What is Bacterial Meningitis?
Every child that dies from meningitis is one child too many. That's the message a group of parents – most of whom have lost children to bacterial meningitis – is trying to get out to parents of children everywhere. They have had some successes, but for the most part it's an uphill battle because public health policy doesn't view meningitis as enough of a statistical risk to devote public health funds to the type of advertising push necessary to inform doctors and parents. Not to mention the fact that most insurance companies don't cover the vaccine.
But, as Sue Koenig, of Coatesville, Penn., points out, for the cost of a pair of sneakers, a parent can protect their child from losing their life or being seriously disabled for life. She knows that any informed parent is willing to bear that small cost to protect their child.
If parents could place an order for the perfect child, they would probably end up with one like Emily Koenig. Bright, bubbly and highly motivated, she never had to be pushed to do her best. "We were very fortunate as parents because she really wanted to do well," says Koenig. "She was just a wonderful child."
On December 7, 2002, Emily accompanied her father, Al Koenig, to a local nursery to buy plants for a school project. While she was there, a woman sneezed on her at close range. Giggling, but kind of grossed out as well, Emily told her father about it, adding that the woman didn't seem to speak English.
Four days later, Emily died in the emergency room of their local hospital. She had contracted the bacterial infection Meningococcal meningitis, possibly from the woman who had sneezed on her. While most people can fight off this bacteria quite easily, for some, particularly those with immature immune systems or immune systems that have been weakened by a cold, illness or lifestyle issues such as smoking, it can sometimes develop into a deadly illness.
Since the loss of their only child, one of the most difficult facts the Koenigs have had to face is the knowledge that there is a safe vaccine that may have protected her from the bacteria. "The general feeling is that this is a relatively rare illness, but if you look over the period of time since this vaccine has been available and add up how many children have died, you're talking 10,000 lives," says Koenig. "It's terrible when you think many of those deaths could have been prevented. Even one is too many."
While the Koenigs were unaware of the existence of a vaccine, the Kepferles, of Lexington Park, Md., had received information about it in their son's college acceptance packet. When they asked about getting Pat the vaccine at his pre-college physical, they were told it was not available in that office. When he left for college, Pat promised to get vaccinated as soon as possible. But, understandably, getting a shot is usually not high on a college freshman's priority list. Pat died of meningitis several months later.
The Koenigs have tried to find solace from their grief in efforts to raise funds for meningitis research and awareness. More research into detecting and preventing meningitis is urgently needed because of the limitations of the vaccine. While it is better than nothing, it's only about 85 percent effective. Also, there currently is no reliable method to test for the presence of meningitis, which lives in the back of the throat, even though it's estimated that up to 15 percent of the population carries the bacteria.
Al Koenig sees meningitis prevention as an issue that is becoming even more important as the world becomes more global, which is why he points out that it's possible the woman who sneezed on Emily was from another country. "The immune system is broken up into inherited and learned immunities," says Koenig. "Generally, as you get older, you're exposed to a lot of different things, and you develop immunities. Those with weakened or immature immune systems don't fight off bacteria that an older or healthier person may not even realize they've been exposed to. Also, when you're exposed to people from different cultures, you often don't have any inherent immunity."
His point is not that we should become more insular, but that we should become more proactive. However, that's not possible if the first a parent ever hears about meningitis is when their child dies from it.
Mike Kepferle, who after Pat's death went on to co-found the National Meningitis Association, says getting the word out to parents is complicated by several factors. One is that the Centers for Disease Control and Prevention (CDC) doesn't see meningitis as enough of a threat to make it part of the recommended childhood vaccines; therefore, it's not usually even on the radar of most doctors. Also, there is some confusion because there are several types of meningitis, so parents may think their child has already been immunized against the deadly Meningococcal bacteria. In fact, this is a vaccine that is not given to a child unless it is specifically requested by a parent.
Thanks to the efforts of parents like the Koenigs and Kepferles, most colleges now strongly recommend a vaccine to protect incoming students from bacterial meningitis – some even require it. While this is a step in the right direction, cases like Emily Koenig's show that it's not just college-age students or the close quarters of college dorm rooms that put young people at risk. That's why they want to see every child vaccinated at as early an age as possible, and they want every parent to be informed about the dangers of meningitis and the availability of a vaccine, so they can make informed decisions.