I've been watching the outbreak of meningococcemia at UO and wondering if it's really what they say...
http://registerguard.com/rg/news/lo...nuary-tells-of-her-near-death-ordeal.html.csp
Tylenol dulled her headache the night of Jan. 14, but the University of Oregon freshman slept poorly at her off-campus apartment and periodically vomited.
Her mother, who lives in Linn County, took her to an urgent care clinic after she was found to have a slight fever in the morning. The doctor suspected the flu and sent her home with advice to rest and drink fluids.
Less than 12 hours later, the 19-year-old student would be clinging to life, rushed by ambulance to Ore*gon Health & Science University in Portland as a massive bacterial infection ravaged her body. She was hemorrhaging, and her mother used a white towel to wipe away blood running from her nose and mouth.
“It was a horror movie,” her mother said. “Everything was unreal at that point, and it was fast. It was so fast.”
Christina suffered the first confirmed case in the outbreak of meningococcemia on the UO campus that would later sicken two other students who recovered and kill Lauren Jones, 18, a member of the UO acrobatics and tumbling team.
Christina would survive, a recovery doctors have characterized to her and her mother as remarkable.
Christina and her mother contacted The Register-Guard to tell their story, to raise awareness about the speed and severity of the disease and to urge students to get the vaccine that can protect against the specific type of bacteria that causes the illness.
On Monday, the university will begin large-scale clinics aimed at vaccinating nearly 22,000 students against the contagious bacteria responsible for the outbreaks at the UO as well as other college campuses around the country.
“Take the easier route (of vaccination), from my experience,” Christina said. “It’s a long and costly and traumatic experience.”
To protect her privacy, Christina asked that only her first name be used. Her mother asked not to be identified by name.
Lane County Public Health, which continues to investigate the outbreak, confirmed to the news*paper Christina’s identity as one of the meningococcemia victims.
Meningitis test requested
Christina has no idea how she contracted the bacteria, which spreads through kissing, sharing utensils or cups, or by having prolonged, close contact.
She sat in large classrooms, attended a roommate’s birthday party the prior weekend, and watched with friends as the Ducks played in college football’s title game two days before she fell ill. Public health officials say they haven’t found a link between Christina and the other three students.
Christina several years ago had received the vaccine that protects against four of the five bacteria types that cause most of the disease, but that doesn’t protect against the B-type bacteria that almost killed her.
Vaccines to protect against the B-type bacteria are very new. The U.S. Food and Drug Administration approved the two new vaccines to protect in October and January, and the UO will provide the October-approved vaccine to its students starting Monday. Christina received her vaccine on Tuesday.
At the Oregon Medical Group clinic on Jan. 15, Christina’s mother said she told both the attending nurse and the doctor to check for meningitis because her daughter is a college student.
Christina’s mother said the doctor didn’t follow through with her request, however, instead running a test for the flu that she later learned came back negative.
At that time, no one had any idea that an outbreak of meningococcal disease was brewing locally, because no one had reported or confirmed any cases. Meningococcal disease can be difficult to detect in its early stages, especially during flu season, because its initial symptoms can mirror those of influenza.
Meningococcemia is an infection of the bloodstream that can damage the walls of blood vessels and organs. Meningitis is the potentially life-*threatening swelling of the membranes that protect the brain and spinal cord.
Dr. Karen Weiner, Oregon Medical Group’s medical director, declined to discuss Christina’s care, citing federal privacy laws.
“The health and well-being of our patients is our highest priority and concern at all times,” she said in an email. “Oregon Medical Group has been and will continue to be vigilant in our effort to appropriately deal with this serious public health issue.”
The illness can worsen very rapidly.
The Register-Guard has reported that Jones was transported, treated and released at the Sacred Heart Medical Center University District hospital near campus hours before her condition worsened and she was transported to and died at Sacred Heart Medical Center at RiverBend.
Two life-saving decisions
After the visit to OMG, Christina’s mother took her daughter back to her off-campus apartment before driving back home to Sweet Home.
But Christina still couldn’t sleep well. She wanted to take a bath, but her apartment only had a shower. She texted her mother, who agreed to pick her up and take her home.
It was the first of two decisions that likely saved her life. The infection was gaining speed but wouldn’t make itself visible for a few more hours.
Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine, told The Register-Guard that the bacteria can lie dormant in the nose and throat of an infected individual for days or weeks before it can break loose.
“It’s a nasty infection,” said Schaffner, who was not involved with Christina’s care. “Subtle at first, and suddenly it turns fierce.”
Once home, Christina rested in her bedroom, but she was getting more disoriented, her headache had returned and she was alternately hot and cold.
Her mother checked on her every hour. At 10:30 p.m., as she was preparing for bed, she came in to tell her daughter to use the bathroom so her sleep wouldn’t be interrupted during the night.
It was the second potentially life-saving decision.
Her mother followed Christina into the bathroom where they both noticed three spots on her upper left thigh.
“Are those new moles?” she recalled asking.
“I’ve never seen those before,” her daughter responded.
What they were seeing — but didn’t understand — was that the bacteria was damaging blood vessels, causing hemorrhaging throughout her body that was gaining steam.
Her mother told her they were going to the emergency room.
“‘How did you know to take her to the emergency room?’ ” Christina’s mother would recall doctors asking her later. “And I said, ‘It wasn’t normal. Those spots aren’t normal.’ They weren’t there, and now they were there.”
“I knew. I had faith.”
They drove to the Samaritan Lebanon Community Hospital emergency room about 20 minutes away. Christina’s last unfragmented memories for a week are of being checked into the emergency room.
As a triage nurse was checking Christina, her mother noticed red spots in the whites of her eyes that weren’t there 20 minutes before.
Christina was rushed back to see the attending doctor. The nurse was having trouble checking her blood pressure, which was becoming erratic as the hemorrhaging accelerated.
Christina’s mother said the emergency room’s medical director, Dr. Daniel Sprague, contacted infectious disease doctors at OHSU and rushed in to say that her daughter had a massive infection.
He immediately started antibiotics. Her mother said OHSU doctors would later tell her his actions saved her daughter’s life.
The hospital declined comment on Christina’s care. A statement from the hospital’s chief operations officer praised Sprague as “an excellent physician and an asset to our team.”
But the immediate scene before Christina’s mother was grim. Her husband whispered in her ear that the doctors had called for a Life Flight. The aircraft was grounded by fog, she’d learn, so they transported her by ambulance.
She recalled a moment when her daughter was being loaded into the ambulance, the advance directive forms she’d been given earlier tucked in her purse. She’d leave the forms in the ambulance when they arrived at OHSU.
“I turned around and looked at all the people, the nurses and the support staff,” she said. “And they were all watching with just this look on their face like ... It went in my head, ‘They don’t think she’s going to make it.’ ... But I knew. I had faith. She’s a strong girl.”
Her mother said doctors later told her they didn’t know if her daughter would survive six hours after her arrival at OHSU around 2 a.m. on Jan. 16.
OHSU didn’t respond to a request to verify information about Christina’s care.
Lucky outcome
Schaffner said that while the antibiotics quickly kill off the bacteria, doctors are confronted with a body in a dangerous state of overdrive.
“This infection has set up biochemical and inflammatory responses by the body that can’t be turned off quickly, and they are the ones that cause all the damage,” he said. As a result, meningococcal disease can leave survivors with hearing loss, damaged kidneys that require lifelong dialysis, or limbs that need to be amputated.
Christina improved rapidly, and she awoke a week later. She’d be released from the hospital on Jan. 30.
Her mother said an ICU nurse told her Christina was the first of the four patients he’d treated for the disease in 20 years who came out of it without long-term complications.
Scarring in her lungs will likely keep her from running marathons, doctors told them, but Christina is otherwise expected to make a full recovery. Her main goal right now is to regain strength and stamina.
The family got another scare five days later when a high fever sent her to a local hospital. Her blood pressure fell once again, but the medical emergency wasn’t as serious as the earlier admittal.
Christina was released after another five days in the hospital. Doctors aren’t certain but suspect she experienced an allergic reaction to the anti*biotics she received to kill off the bacteria.
Christina plans to return to the university when spring term begins March 30.
Both daughter and mother are grateful to the doctors and emergency responders who came to her aid, and their friends, family and community members who offered their support and prayers.
But Christina also recognizes how close she came to dying.
“If I hadn’t gone home that night, I probably wouldn’t have noticed the spots on my leg and ended up ...”
A barely perceptible pause.
“... not good.”
