Meningitis: What all parents need to know

Photo courtesy of Michelle Akins.

Four days before Christmas 2007, 15-year-old Jessica Elkins went to school to take her final exams and later met her sister and brother for lunch. At the restaurant, however, Jessica felt sick and was unable to eat. She went to the car to rest and burst into tears.

“Mom, Jessica is in a lot of pain. I think you need to come home and check on her,” Michelle Elkins, 55, of Athens, Alabama. recalls her daughter Emilee explaining.

Since the local health clinic was already closed, Michelle took Jessica to the pediatrician. When the pediatrician performed a culture for strep throat, Jessica began to vomit. She was diagnosed with the flu and sent home with Tamiflu, and told to get plenty of fluids and rest.

Jessica continued to vomit throughout the night and into the next day. When Michelle called the pediatrician, he told her to get to the emergency room immediately.

Once there, Jessica was in and out of consciousness as doctors made a diagnosis: meningococcal meningitis. “They came in and said ‘We’re dealing with meningitis and it’s the worst case scenario there is,’” Elkins recalled. “Even when the doctor told us, he had tears in his eyes.”

Doctors administered antibiotics and Jessica was airlifted to the children’s hospital.

The following day Jessica seemed better, but the day after, her conditioned worsened. She developed pneumonia, her kidneys failed and she was put on a ventilator.

“From that Saturday night, it was just a roller coaster,” Elkins said.

Jessica suffered a series of mini strokes and within hours, she was brain dead.

“I got in the bed with her and I held her in my arms…and I handed her over to God,” Elkins said.

What is meningitis?
Bacterial meningitis is spread from person to person through organisms in the nose or throat. These organisms travel into the bloodstream and cause swelling of the protective covering of the brain, also known as the meninges, and the spinal cord.

There are three types of bacteria responsible for bacterial meningitis: haemophilus influenzae type b (H flu or Hib), Neisseria meningitidis (meningococcus) and streptococcus pneumoniae (pneumococcus).

Enteroviruses, such as EV68, can also cause meningitis.

Last month, a 9-year-old girl from Chicago died from meningitis and just last week, a 5-year-old boy from Harrisburg, Pennsylvania died from the disease.

Anyone can get meningitis, but babies, teens and college-age young adults are at an increased risk.

However, bacterial meningitis is rare in the U.S. Approximately 4,100 cases and 500 deaths occured each year between 2003 and 2007, according to the Centers for Disease Control and Prevention (CDC).

In babies and toddlers, meningitis is common because of their immature immune systems. The three types of bacteria are encapsulated by polysaccharides, or a sugar-like coating.

“It’s antibodies that are directed towards this polysaccharide that seems to be protective against infection,” said Dr. Michael Brady, a member of American Academy of Pediatrics’ Committee on Infectious Disease.

Yet since their immune systems don’t respond well to polysacchriardes and they don’t make antibodies well until 18 to 30 months of age, they are at an increased risk.

“In that age group, there seems to be an inability for the immune system to naturally fight those particular organisms,” Brady said.

Symptoms of meningitis
Symptoms of meningitis can include high fever, nausea, vomiting, sensitivity to light, confusion, joint pain, a stiff neck and a reddish or purple rash.

In babies, meningitis can start out looking like a cold but symptoms can worsen and lead to irritability, poor feeding and lethargy. A telltale sign that a baby is in pain is that rocking doesn’t soothe him, Brady said.

As more time passes and meningitis is left undiagnosed, a patient can experience seizures. The swelling in the skull can lead to brain damage and between 10 and 15 percent of people will have hearing loss.

Some will have seizure disorders or brain injuries and have developmental and intellectual problems. They can also lose their fingers, toes and extremities because of the damage, which is most common in those with meningococcus.

Between 3 and 10 percent of children die from meningitis.

“A lot of that has to do with how quickly they get identified and how quickly they get started on treatment,” Brady said.

Meningitis on college campuses
Since meningitis can spread where groups gather or in close living quarters, it’s common on college campuses.  

In 1998, Lynn Bozof, now 66, of Fort Myers, Fla. received a call from her 20-year-old son Evan while he was at college. He told his mom that he had a migraine, was sensitive to light, nauseous, vomiting and was going to miss his baseball game.

“Evan never missed a baseball game,” Lynn recalled.

He rested for a few hours but when he didn’t feel better, he went to the emergency room. Doctors diagnosed him with a virus and said they would keep him overnight.

“We went to bed thinking our son will be fine. The next morning we get a call from the hospital saying your son has bacterial meningitis, he has a 5 percent chance of survival,” she said.

For 26 days, Evan was treated in three hospitals and lost kidney and liver functions, all  of his limbs were amputated and he endured 10 hours of grand mal seizures.

“Eventually the brain swelling herniated his brain stem and we had to have him disconnected from life support,” Lynn said.

Meningitis is preventable
“If people follow the current CDC and American Academy of Pediatrics immunization schedule, there’s a very, very low likelihood their child will develop meningitis,” Brady said.  

The recommended immunization schedule for children includes vaccines for Hib, pneumococcus and meningococcal serotypes A, C, W and Y. There are also two meningococcal B vaccines that parents should discuss with their child’s pediatrician.

Parents should know that if their child has symptoms of meningitis and has not been vaccinated, they must go to the ER immediately for a spinal tap.

“Bacterial meningitis is very severe [and] life threatening,” Brady said. “I think it’s something that if you have a child that is not immunized, you should be very concerned about it.”

In 2002, Lynn Bozof founded the National Meningitis Foundation to raise awareness about meningitis and educate parents on how to prevent it.

“I just thought that it was this rare disease and it’s going to affect somebody else,” Lynn said. “And that’s what my son died of. The disease can be in your own backyard.”