  We examine the role of the Delta-Delta intermediate state in low energy NN
scattering using effective field theory. Theories both with and without pions
are discussed. They are regulated with dimensional regularization and MSbar
subtraction. We find that the leading effects of the Delta-Delta state can be
absorbed by a redefinition of the contact terms in a theory with nucleons only.
It does not remove the requirement of a higher dimension operator to reproduce
data out to moderate momentum. The explicit decoupling of the Delta-Delta state
is shown for the theory without pions.
