other symptoms and usually go away by themselves -- sometimes within a few hours and sometimes not for two weeks.

Though they do not appear to be contagious, "in-school 'sympathy' cases have reportedly occurred," the CDC said.

At one Indiana school of 390 students in October, 18 third-graders and a substitute teacher developed rashes that spread from the face to the upper arms. Most of the rashes occurred on exposed skin. No cause of the rash was identified.

In southwestern Oregon, rashes were reported in early February among 53 children and 11 adults in one elementary school of 589 students. The rashes appeared on cheeks and arms, were itchy and looked like sunburns. No source of the rash was found.

Since February 21, seven adults and 84 children in a northern Oregon middle school of 314 students have broken out in a variety of rashes, including eczema and a red, itchy rash on the face, arms, neck and back, the report said. No environmental cause has been found.

In both Oregon schools, the rash improved among several children when they left school but returned when they went back to class. No environmental cause has been found.

In Connecticut, 25 fourth-graders in a school of 253 students and 12 classrooms broke out February 20 and 21. The rash appeared on the pupils' trunks and arms and legs and disappeared in one to three days.

The school was closed for a day while authorities cleaned the classrooms and replaced air filters, but no environmental source of the rashes has been found. Rashes were not reported among parents or siblings of the affected students.

In Pennsylvania, 575 cases of rashes have been reported to the state health department in 58 schools and child-care centers in January and February.

Most of the cases were among elementary and middle school students, with cases involving girls outnumbering those among boys.

In some cases, the rash went away and came back.

Investigators have unsuccessfully looked for a cause in dust mites, cockroach allergens, solvents and cleaners, fungi and bacteria.

The mildness of the rashes has hindered attempts to study it, said Dr. John P. Maher, director of the Chester County, Pennsylvania, Health Department.

As a result, "it is difficult to get parents to want to have their young children subjected to invasive clinical studies," Maher said in an e-mail posting to other health officials.

The CDC is asking dermatologists and local school and health officials to share their clinical observations.

Rashes also have been reported in Arizona, Florida, Georgia, Mississippi, New York, Ohio, Texas, Virginia, Washington and West Virginia.


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