Meningitis
deaths of 2 spark quest for answers
HEALTH
Q&A: Parents can take steps to guard against
the dangerous infection.
September 29,
1998
By LIZ KOWALCZYK
The Orange County Register
Two Orange County children have died
of fast-moving bacterial meningitis in the past week. Felipe Carrillo,
8, of Santa Ana came down with an ear infection Friday morning and died
in the hospital Saturday afternoon. Ashley Williams, 13, of Anaheim developed
a fever Sept. 22 and died in the hospital Wednesday morning. They are the
fourth and fifth county residents to die of the disease this year.
After Ashley's death, more than 200 anxious parents crowded
Lexington Junior High School in Cypress to demand answers: How could this
happen to a healthy young girl so fast in a county where the latest medical
treatments are readily available? Santa Ana school officials will answer
parents' questions at a meeting Wednesday.
Q. Does this mean there is a bacterial meningitis
outbreak in Orange County?
A. No. The two deaths are not connected and in
all likelihood had different causes. Ashley's meningitis was caused by
meningococcus bacteria. Doctors are doing tests to determine what caused
Felipe's illness, but they believe it was the pneumococcus bacteria because
ear infections are a common symptom.
Q. But aren't two deaths in one week out of
the ordinary?
A. Not really. Orange County health officials have
confirmed 21 cases of meningococcal meningitis so far this year. Three
of those people died. There have been 42 cases of other types of bacterial
meningitis, including pneumococcal, with one death. Those numbers are similar
to previous years. Cases usually peak in December, but it's not unusual
to see meningitis when children start school and are exposed to a host
of new germs.
Q. If my child gets sick, how do I know if he
or she has one of these dangerous, life-threatening infections or a simple
flu?
A. Parents need to pay close attention to their
child's symptoms. Bacterial and viral meningitis and the flu start out
with similar symptoms: aches, nausea and fever. But meningitis rapidly
worsens to include a stiff neck, severe headache and sometimes confusion.
A child with these symptoms should see a doctor immediately. Only by testing
the spinal fluid can a doctor tell whether the child has meningitis and
if it's bacterial or viral.
Q. Then why couldn't doctors save these two
children? Is it because their parents didn't bring them to the hospital
soon enough?
A. Their parents brought them to the hospital as
soon as they realized something was seriously wrong, but sometimes the
infection is too powerful and moves too quickly for aggressive antibiotics
to work.
Q. What is the usual treatment?
A. High doses of intravenous antibiotics.
Q. What is meningitis?
A. It's an inflammation of the lining of the spinal
cord and brain. It does not indicate the cause of the illness, either a
bacteria or virus.
Q. How do they differ?
A. Bacterial meningitis is caused by a bacteria,
is potentially life-threatening and can be treated with antibiotics. Viral
meningitis is caused by a virus, is not usually dangerous and clears up
on its own after several weeks.
Q. How common is the more dangerous bacterial
meningitis?
A. Each year in the United States, 0.5 of every
100,000 people between the ages of 2 and 29 contract pneumococcal meningitis
and 1.1 of every 100,000 come down with meningococcal meningitis (the two
most common types of bacterial meningitis.) The fatality rate is 1 in 5
for pneumococcal, and 3 percent for meningococcal (12 percent if bloodstream
infections are included.)
Q. How are these bacterium spread?
A. They are commonly found in human saliva, and
are spread through sharing food, drinking from the same glass and kissing.
The bacterium also are spread through sneezing, but this is less common.
Q. If the bacterium are common, why don't
more people get sick?
A. Most people who come into contact with the meningococcal
and pneumoccocal bacterium don't even know it. Others get ear infections
or minor illnesses. But some people, for reasons doctors don't understand,
are unable to fight off the infections, which get into the nervous system
and bloodstream. Some of these people may have weakened immune systems.
Q. Is there any way to prevent my family from
contracting these infections?
A. The best way to stop transmission is thorough
and regular handwashing with soap and water.
Sources:
Dr. James Cappon, critical care medicine specialist at Children's Hospital
of Orange County; Dr. Hildy Meyers, medical director of communicable disease
control and epidemiology at the Orange County Health Care Agency; Dr. Nancy
Rosenstein, epidemiologist at the Centers for Disease Control in Atlanta.