Risk of Bacterial Meningitis and Death in Children with Cochlear Implants

LTHFAdvocate said:
What I think it translates to is some clinics not doing a thorough enough job. If every implant center refused to do an implant without proof of vaccination from the GP/pediatrician, then it wouldn't matter whether the families remembered if the vaccination had been done.

Sheri
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That's so true; are you in a position to make said policy where you work? Or suggest it?
 
Audiofuzzy said:
I just wanted to clear up something with Angel - did you actually contracted tetanus, or some other infection but the doctor advised you take tetanus shots as precaution?
And it does looks very painful. I am sorry about that.

Fuzzy
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It can be either, they just didn't know, and yes they advised me to take tetanus anyways....


Once again sorry for the off-topic....
 
Advice for Patients with Cochlear Implants: New Information on Meningitis Risk

ROCKVILLE, Md., Oct. 11 -- The FDA has alerted physicians to the need for children with cochlear implants to be fully immunized against bacterial meningitis, citing two recent deaths that might have been prevented.

In a public health notice, the FDA said there was an increased life-threatening risk of bacterial meningitis in cochlear implant recipients caused by Streptococcus pneumoniae, particularly those children with implants that have a positioner.


Only one cochlear implant has a position and that device was withdrawn from the market in July 2002.


The FDA said the two deaths -- in children ages nine and 11 -- both occurred in the past year in children who were not fully immunized and had been implanted with a cochlear implant with a positioner.


"At least one of these children had meningitis caused by a serotype of Streptococcus pneumoniae that may have been prevented by proper vaccinations," the FDA said.


The FDA said that results of a recent survey revealed that only 29% of parents or guardians of children younger than two with cochlear implant knew whether their children were properly vaccinated. The survey, by John Niparko, M.D., of Johns Hopkins, found that vaccination status was also unknown for 43% of implant patients older than two.


The FDA said physicians should follow CDC recommendations regarding vaccinations for cochlear implant patients, which is the same vaccination schedule as that recommended for other high-risk patients.


The FDA also recommended that cochlear implant recipients, their families, teachers, and daycare providers be briefed on the signs of meningitis in order to ensure early detection and treatment.


Early signs of meningitis may include high fever, headache, stiff neck, nausea, or vomiting, discomfort looking into bright lights, sleepiness, or confusion. Some patients have ear pain or ear infection. Very young children may be sleepy, cranky, or eat less.


Finally, the FDA recommended that physicians:


Diagnose and treat otitis media promptly. In some of the meningitis cases reported to FDA, cochlear implant recipients had signs of middle ear infection prior to surgery or before the meningitis developed. For this reason, according to American Academy of Pediatrics clinical practice guidelines, clinicians should diagnose and treat otitis media promptly in patients with cochlear implants. They should also consider antibiotic therapy more readily in these patients than others. Consider prophylactic antibiotics. Healthcare providers should consider prophylactic antibiotic treatment perioperatively in children receiving cochlear implants.

Medical Device Safety: Advice for Patients with Cochlear Implants: New Information on Meningitis Risk
 
^ Thanks for reposting my post #142.

I can see that it is being overlooked a bit. No wonder why they are right about a lot parents of CI users are not aware of whether or not their children were vaccinated. I feel that some parents rush with the Cochlear Impants on their children without researching on it more deeply. I do hope that the article will help them to be more aware of the risks with Bacterial Meningiitis. I do feel bad for these children who died from it :(
 
Studies on meningitis after implantation.

Keep in mind these studies are in RATS

Threshold shift: effects of cochlear implantation ...[Otolaryngol Head Neck Surg. 2007] - PubMed Result

Protective effects of local administration of cipr...[Laryngoscope. 2006] - PubMed Result

And one by the same authors not yet available on PubMed, "Assessment of the Protective Effect of Pneumococcal Vaccination in Preventing Meningitis After Cochlear Implantation, Arch Otolarnygol Head Nec Surg. 2007; 133(10):987-994.

Sheri
 
IslandGal said:
^ Thanks for reposting my post #142.

I can see that it is being overlooked a bit. No wonder why they are right about a lot parents of CI users are not aware of whether or not their children were vaccinated. I feel that some parents rush with the Cochlear Impants on their children without researching on it more deeply. I do hope that the article will help them to be more aware of the risks with Bacterial Meningiitis. I do feel bad for these children who died from it :(
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The recent news about the two deaths was the hot topic at work today. Wow..I couldnt bear to listen anymore cuz it is so sad.

Notices were sent home to the parents of the implanted students about the vaccines.
 
shel90 said:
The recent news about the two deaths was the hot topic at work today. Wow..I couldnt bear to listen anymore cuz it is so sad.

Notices were sent home to the parents of the implanted students about the vaccines.
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Better retroactive than nonactive, I suppose. Why in the world is the medical community failing to get this information to parents? How can anyone claim that parents are making informed decisions under these circumstances?
 
jillio said:
Better retroactive than nonactive, I suppose. Why in the world is the medical community failing to get this information to parents? How can anyone claim that parents are making informed decisions under these circumstances?
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I suspect that getting the information to the parents is not the problem, since no CI center worth it's legal salt is going to forget something like that when it could result in a lawsuit. The problem is motivating parents to actually do it.

Some people have a "it will never happen to me" mentality. I see kids all the time in the back seat of cars unrestrained by seat belts and shake my head. If the percentage of CI children actually getting meningitis was higher than it was then perhaps they would be more diligent about it but because its under 1%, it gets dismissed and forgotten about?
 
LTHFAdvocate said:
This has been the policy at our clinic for quite some time, but it may not be the policy at all clinics.
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Surely, this information/policy can be made known through your field's periodicals, conventions, etc, no?
 
Audiofuzzy said:
and some people "doesn't believe" in vaccinations...

Fuzzy
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Yes, that's the truth, some parents are not aware that immunizations are one of the most important to protect their children, their families and communities against serious diseases. They're only putting their own children at risk of catching a serious disease and it can be deadly.


They also don't believe that vaccinations are important because nothing happened to their child as far yet, but they're putting their children on a hot spot of being harmed.

I as a parent do think vaccinations and being immunizations are very important.
 
R2D2 said:
I suspect that getting the information to the parents is not the problem, since no CI center worth it's legal salt is going to forget something like that when it could result in a lawsuit. The problem is motivating parents to actually do it.

Some people have a "it will never happen to me" mentality. I see kids all the time in the back seat of cars unrestrained by seat belts and shake my head. If the percentage of CI children actually getting meningitis was higher than it was then perhaps they would be more diligent about it but because its under 1%, it gets dismissed and forgotten about?
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I'm going to have to disagree on that one. If parents were getting the information, they wouldn't be "unaware". Surgeons are obviously implanting children without the vaccine having been completed. And what about follow up? Are these kids just being implanted with no medical follow up? I have already decided to poll my students that are implanted to see howamnyof them have been vaccinated, or were even aware of the need.
 
Audiofuzzy said:
and some people "doesn't believe" in vaccinations...

Fuzzy
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I doubt seriously that parents who are opposed to vaccinations are the type of parents with the mentality to opt for CI in an infant, either.
 
It is well known in the clinical community, but no one (except perhaps the FDA or the AAO-HNS) can force a clinic to make changes in their procedural policy. Note that the poll only asked *families* if they knew/remembered whether or not the shots had been done, if you call 100 implant centers, I expect that all of them discuss the shots as part of the eval process, and most require them.

If I remember correctly, one newspaper article (posted in the original threat on this board about one of the girls that died) stated that the parents admitted they were told by the implant center to get the vaccine, but the pediatrician didn't have it in stock and the family didn't follow up. Working with as many HI people as I do, and with a child in college, I have demanded (and received) this shot for all of my children as well as myself, even though none of us have implants, I just don't believe in messing around with something this serious when a simple preventative measure is available.

Sheri

Tousi said:
Surely, this information/policy can be made known through your field's periodicals, conventions, etc, no?
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I disagree. Most people who object to vaccines do so on the grounds that they think they are linked with a higher rate of autism. Recent studies say they aren't, but many people still believe they are. Totally different underlying reasoning than the decision about whether or not to get a CI.

jillio said:
I doubt seriously that parents who are opposed to vaccinations are the type of parents with the mentality to opt for CI in an infant, either.
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