Why Did Katie Engle Die?

Two weeks ago little 7-year-old Katie Engle died at Children's Hospital in Omaha NE from bacterial meningitis.

According to a statement made by her mother, Roxanne Engle, to KETV.com, the Washington Elementary School second-grade student had been complaining of a headache a few days earlier, but was well enough to go to school.

"She was happy one day and I took her to school and it went down hill from there".

It began with a headache, but appears that by the time Katie was admitted to the hospital she did have other systems associated with the disease, including vomiting, fever and lethargy.  The doctors at Children's Hospital did what they could, but the meningitis caused Katie's brain to swell and she died shortly thereafter.

According to the KETV.com report, the doctors felt  Katie's meningitis may have been caused by her cochlear implant and her death could have been prevented with a vaccination.

When questioned about the vaccination Roxanne Engle stated to KETV.com

"I had tried and they were always out," Engle said. "After going back several times, I forgot about it."

"they were always out"  How can a clinic/hospital be "out" of a vaccine that has such deadly consequences if not taken?

"I forgot about it"  How does a mother forget about a vaccination that has the potential of giving her daughter bacterial meningitis?

On February 6, 2006 the Federal Drug Administration, FDA, issued a public health notification on the "Continued Risk of Bacterial Meningitis in Children with Cochlear Implants" that includes the following statement:

"A new CDC/FDA study has shown that children with cochlear implants with a positioner remain at increased risk of bacterial meningitis caused by Streptococcus pneumoniae beyond 24 months post-implantation. Cochlear implants with a positioner were manufactured only by Advanced Bionics Corporation. None have been implanted since July, 2002."

The original publication on this subject was July 24, 2002 and was updated on September 25, 2003.  By May of 2003, the FDA had been notified of 118 cases worldwide as follows:

"FDA first became aware of the possible association between cochlear implants and meningitis in June 2002. As of May 2003, we have learned of 118 cases of cochlear implant recipients worldwide who developed bacterial meningitis (55 cases in the United States and 63 cases in foreign countries). The patients ranged in age from 13 months to 81 years. The majority of U.S. patients were no older than five (5) years of age, while meningitis cases in the non-U.S. patients were distributed equally among children and adults."

It is estimated by the National Institute on Deafness and other Communication Disorders, NIDCD, that 59,000 adults and children worldwide already have cochlear implants and another 250,000 would benefit from the implant. 

There are medical risks involved with any surgery and in the case of bacterial meningitis the risk can result in death if medical advice is not followed.

FDA recommendations to decrease the risk of bacterial meningitis have been in effect since 2003 and have not changed. 

Recommendations to decrease the risk of meningitis in cochlear implant recipients

These recommendations have not changed from the 2003 recommendations.

• Follow CDC’s vaccination recommendations. CDC has issued recommendations about which vaccines cochlear implant patients should receive and when the vaccines should be given. These vaccine recommendations continue to apply to all children with a cochlear implant, with or without a positioner, and all potential implant recipients. Healthcare providers and families should review vaccination records of current and prospective cochlear implant recipients to ensure that the patient is current on all the CDC recommended vaccinations. These recommendations are available on the CDC’s Webster at www.cdc.gov/nip/issues/cochlear/cochlear-gen.htm.

• Recognize the signs of meningitis early. Cochlear implant recipients, along with their families, educators, daycare and healthcare providers, need to be aware of the signs of meningitis. This can help ensure early detection and treatment of this life-threatening illness. Early intervention is vital in successfully treating the infection and minimizing permanent neurological damage. Early signs of meningitis include high fever, headache, stiff neck, nausea or vomiting, discomfort looking into bright lights, and sleepiness or confusion. A young child or infant with meningitis might be sleepy, cranky, or eat less.

• Diagnose and treat middle ear infections promptly. In some of the meningitis cases reported to FDA, cochlear implant recipients had signs of middle ear infection (otitis media) prior to surgery or before the meningitis developed. For this reason, healthcare providers should diagnose and treat otitis media promptly in patients with cochlear implants.

• Consider prophylactic antibiotics. Healthcare providers should consider prophylactic antibiotic treatment perioperatively in children receiving cochlear implants.

Advice to Patients with Cochlear Implants can be found at http://www.fda.gov/cdrh/medicaldevicesafety/atp/020606-cochlear.html.

Katie's organs were donated after her death so she will continue to live on in the hearts and minds of the recipients of her organs as well as in the hearts and minds of her family and friends.

Katie's death needs to be a wake-up call to all parents, educators and health care providers so that another youngster does not die from failure to obtain vaccinations necessary to ward off bacterial meningitis.

"There's no tragedy in life like the death of a child. Things never get back to the way they were."

~ Dwight David Eisenhower