Risk of Bacterial Meningitis and Death in Children with Cochlear Implants

Hey, I'm not the one who threw out the red herring about Smallpox and Polio. Plus, I've already pointed you to the WHO research. I dare you to read it then find something reputable that refutes it.

Again with the childish games. I will find what you request, but will do so without the use of WIKI. And while I take the time to do that, how getting back to the discussion regarding whether a doctor who is aware of an increased risk of bacterial meningitis is responsible for insuring through documentation, that a patient who he is putting in the situation that increases the risk?
 
Bacterial Meningitis is a airborne can spread unless the doctor give you shot to reduce the risk of getting meningitis. I had my shot before I got CI. It important to be warn about meningitis. I had that shot before I went to college and I got CI later in life. Bacterial Meningitis can spread through schools and colleges too since it is airborne. My sister had meningitis when she was two years old that causes her to be come deaf. But she can't have CI because of the past history that she had meningitis. Doctors today should be giving shots on meninigitis to reduce the risk before giving CI. I been fine for almsot 4 years.
 
I guess, tonight, we are gonna hafta have something a little stronger than the coffee we had last night. :giggle:
 
Bacterial Meningitis

Bacterial meningitis is a serious infection of the fluid in the spinal cord and the fluid that surrounds the brain.
Bacterial meningitis is most commonly caused by one of three types of bacteria: Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae bacteria.
The bacteria are spread by direct close contact with the discharges from the nose or throat of an infected person.
Bacterial meningitis can be treated with antibiotics.
Prevention depends on use of vaccines, rapid diagnosis, and prompt treatment of close personal contacts.


What is bacterial meningitis?

Meningitis is an infection of the fluid in the spinal cord and the fluid that surrounds the brain. Meningitis is usually caused by an infection with a virus or a bacterium. Knowing whether meningitis is caused by a virus or a bacterium is important because of differences in the seriousness of the illness and the treatment needed.

VIRAL MENINGITIS is usually relatively mild. It clears up within a week or two without specific treatment. Viral meningitis is also called aseptic meningitis.

BACTERIAL MENINGITIS is much more serious. It can cause severe disease that can result in brain damage and even death.



What bacteria cause bacterial meningitis?

Bacterial meningitis is most commonly caused by one of three types of bacteria: Haemophilus influenzae type b (Hib), Neisseria meningitidis, and Streptococcus pneumoniae.

Before the 1990s, Hib was the leading cause of bacterial meningitis, but new vaccines being given to children as part of their routine immunizations have reduced the occurrence of serious Hib disease. Today, Neisseria meningitidis and Streptococcus pneumoniae are the leading causes of bacterial meningitis. Meningitis caused by Neisseria meningitidis is also called MENINGOCOCCAL MENINGITIS. Meningitis caused by Streptococcus pneumoniae is called PNEUMOCOCCAL MENINGITIS.

It is important to know which type of bacteria is causing the bacterial meningitis because antibiotics can prevent some types from spreading and infecting other people.



Where is bacterial meningitis found?

Bacterial meningitis is found worldwide. The bacteria often live harmlessly in a person's mouth and throat. In rare instances, however, they can break through the body's immune defenses and travel to the fluid surrounding the brain and spinal cord. There they begin to multiply quickly. Soon, the thin membrane that covers the brain and spinal cord (meninges) becomes swollen and inflamed, leading to the classic symptoms of meningitis.



How do people get bacterial meningitis?

The bacteria are spread by direct close contact with the discharges from the nose or throat of an infected person. Fortunately, none of the bacteria that cause meningitis are very contagious, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.



What are the signs and symptoms of bacterial meningitis?

In persons over age 2, common symptoms are high fever, headache, and stiff neck. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms can include nausea, vomiting, sensitivity to light, confusion, and sleepiness. In advanced disease, bruises develop under the skin and spread quickly.

In newborns and infants, the typical symptoms of fever, headache, and neck stiffness may be hard to detect. Other signs in babies might be inactivity, irritability, vomiting, and poor feeding.

As the disease progresses, patients of any age can have seizures.



Who is at risk for bacterial meningitis?

Anyone can get bacterial meningitis, but it is most common in infants and children. People who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis or Hib can also be at increased risk. This includes people in the same household or day-care center, or anyone with direct contact with discharges from a meningitis patient's mouth or nose.



How is bacterial meningitis diagnosed?

The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by a spinal tap. A doctor inserts a needle into the lower back and removes some fluid from the spinal canal. Identification of the type of bacteria responsible for the meningitis is important for the selection of correct antibiotic treatment.

What complications can result from bacterial meningitis?

Advanced bacterial meningitis can lead to brain damage, coma, and death. Survivors can suffer long-term complications, including hearing loss, mental retardation, paralysis, and seizures.



What is the treatment for bacterial meningitis?

Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor right away. Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early.



How common is bacterial meningitis?

In the United States, bacterial meningitis is relatively rare and usually occurs in isolated cases. Clusters of more than a few cases are uncommon.

In parts of Africa, widespread epidemics of meningococcal meningitis occur regularly. In 1996, the biggest wave of meningococcal meningitis outbreaks ever recorded hit West Africa. An estimated 250,000 cases and 25,000 deaths in Niger, Nigeria, Burkina Faso, Chad, Mali, and other countries paralyzed medical care systems and exhausted vaccine supplies.



Is bacterial meningitis an emerging infectious disease?

With the decline in Hib disease, cases of bacterial meningitis have decreased since 1986. Meningococcal meningitis is a continuing threat in day-care centers and schools. Healthy children and young adults are susceptible, and death can occur within a few hours of onset.



How can bacterial meningitis be prevented?

Vaccines -- There are vaccines against Hib, some strains of Neisseria meningitidis, and many types of Streptococcus pneumoniae.
The vaccines against Hib are very safe and highly effective. By age 6 months of age, every infant should receive at least three doses of an Hib vaccine. A fourth dose (booster) should be given to children between 12 and 18 months of age.

The vaccine against Neisseria meningitidis (meningococcal vaccine) is not routinely used in civilians in the United States and is relatively ineffective in children under age 2 years. The vaccine is sometimes used to control outbreaks of some types of meningococcal meningitis in the United States. New meningococcal vaccines are under development.

The vaccine against Streptococcal pneumoniae (pneumococcal vaccine) is not effective in persons under age 2 years but is recommended for all persons over age 65 and younger persons with certain medical problems. New pneumococcal vaccines are under development.

Disease reporting -- Cases of bacterial meningitis should be reported to state or local health authorities so that they can follow and treat close contacts of patients and recognize outbreaks.
Treatment of close contacts -- People who are identified as close contacts of a person with meningitis caused by Neisseria meningitidis can be given antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated.
Travel precautions -- Although large epidemics of bacterial meningitis do not occur in the United States, some countries experience large, periodic epidemics of meningococcal disease. Overseas travelers should check to see if meningococcal vaccine is recommended for their destination. Travelers should receive the vaccine at least 1 week before departure, if possible.


Where can I find more information about bacterial meningitis?

Removed: Meningitis G | CDC DBMD



This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have any questions about the disease described above, consult a health-care provider.
 
It has been shown that there is an increased risk with invasive surgeries. Therefore, a physican should not be performing a surgery that is not to correct a life threatening condition and is categorized as "elective" without first insuring that all precautions have been taken to reduce the risk. Again, do no harm.

It hasn't been conclusively proven in studies that the surgery by the surgeon itself causes meninigitis in children with CIs. At the moment they have a link with children with CIs, but do not actually know what is the genesis of the meningitis - the presence of the implant, the surgery, trauma occuring in surgery, the pre-existing etiology of deaf child or other unknown factors.

I'm just surprised with your background with methodology that you are drawing such a strong conclusion between the surgeon and the appearance of meningitis considering that there is no proof except for an association.

I'm not against the idea of the surgeon adopting a more fool proof system to ensure that children are vaccinated. I just think that if deaf children as a population are at additional risk of meningitis compared to the hearing population and it is not clearly understood how the cases are coming about then there could be a good case for all professionals working with deaf children to adopt systems to ensure that vaccination is carried out.
 
It hasn't been conclusively proven in studies that the surgery by the surgeon itself causes meninigitis in children with CIs. At the moment they have a link with children with CIs, but do not actually know what is the genesis of the meningitis - the presence of the implant, the surgery, trauma occuring in surgery, the pre-existing etiology of deaf child or other unknown factors.

I'm just surprised with your background with methodology that you are drawing such a strong conclusion between the surgeon and the appearance of meningitis considering that there is no proof except for an association.

I'm not against the idea of the surgeon adopting a more fool proof system to ensure that children are vaccinated. I just think that if deaf children as a population are at additional risk of meningitis compared to the hearing population and it is not clearly understood how the cases are coming about then there could be a good case for all professionals working with deaf children to adopt systems to ensure that vaccination is carried out.


But it has been supported that the surgery increases the risk of contraction. Whether it is peripheral or direct, the risk is still increased. Given that, the surgeon should not be performing surgery without insuring that the vaccination has been given.

Just as a patient with a hip replacement does not contract bacterial endocarditis directly from having a dental procedure done, the risk is increased by the invasive procedure, and therefore, patients are premedicated with antibiotics prior to dental procedures. Standard of practice. Placing the patient at increased risk requires that the physican take responsibiltiy for reducing that risk to the greatest degree possible. Again, "Do no harm".
 
But it has been supported that the surgery increases the risk of contraction. Whether it is peripheral or direct, the risk is still increased. Given that, the surgeon should not be performing surgery without insuring that the vaccination has been given.

Actually, in the case of the two children who died, vaccinations were commenced at the time of the surgery. The problem was with the follow up repeat vaccinations and not keeping to the vaccination schedule for their age. I'm not sure what the surgeon can do to ensure that families comply with this once the surgery has been performed especially since it is recommended that the vaccination be repeated every 3-5 years. They can only remind families, hence the specifics of the FDA warning but cannot force them further than that.

The other thing is that while it has been suspected that surgery may increase the risk of meningitis, it has not been proven to be the only suspected source. For example, a very high percentage of the cases where meningitis has occured has been with implants with a positioner attached to it. Why is this? No one really knows, except that there is an association present. The same strength of assocation is not present with other brands.

And they don't really know how much additional risk there is for CIs without positioners compared to non implanted deaf children with a similar etiology.
They do know that the risk for contracting meningitis for children with CIs without positioners is much lower than those with it.

So you can see how messy it actually is in terms of lack of information and the long term role of the surgeon. People move house and lose contact with their clinics, which it just seems to me to make sense to make it something that should concern all professionals working with deaf children so that the drag net so to speak is catching more potential cases.
 
Actually, in the case of the two children who died, vaccinations were commenced at the time of the surgery. The problem was with the follow up repeat vaccinations and not keeping to the vaccination schedule for their age. I'm not sure what the surgeon can do to ensure that families comply with this once the surgery has been performed especially since it is recommended that the vaccination be repeated every 3-5 years. They can only remind families, hence the specifics of the FDA warning but cannot force them further than that.

The other thing is that while it has been suspected that surgery may increase the risk of meningitis, it has not been proven to be the only suspected source. For example, a very high percentage of the cases where meningitis has occured has been with implants with a positioner attached to it. Why is this? No one really knows, except that there is an association present. The same strength of assocation is not present with other brands.

And they don't really know how much additional risk there is for CIs without positioners compared to non implanted deaf children with a similar etiology.
They do know that the risk for contracting meningitis for children with CIs without positioners is much lower than those with it.

So you can see how messy it actually is in terms of lack of information and the long term role of the surgeon. People move house and lose contact with their clinics, which it just seems to me to make sense to make it something that should concern all professionals working with deaf children so that the drag net so to speak is catching more potential cases.

And, in the case of the two children you are referring to, it is indeed the parents resposnibility to insure that the vaccines are kept up to date. Failure to do results in the parent putting their child at increased risk. However, this does not absolve the medical community from their obligation to insure that prior to surgery, the vaccine has been given, nor todo everything in their power to insure that the parents are aware of the need to continue the vaccine. These surgeons, clinics, and audis have tremendous influence over these parents and their decisions to implant. Often, these are the only people consulted prior to a parent making their decision to implant. The only information the parent receives comes from the medical perspective. When one has that degree of influence, one is ethically bound to insure that the influence is repsonsible.
 
And, in the case of the two children you are referring to, it is indeed the parents resposnibility to insure that the vaccines are kept up to date. Failure to do results in the parent putting their child at increased risk. However, this does not absolve the medical community from their obligation to insure that prior to surgery, the vaccine has been given, nor todo everything in their power to insure that the parents are aware of the need to continue the vaccine. These surgeons, clinics, and audis have tremendous influence over these parents and their decisions to implant. Often, these are the only people consulted prior to a parent making their decision to implant. The only information the parent receives comes from the medical perspective. When one has that degree of influence, one is ethically bound to insure that the influence is repsonsible.

There is no disagreement there and I believe that in the vast majority of cases this is probably what happens. As you say, its a time when parents are the most heightened, since their child is about to undergo surgery and its a time when the surgeon has the most influence over parents and so there is more motivation to get the vaccination done and the surgeon will be more likely to make sure it's done at that stage if not for altruistic reasons, for legal self interest.

However, I feel that follow ups a very worrysome thing compared to the time around surgery because as the survey states, many parents are not aware of their child's current vaccination status. That probably means they remembered the first shot at the time of surgery but don't know if they are up to date with repeats or on schedule or not.

Since the influence of the surgeon declines after the incision is successfully healed and the CI successfully activated, there is a need for a global interest from all professionals working with the child. Successfully implanted children don't tend to go back to the surgeon but rather are transferred to the care of audies, teachers, schools, social workers etc. So while the clinic can send out reminders to keep with vaccinations, the reminders coming from other professionals would catch those who have lost contact with their clinics (e.g moving home). This care could include those deaf children without CIs but who are at additional risk compared to the hearing population due to their etiologies.

Now I know I'm repeating myself so I'll stop there. I'm sure you don't disagree.
 
What if they set up an alert system in the computer that sends an email the the audis, the ENTs, and the parents reminding that a vaccine is due?
 
What if they set up an alert system in the computer that sends an email the the audis, the ENTs, and the parents reminding that a vaccine is due?

Good idea, but on the other hand I thought before having a cochlear implant surgery even when they're told that they're candidates for cochlear implants, should have asked for their immunization history records before the set up of surgery. How come that wasn't asked? Doctors should know better than that to required to have it before the surgery is taken place.

Because I know the schools needs the immunizations records as required for school entrance, if no records, no school.
 
Good idea, but on the other hand I thought before having a cochlear implant surgery even when they're told that they're candidates for cochlear implants, should have asked for their immunization history records before the set up of surgery. How come that wasn't asked? Doctors should know better than that to required to have it before the surgery is taken place.

Because I know the schools needs the immunizations records as required for school entrance, if no records, no school.

It puzzles me too. Makes me kinda scared to really trust doctors fully. :dunno:
 
What if they set up an alert system in the computer that sends an email the the audis, the ENTs, and the parents reminding that a vaccine is due?

That is an excellent idea, and is not difficult to achieve. Dental offices have such a system that automatically generates reminders that it is time for bi-annual exams; my son's pediatrician's office had no problem sending out reminders that MMR boosters were due, etc. It is not that difficult.
 
There is no disagreement there and I believe that in the vast majority of cases this is probably what happens. As you say, its a time when parents are the most heightened, since their child is about to undergo surgery and its a time when the surgeon has the most influence over parents and so there is more motivation to get the vaccination done and the surgeon will be more likely to make sure it's done at that stage if not for altruistic reasons, for legal self interest.

However, I feel that follow ups a very worrysome thing compared to the time around surgery because as the survey states, many parents are not aware of their child's current vaccination status. That probably means they remembered the first shot at the time of surgery but don't know if they are up to date with repeats or on schedule or not.

Since the influence of the surgeon declines after the incision is successfully healed and the CI successfully activated, there is a need for a global interest from all professionals working with the child. Successfully implanted children don't tend to go back to the surgeon but rather are transferred to the care of audies, teachers, schools, social workers etc. So while the clinic can send out reminders to keep with vaccinations, the reminders coming from other professionals would catch those who have lost contact with their clinics (e.g moving home). This care could include those deaf children without CIs but who are at additional risk compared to the hearing population due to their etiologies.

Now I know I'm repeating myself so I'll stop there. I'm sure you don't disagree.

You are correct....I don't disagree at all!
 
Wow!

That's very sad news. I was born deaf. Lucky, I don't have C.I. but just wearing my hearing aid only.

Do you know? Mother Margie still loves her deaf son Luke very much. Lucky, she NEVER ask her doctor about C.I. She saves her son life. Very natural born deaf boy.
 
Hey, Iv got a question. I dont know if its already been asked and answered in this thread but...

I had a meningitis vacination(the one specifically for ci patients)before surgery. Do I need it again?
 
Hey, Iv got a question. I dont know if its already been asked and answered in this thread but...

I had a meningitis vacination(the one specifically for ci patients)before surgery. Do I need it again?

Depends on your guidelines. Here in the US, they require two vaccines. The one for meningiococcal meningitis and the one for streptococchi infection. The strep vaccine is given once every 5 yrs.
 
That's very sad news. I was born deaf. Lucky, I don't have C.I. but just wearing my hearing aid only.

Do you know? Mother Margie still loves her deaf son Luke very much. Lucky, she NEVER ask her doctor about C.I. She saves her son life. Very natural born deaf boy.

Actually, I believe he has a CI, just doen't use it. That is what I read.
 
Hey, Iv got a question. I dont know if its already been asked and answered in this thread but...

I had a meningitis vacination(the one specifically for ci patients)before surgery. Do I need it again?

I had a meningitis vaccination prior to my first CI surgery, but haven't had another one since.
 
Back
Top