Concerns mount as child dies of meningitis
A four-year-old boy is dead tonight, believed to be the victim of meningitis. The child, a student of Hummingbird Primary School in Belize City, was admitted to the K.H.M.H. around seven Monday night, but his condition rapidly deteriorated and within hours, he was brain dead, kept alive only by a respirator. The boy’s paediatrician, Dr. Egbert Grinage, tells News 5 why he suspects meningitis and how other children with symptoms are being treated.
Dr. Egbert Grinage, Paediatrician
“Well the situation is that a child from Hummingbird Primary School was admitted to Karl Heusner late last night. He had a short duration of symptoms of fever, headache and fatigue and shortly after that, he suffered an arrest associated with a seizure. When he was put on life support last night we realise shortly after that he had suffered brain death and that the process appears to have been a fulminant, either meningitis or what we call encephalitis, which is an infection of the brain or the covering of the brain. I’m about to go in and take him off…I’ve spoken with the family to take him off the channel of life support.
Since then, a lumbar puncture has been done and it’s been found to be cloudy and very, very thick, suggestive of meningitis. Following that, a whole cascade of events has been ignited and has resulted in the public health authorities visiting the school and starting immunisation of at least close contacts of the child, and in fact they are trying to mass immunise the entire school.
There are three main bacteria that cause meningitis in children, meningococcus is probably the most fatal and fulminant. There is another called Hib or haemophilus, which is probably the second most lethal and there is one called pneumococcus, which is always present, but which also causes a bad sort of meningitis, but not like the other two. It could also have been cause by a virus, viral encephalitis, with rapid onset and rapid progress to death. But we are assuming a bacterial pathogen and one that we can respond to at this point in time, in terms of what the facilities we have in Belize, is the meningococcus, in that the close contacts of the child and his family can be given what we call antibiotic prophylaxis, because this bacteria colonises or lives in what we call the nasopharynx of adults and children, and it’s transmitted by droplets spread, meaning it flows across the air-currents from one person to the next. So we’re giving children who have been in close contact with this child antibiotic either by injection or by mouth.”
Janelle Chanona
“No doubt the parents watching this right now are going through some sort of panic. What are you telling parents of the school and even in general?”
Dr. Egbert Grinage
“Well I have to caution you that I am not the local public health. This should really be the jurisdiction of the local public health. I am aware that several paediatricians, several doctors have been advising the public health and they have taken steps to give antibiotics to the children who have been in close contact with the index case, the child who is on life support. They have tried to extend that to include the entire school since it’s a small school and this child could have moved easily in and out of his own class to meet other children from other classes.
Janelle Chanona
“Is it true that there are several children already hospitalised?”
Dr. Egbert Grinage
“What you tend to do is we are assuming that it’s a case of meningococcus meningitis, what the infectious disease experts all over the world advise you to do is to treat children, observe especially those who have been in touch with the patient who have fever; those cases because they may proceed to what we call invasive meningococcal disease, have been admitted and we’ve done in some cases where there has been headache and fatigue, we’ve done lumbar punctures. And in other cases where the child just has a fever we’ve done blood cultures and the child has been put on medication to treat this invasive form of the presumed organism until those cultures return.”
Janelle Chanona
“Can you tell us anything else about this case doctor?”
Dr. Egbert Grinage
“Just that it’s a very sad case whenever a child dies. The bad thing about meningococcus all over the world is that its incubation period can be very short. It can vary from four days to ten days, but often it is very short. The child present with symptoms that could be consistent with…we have a lot of acute viral respiratory illnesses going on right now and it’s very difficult to tell sometimes, in spite of the height of the fever that a child is going to progress rapidly to the kind of death that this child did, in that his brain almost immediately became swollen and then it’s started protruding into the base of the skull, resulting in pressure on the vital organs of the brain and eventual death of his brain.”
Health authorities are asking all parents to closely monitor their children for the flu-like symptoms of the disease and seek attention immediately in any suspicious cases. According to health authorities, it has been nearly five years since the last confirmed case of meningitis in Belize. Adults rarely catch the disease, but they can act as carriers and transmit it to children.
