Meningococcal: Stalker of our young.

Chuck
was an “Artful Dodger of a cad”, says Maggie. At 14, the 9th grader
was vibrant, full of energy, engaging and funny. “He was a redhead, freckly,
cute as a button boy. He really did light up the room.”  He had “a little
dyslexia” but nothing too serious. Maggie was an experienced teacher, and in
her judgment Chuck was going to be “absolutely fine”. 
He wrote her a letter one day. He told her that although she was hardcore, and
gave them no breaks, he appreciated the fact that she shouted “Safe and
sane!” every Friday.
Because
of his parents’ divorce and his anger at them, Chuck ran away from home. No one
knew where he was staying: each parent thought he was staying with the other,
while he was actually staying with a friend. Maggie knew something was wrong,
but did not know exactly what.
Maggie
does not remember if it was Monday or Tuesday. Chuck had “a horrid headache” in
class in the morning. He kept putting his head down. Maggie kept rebuking him.
She told him to go to the nurse if he was sick. If he was not sick enough to go
to the nurse, he should sit up in her class. A girl sitting behind Chuck
massaged his neck and shoulders, and told him to “come on.” Maggie told her to
“keep your hands off him, we don’t want to reward him for being lazy”.
Later that afternoon Chuck was caught shoplifting. His
headache got so bad he really needed aspirin. Since he was a runaway, he had
none. So he stole some from a store, and got caught. He was in such bad shape
at that point he was taken immediately to the Community Hospital. They could
not save him. He was dead by 7 pm that night.
When
Maggie arrived at school the next day, she saw a school counselor that worked
with Chuck. The counselor said: “Maggie, I need to talk to you about Chuck.”
“Yes,” agreed Maggie. “We need to get him pinned down.” “No, it’s not that,”
said the counselor. “He’s dead.”
Maggie
described this as devastating. Devastating to her, devastating to the
community, and above all to Chuck’s parents. Maggie says, “His parents
were absolutely heartbroken. They were so immersed in their own little drama
that they felt guilty that they have not checked with other. And he was an only
child.”
In addition to the psychological consequences, she remembers that everyone who came in touch with
Chuck – 1400 children, all the adults that had contact with him, and their
family – had to take Rifampin for a month.
Maggie had two little girls, also at risk, also now on the medicine, as was her
partner. She was frightened.
Two
weeks after Chuck’s death a girl burst into tears in class. She was crying
orange tears, from the medicine.
Meningococcal
disease struck Maggie’s students twice more, in 1998 and 2000. This time the
victims were undergraduate students in classes Maggie was teaching as an
Adjunct Professor. Again, the students had a bad headache, and were dead
shortly after. Maggie says: “What’s amazing is how fast they go from I
don’t feel so well, or I got a really bad headache, to dead in about six
hours.” There was a vaccine available at the time; but it was only recommended for high-risk groups. The vaccine was recommended only after the new, conjugate vaccine was licensed in 2005.[1]
******
Meningococcal goes for our young. Children under 5 are
most at risk, followed by adolescents .
People who live in close quarters  – like
college students in dorms – are also at risk.[2] It
kills 9-40% of the people who catch it, depending on the form it takes.
Young Landan Harris was one of the victims of the
disease. A happy, beautiful toddler, he was 3 when he died.

Picture taken from: http://www.meningitis-angels.org/LandanHarris.html, with permission from Lacey, Landan’s mother. 

He was crabby in the evening. His mother described
what happened next (the text is taken verbatim from the site his mother, Lacey created to honor her son’s memory):
“At 9am I woke up to find Landan laying on the floor next to my bed
covered in, what looked to me, like bruises. I thought he was dead, I was so
afraid to touch him. I called my mom & then called 911. We took him to the
best children’s hospital in the area ….
His left foot was completely purple, so were his entire back &
nose. His other extremities were very splotchy purple. … If Landan would have made it he would have had several amputations. But
selfishly we would have taken him any way we could have him as long as he was
still here with us.
Landan fought for 23hrs [sic] at the hospital enduring 3 hyperbaric treatments.
The treatments were helping bring back color to the purple areas. They said it
was a miracle he lasted as long as he did, that’s why are [sic] hopes were
high.
His little heart finally couldn’t take it anymore & stopped, we
watched them doing chest compressions & then the doctor stopped
& my mom asked him if Landan was gone & he said yes, there was no
more brain function. I still was unable to cry at this point, I couldn’t
believe what I’d seen with my own eyes & that he was gone.”
Landan’s mother Lacey created a YouTube dedicated to his
memory.

She is now working to raise awareness of this disease, and
especially of the availability of a vaccine for it. Other parents, suffering
similarly, created the National Meningitis Association, to raise awareness of
the disease and the existence of the vaccine, and offer support to victims and
their families: .
****
About 20% of those who survive the disease will have
lasting damage, including  “hearing loss, neurologic damage, or loss of
a limb.” 

Here is one
such little girl:

Courtesy of:
https://www.facebook.com/pages/The-Vaccine-Meme-Machine/302477036534120, who got it through Charlotte’s website, http://www.charlottecleverleybisman.com/.

Other
pictures of the disease can be seen here – scroll down for pictures of children
suffering from it. Warning: these are hard pictures.

******

One of
the problems highlighted by the National Meningitis Association is the lack of
awareness of the vaccine.  In the United
States, the vaccine is recommended for teenagers but parents may not be aware of
it. Losing a teenager or young adult is always painful; losing them when there
was a vaccine available, and it could have been prevented, but you did not
know, is excruciating.
Somestates now require the vaccine before a student can enroll in a public
university, and others require that students and parents be given information
about the disease and the vaccine. Hopefully, this can help raise awareness among parents, teenagers and young
adults, and help protect them.
The
vaccine is also recommended for high-risk toddlers and infants but notroutinely for toddlers or babies.  In contrast, in Australia thevaccine is recommended at the age of 12 months. The
currently used meningococcal vaccine covers only certain types of the bacteria, and it does
not cover strain B, the one responsible for more than 50% of the cases inchildren under one. So there is no recommendation of the vaccine for routine use in young children. A vaccine that covers strain B
was approved in Europe but as far as I know is not currently in use. Several
vaccines that cover it are currently at different stages of testing in the
United States. 
Lacey,
Landan’s mother, strongly urges parents to get the vaccine for their young
children as well, if they have access to the vaccine and can afford it, imperfect as its coverage is. She wants to protect other
children from what happened to Landan.

She
convinced me.

Acknowledgements: Thank you to the National Meningitis Association, Alice Warning Wasney, Clara Obscura, and Paul Offit for advice and help on this post. Thank you to Maggie and Lacey for sharing their story. 


[1]
Paul A. Offit and Charlotte A. Moser, Vaccines and Your Child,  196 (2011).
[2]
Id.
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