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Thursday, August 28, 2014
When I was an intern almost 30 years ago, I took care of an 18-month-old boy with meningitis caused by a bacterium called Haemophilus influenza or simply, H. flu. One day, he was a happy toddler. Forty-eight hours later, this horrific infection of the protective membranes surrounding the brain and spinal cord had killed him.
Although I was still training, this tragic experience already was familiar to me. Bacterial meningitis was common, and deaths were not unusual despite excellent pediatric intensive care. Children who were lucky to survive often suffered hearing loss as well as various learning problems.
Because I had seen so many similar patients, I might not have remembered this particular boy today. But events that occurred two years later forever seared the case in my memory.
That's when the boy's mother called our office and asked to meet so I could answer some of her questions. Because I was still a trainee, a senior colleague joined us when we got together a few days later. We met for more than an hour. The mother asked questions from a long list she had thoughtfully written on paper. Her voice was choked with pained emotion. There were many tears, including some shed by me and my colleague.
She asked how her son had gotten meningitis. She wanted to know why he died so quickly and why we could not save him. And she wanted to know that if she had more children, would they, too, be susceptible? She asked some questions again and again, striving to somehow understand.
I remember realizing that this single mother suffered privately every day with this unimaginable heartbreak. Even two years later, the pain seemed to be as unbearable as it was the day her son passed away. It remains one of the most poignant moments of my career.
She had asked another question: Could her son's meningitis have been prevented? The answer was no, but I told her that experimental vaccines to prevent H. flu were being tested in studies at our hospital.
By the early 1990s, these studies were completed, and the Food and Drug Administration had approved the H. flu vaccine. Infants who receive it at 2 months, 4 months, 6 months, and 12 to 15 months are now fully protected.
Last week, I asked my colleagues in the microbiology lab how many cases of H. flu infection have been diagnosed in recent years. The answer was stunning.
Since 1997, our physicians have treated one case of H. flu meningitis, which occurred in a child whose parents refused vaccination. Before 1990, more than 100 children were hospitalized with H. flu infections (including meningitis) at Nationwide Children's Hospital each year. Many of those children died.
It is remarkable that during my relatively short medical career, a killer disease has been all but eradicated by biomedical research that led to a simple, safe vaccine strategy. I am saddened that this research came too late for my patient and his mother, and I worry that somehow she still has questions that no answer can fully resolve.
This article originally appeared in The Columbus Dispatch and is reprinted here with permission.
Last Reviewed: Nov 17, 2011
John A Barnard, MD
Professor of Pediatrics
College of Medicine
The Ohio State University