Statistical Numbers of Deaths from Bacterial Meningitis Post CI Surgeries?

[yizuman]

Anyone have any statistics of exactly how many reported deaths ranging from children to adults who died post surgery from CIs?

Appreciate any info.

Yiz

 

[Oceanbreeze]

Anyone have any statistics of exactly how many reported deaths ranging from children to adults who died post surgery from CIs?

Appreciate any info.

Yiz

No idea, but I'd be curious to know. A dear friend of mine was implanted with the Advanced Bionics implant back in 2002. Nearly two years later, she contracted bacterial meningitis from the implant. She survived and her device was removed, but I really would like to know just how many people with a CI die from meningitis.

Incidently, she was reimplanted with a newer model AB implant after she recovered from the infection.

 

[RonJaxon]

Well it's a very, very small risk if you get vaccine before hand like you should. The chances of getting meningitis is 1/1000.

Source:

Recently a possible link between cochlear implantation and meningitis has been suggested. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and others published a study addressing this issue in the July 31, 2003 issue of The New England Journal of Medicine. In 4,264 children implanted before age 6, they found an incidence of meningitis of just over one half of one percent (0.6 percent or 26 patients). The authors reported that: 1) Meningitis occurred more often in children with cochlear implants than in children of the same age group in the general population. 2) Children who received a cochlear implant with a positioner were more likely to get bacterial meningitis than children with other types of cochlear implants. 3) Children with a cochlear implant who had congenital inner ear malformations alone or in association with cerebrospinal fluid leaks were at increased risk for bacterial meningitis.

Although this study is vitally important, there is one major weakness. The study infers that children with implants are at a 30-fold increased risk of meningitis compared to a normal child. This is misleading. Hearing-impaired children are at increased risk of meningitis, even without implants. In the New England article, 11.5 percent of the implanted children had an inner ear deformity that put them at risk for meningitis, with or without an implant. 23 percent of the implanted children in the study had meningitis BEFORE receiving their cochlear implant. In another report of a child who developed meningitis after a cochlear implant, the non-implanted ear was found to be the source of the infection. The implant and the implanted ear were in no way involved.


Based on this and other studies, The CDC and FDA recommend that children and adults with cochlear implants should be vaccinated for pneumococcus and children should also be vaccinated for H. Influenza. Otitis media should be treated aggressively with antibiotics and/or ventilation tubes.

 

[Oceanbreeze]

Well it's a very, very small risk if you get vaccine before hand like you should. The chances of getting meningitis is 1/1000.

Source:

My friend WAS vaccinated per the recommendations of her CI center at the time. The strain of meningitis that she contracted was caused by strep. She was vaccinated for Hib ONLY pre-implantation.

 

[dreama]

I think a lot of the cases were from a type of CI which was withdrawn. It was due to where the placer was put. Altogether it is rather surprising that there hasn't been more deaths due to CI. I mean sticking metal in people's head has to be really risky.

 

[Oceanbreeze]

I think a lot of the cases were from a type of CI which was withdrawn. It was due to where the placer was put. Altogether it is rather surprising that there hasn't been more deaths due to CI. I mean sticking metal in people's head has to be really risky.

That's right, Dreama. Back in 2002, Advanced Bionics designed their CI with a positioner, which basically held the electrodes in place. In theory, that sounds nice, but it allowed for a nice place for bacteria to invade. They recalled that cochlear implant and subsequently released a newer version that doesn't require a positioner.

My point was to draw attention to getting all recommended vaccinations. My friend thought she was OK. She did everything her CI center told her to do before her surgery, but she still contracted strep meningitis, which nearly killed her.

 

[sr171soars]

I think a lot of the cases were from a type of CI which was withdrawn. It was due to where the placer was put. Altogether it is rather surprising that there hasn't been more deaths due to CI. I mean sticking metal in people's head has to be really risky.

Why do you think that? They have been sticking metal in people's bodies for years and nary a controversy. Think metal screws for spines, artificial knees, leg fractures. The skull is no different. Heck in some rare cases, they put a metal plate on the skull of some patients for good reason.

 

[dreama]

Depends where you stick the metal. The brain is one of the more sensitive and less understood organs in the body. It doesn't self repare quite so well as other parts.

I mean if your leg is fractured, shot at or simply removed altogher you would still be alive and relatively well. Do that to the brain and you wouldn't likely be around at all.

So I'm for more of in favor of caution.

 

[SeanB]

Quite a bit of gold is used in CIs. Those that react (ie iron), or can be easily rubbed off (ie copper) are a bad choice as it can lead to OD of these metals. Heavier metals are not suitable since they have toxic properties to affect and even kill nerve cells.

 

[sr171soars]

Depends where you stick the metal. The brain is one of the more sensitive and less understood organs in the body. It doesn't self repare quite so well as other parts.

I mean if your leg is fractured, shot at or simply removed altogher you would still be alive and relatively well. Do that to the brain and you wouldn't likely be around at all.

So I'm for more of in favor of caution.

Er...do you realize that the brain is not involved when a CI is implanted? A CI and it components are all outside the brain. The closet one gets is with the cochlea itself and still that is outside the brain. Thus, there is no danger where the brain concerned.

 

[Bottesini]

Er...do you realize that the brain is not involved when a CI is implanted? A CI and it components are all outside the brain. The closet one gets is with the cochlea itself and still that is outside the brain. Thus, there is no danger where the brain concerned.

There has to be some pathway and there is danger, because meningitis is involving the brain.

 

[sr171soars]

There has to be some pathway and there is danger, because meningitis is involving the brain.

Metal (as the electrode) in the cochlea and meningitis are two different things. The metal electrode has never been pointed out as a problem especially from the standpoint of meningitis. The story about meningitis from AB came about due to a positioner which I believe wasn't made of metal.

Now on the other hand, I can believe one can react to metal as in some kind of allergic reaction. That would be true regardless where the metal was placed in the body. I think "Smithr" and his story where he received a CI and then later had it removed was such a case. There have been other stories not associated with CIs that also lend itself to such phenomenon.

 

[deafdude1]

That's right, Dreama. Back in 2002, Advanced Bionics designed their CI with a positioner, which basically held the electrodes in place. In theory, that sounds nice, but it allowed for a nice place for bacteria to invade. They recalled that cochlear implant and subsequently released a newer version that doesn't require a positioner.

My point was to draw attention to getting all recommended vaccinations. My friend thought she was OK. She did everything her CI center told her to do before her surgery, but she still contracted strep meningitis, which nearly killed her.

That's why I have very little interest in CI, id only consider it if I lost all my residual hearing. I won't force CI on any children if they respond at all to HAs. Most deaf people still have residual hearing that can be amplified with today's wonderful powerful HAs. Being deaf is not harmful to your health, just inconvenient(in my opinion) I would love to hear better but only if it's safe such as HAs and future technologies.

 

[Oceanbreeze]

There has to be some pathway and there is danger, because meningitis is involving the brain.

Also, too, if one gets all their vaccinations and keeps them up to date, the chances of infection are almost nil. My point bringing up what I did was to educate people into making sure they get ALL available vaccinations before their surgery.

 

[Oceanbreeze]

That's why I have very little interest in CI, id only consider it if I lost all my residual hearing. I won't force CI on any children if they respond at all to HAs. Most deaf people still have residual hearing that can be amplified with today's wonderful powerful HAs. Being deaf is not harmful to your health, just inconvenient(in my opinion) I would love to hear better but only if it's safe such as HAs and future technologies.

It IS safer these days, Deafdude. No surgery is 100% safe, but the guidelines for implantation have gotten stiffer. They require being vaccinated against all pathogens that cause meningitis. If I were late deafened, and a candidate for a cochlear implant, I'd go for it. I don't know if I would go with Advanced Bionics, though. I'd probably go with Cochlear, but that's just my hypothetical preference.

 

[Oceanbreeze]

Metal (as the electrode) in the cochlea and meningitis are two different things. The metal electrode has never been pointed out as a problem especially from the standpoint of meningitis. The story about meningitis from AB came about due to a positioner which I believe wasn't made of metal.

Now on the other hand, I can believe one can react to metal as in some kind of allergic reaction. That would be true regardless where the metal was placed in the body. I think "Smithr" and his story where he received a CI and then later had it removed was such a case. There have been other stories not associated with CIs that also lend itself to such phenomenon.

This is true, SR. I know someone who is allergic to titanium. She can't have any of it placed in her body, anywhere. She has a condition that made her a candidate for a hip replacement and she couldn't have it done. She had another procedure instead. In that procedure, titanium was temporarily used to reinforce her thigh bone, and she ended up with a raging bone infection.

These infections are far more common and dangerous then possible infection of meningitis from a CI AND you CAN'T vaccinate against a reaction against titanium like you can against meningitis.

 

[Fumasivil]

There has to be some pathway and there is danger, because meningitis is involving the brain.

It doesn't quite involve the actual brain itself. The meninges - the fluid that protects the brain from impacts and sits between the brain and the skull can get inflamed - hence the name meningitis.

As quoted from the meningitis UK website:
'Meningitis is caused when the protective membranes covering the brain and spinal cord - known as the meninges - become inflamed, usually as a result of an infection.'

It's a nasty piece of work as it can be caused by either a virus or bacteria around 50 kinds that can cause meningitis and is often known as a secondary infection.

 

[sallylou]

Picking up a secondary infection in a hospital setting is a real risk. Not just for CI but for any surgery.

When you have anything implanted in your body, the drs administer prophylactic antibiotics, don't they? That cuts down on the risk.

Is there a vaccination that can protect against strep?

 

[yizuman]

Well it's a very, very small risk if you get vaccine before hand like you should. The chances of getting meningitis is 1/1000.

Source:

That's from a 2003 report, I'd be interested to see what an more recent report shows now, say from 2008 perhaps? Anyone have something like that?

Yiz

 

[Oceanbreeze]

Picking up a secondary infection in a hospital setting is a real risk. Not just for CI but for any surgery.

When you have anything implanted in your body, the drs administer prophylactic antibiotics, don't they? That cuts down on the risk.

Is there a vaccination that can protect against strep?

Yes there is and it's good for five years. You need to get re-vaccinated, but it provides good protection against illnesses caused by strep including meningitis.

http://wiki.medpedia.com/Streptococcal_Infections#Prevention