CONCORD, N.H. (AP) -- State health officials are cautiously optimistic about the cluster of bacterial meningitis cases diagnosed last week that left one teenager dead and four others hospitalized.

The optimism came on the heels of good news: The strain of bacteria that killed an 18-year-old Bennington woman during the weekend is not related to the strain contracted by two Keene-area teenagers.

"It provides us a little more comfort that these may be sporadic cases temporally and geographically linked, but don't represent anything more than a coincidental cluster," said Dr. Jesse Greenblatt, the state epidemiologist.

Similar strains might have indicated that a new, more aggressive strain had entered the state, he said.

Greenblatt said the state nevertheless was alerting hospitals, health professionals and the public to be especially vigilant about the symptoms of meningitis, which include high fever, rash, stiff neck and sensitivity to light.

Because early symptoms can mimic influenza, he urged anyone with unusual flu-like symptoms to seek medical help.

"Meningitis can present subtly, particularly in the early course of the disease," he said Monday. "We want people to ... understand how the progression of symptoms happens and the warning signs that they need to call their health care provider."

Meningitis, which causes the brain to swell, is spread by intimate contact such as kissing or sharing utensils or water bottles. It is not easily transmitted through sneezing and coughing.

Greenblatt cautioned that it will be some time before the state is confident the situation is under control.

"Unfortunately meningitis is the sort of disease where we'll need to watch what is going on in the state for at least another month or two to be comfortable that this situation has subsided," he said.

No additional cases had been reported as of Monday afternoon, Greenblatt said.

Rachael Perry died Saturday after being hospitalized since Christmas.

Four boys also have been sickened by the disease, including two 15-year-old classmates at Monadnock Regional High School in Swanzey, a 14-year-old from the Concord area and a 13-year-old from Colebrook.

The Swanzey- and Concord-area boys were in fair condition Monday; the Colebrook boy was serious, but improving.

Greenblatt said the 15-year-old boys, Brady Ells and Louis Gilman, likely infected each other, but no links between the other cases had been found. He said only Perry's case could have been prevented by vaccination.

Monadnock Regional High's 1,300 students and staff were offered antibiotics on Friday, as were about 40 of Perry's co-workers, friends and family.

Meanwhile, school systems near the Monadnock region have been taking advantage of the winter break to prepare themselves for possible meningitis outbreaks when students return to classes next week.

In the Claremont School District, Assistant Superintendent Allan Damrun said there would be a planning session held this Friday in anticipation of the students' return on Monday.

"We'll be going over training and instructional techniques," he told The Union Leader. "Our goals are to A, make people aware of the problem, and B, determine what we should be doing. We want to hit the ground running, with our nurses leading the front line. This disease can be quite dangerous, and we want to be prepared."

Greenblatt said that despite the rash of cases, the state's 11 cases of meningitis this year is down from the average of 15 to 25. He said typically there are one or two deaths.

Dr. Susan Saviteer, an infectious disease specialist at Concord Hospital, said the state's alert hasn't changed how they handle flu symptoms, which she said always get careful screening.

She said the hospital has received numerous calls from people with questions about the illness and its symptoms, but not a rush of patients coming into the emergency room.

Saviteer said vaccinations against meningitis are good for at-risk populations, including young people living in close quarters, such as dorms or barracks. But she said they generally aren't necessary for the general public.

Bacterial meningitis infects the membranes surrounding the spinal cord and brain. Symptoms include severe headache, fever, nausea, stiff neck, and sometimes a rash. The incubation period is generally two to six days.

According to the federal Centers for Disease Control, up to 15 percent of meningitis cases are fatal.

Copyright 2003 The Associated Press. All rights reserved.