[1] There were two epicenters for this outbreak within the area: The Faith Tabernacle Congregation and the First Century Gospel Church.
Both churches discouraged the use of not only vaccinations, but also all other forms of medical treatment, instead relying solely on faith healing.
[2] Following an investigation into the first death from the outbreak, a court order was obtained to forcibly treat and vaccinate children whose parents would not agree to seeking medical care.
[4] The formally-defined outbreak began in October 1990,[5] but the bulk of incidents of illness, and all of the related deaths and responses to them, occurred in 1991.
[6] In February 1991, it was reported that "Health workers are now going to the homes of all students in a frantic effort to monitor their conditions to prevent further deaths",[8] and that local officials were "prepared to seek court orders to force the families to accept medical care if the children are in serious condition".