It is Christmas 1997 and I am a junior doctor on-call at St Mary’s Hospital, Paddington in Paediatric Intensive Care – a unit set up specifically to manage and study children with meningitis and septicaemia. We are preparing a bed for yet another child with meningococcal septicaemia being retrieved by the mobile intensive care unit.
I feel I could write the notes before I have even met the family and child – a perfectly healthy child, will have developed a fever and looked unwell. Within a few hours the parents will have decided the child is unusually unwell and started the tricky journey of trying to get appropriate medical help. This can be an odyssey of misdiagnosis and precious minutes ticking by whilst this rapidly fatal infection takes hold.
At best the child and family will have to recover from a stay on intensive care, at worst their lives will have changed forever in a way they never foresaw – death or survival with amputations, skin scarring, brain damage.
In 1997 we were seeing at least two children a week critically ill with this infection. I then spent three years conducting a national study of children who had died of meningitis and septicaemia funded by Meningitis Research Foundation. The parent’s grief lives with me still.
In the winter of 1999, the UK led the world in vaccinating teenagers with the new MenC vaccine – instant success! The numbers of cases started to tumble. But people’s memory is short and the media demands for “something to be done” about the numbers of deaths in children from meningitis were rapidly forgotten.
Yet children are still dying from meningitis and septicaemia. Not all strains are covered by current vaccines and even the widely reported MenB vaccine, which campaigners like Meningitis Research Foundation hope to see introduced into the Child Immunisation Schedule, won’t prevent all strains of the diseases.
Yet I continue to hear anti-vaccination comments about “immune overload”. It leaves me aghast that anyone might risk allowing their child to get a vaccine preventable disease. I realise of course that being a doctor for over 20 years and watching children develop meningitis, septicaemia, measles, chickenpox and all the after affects and complications does bias one’s mind.
Vaccinations are only developed to combat serious infections. You only need to walk round a Victorian cemetery to realise how vulnerable children are. In 2012, in a developed country like the UK we should be aiming to stop every child dying of a vaccine preventable disease. I never want to see a child with severe meningitis again, nor one loose legs or arms from septicaemia. I will never be out of a job, new infectious agents emerge all the time. Different professional challenges are welcome!
Nelly Ninis is a Consultant in general paediatrics at St Mary’s Hospital, Paddington and Medical Advisor for Meningitis Research Foundation.