the ounce of prevention

A code that came in this weekend brought me back in time about a decade.

He came in dead, and he left that way too, as these things are sometimes wont to go. Later, after the post-mortem, the infection control officer did her customary chasing down of the staff members who were at the code. Seems the patient had meningococcal meningitis, a severe infection of the brain linings caused by a bacterium which spreads in the droplets of respiratory secretions. The infection control officer was there with a stack of prescriptions for antibiotics, a dose of which we all had to take to ensure that we who were exposed would not succumb to this infection.

The scariest part about meningococcus isn’t antibiotic resistance (MRSA) or disease mutations in animal hosts making the pathogen more dangerous to humans (H1N1), but rather how fast the disease progresses from an asymptomatic incubation stage to causing severe brain damage or death. Vaccination is available against the infection but vaccination campaigns in Canada haven’t been part of the routine immunization series, so herd immunity is nonexistent. The last time a number of teenagers died of this vaccine-preventable disease was when I received my immunizations against it.

About ten years ago, several high-school aged kids where I lived contracted meningococcal infection. Some of them got treated early enough on for meningitis, but the unlucky ones ended up like this kid. The infection overwhelmed their bodies, resulting in a the typical meningitis-type rash growing and growing into purpura, a sign the infection had caused DIC. At that point, the sepsis had progressed so far that the likelihood of a good outcome was extremely poor, and as a result, two very healthy kids died very suddenly.

Meningococcal disease is downright frightening, and is one of the few examples of infections you shouldn’t wait to get antibiotics for. It’s one of relatively few infections that, even in industrialized nations, still kills people fast enough that a matter of hours can make the difference between alive and dead. It’s one infection where the best treatment is that ounce of prevention: vaccination for those who are at risk. It’s one infection that emphasizes how important vaccination can be in avoiding preventable deaths. It’s one infection that really lays bare how little the medical community can do if we don’t catch you in time. And it makes it very starkly clear how dangerous it can be to not pay attention to your body.