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150227MeningococcusI remember the phone call like it happened yesterday.

I was in the mother-baby unit of the former Sacred Heart Hospital nearly 15 years ago when I received an urgent call from a clearly shaken emergency room doctor. "Pilar, come quick, this is a bad one." I raced to emergency to find my toddler patient barely conscious and covered in purple spots. In an instant, I knew I was dealing with one of Oregon's most dreaded infections – Meningococcus B.  

What followed next was a blur of activity. I worked quickly with a team of amazing nurses, anesthesiologists, and E.R. doctors while speaking by phone with physicians at the Pediatric Intensive Care Unit at Doernbecher Children's Hospital. Together, we worked furiously to get this beautiful little girl onto a ventilator and pumped full of I.V. fluids, blood, antibiotics and medications to support her heart. Life Flight arrived a few hours later to rush her to Portland, and the entire medical team collapsed in tears, all of us wondering if she would survive.

Fast forward to 2015.

Meningococcus B recently hit the University of Oregon, sickening multiple young adults. It's a truly fearsome bacterial infection. It spreads by respiratory droplets or shared saliva. In a matter of hours, it can cause a healthy person to develop fever, headache, intensely painful body aches, nausea, vomiting, and poor concentration. If unchecked, it leads to sudden shock, multiple organ failure, and often death. Meningococcus responds to antibiotics, but isn't often identified among the annual outbreak of illnesses with similar symptoms.

Oregon has long been a hotspot for the Meningococcus B serotype, which is not covered by the Menactra vaccine that 11 and 15-year-olds are required to receive to attend school. That vaccine protects against the equally deadly A, C, Y, and W135 serotypes. But all of that has changed. The FDA recently approved two vaccines specific to the B serotype, which will soon be able to prevent epidemics.

I spoke recently to Dr. Patrick Luedtke, Director of Lane County Public Health, who shared the following information:

  1. Two brands of Meningococcus B vaccine are now FDA approved: Trumenba and Bexsero.
  2. Neither of these vaccines is available for widespread use, due to a pending decision about age and booster schedule from the ACIP (Advisory Committee on Immunization Practices). That meeting was scheduled to happen this week, but was delayed at the last minute.
  3. Because the UO outbreak is large enough to constitute a public health emergency, Lane County Public Health approved a rapid vaccination campaign of 20,000 people affiliated with the university before the ACIP decides. This effort is now underway and will hopefully protect people on campus, as well as the rest of our community.

As soon as the Meningococcus B vaccine is available to our patients at Eugene Pediatrics, we will publicize the ACIP recommendations and outline who should be vaccinated, the schedule of the vaccine, side effects and benefits, and information about vaccine availability at our office.

I advise all parents not to panic. The illness has not appeared outside the UO community. We have seen no recent cases of Meningococcus in children; but it's important to be aware. If your child develops a sudden onset of high fever, lethargy, vomiting, headache and body aches, seek medical attention immediately. Blood work can help differentiate Meningococcus from less dangerous viral syndromes.

As for my little patient of many years ago, she is all grown up now — fit and healthy.  The only remaining evidence of her illness is a small scar on her ankle, left from the infection. She survived, thanks to early recognition of her illness by her family, the work of the E.R. team, and many blessings from Heaven.
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