Invasive meningococcal disease is the most common form of bacterial meningitis in Ireland, causing up to 90 per cent of cases, and it can present as meningitis or septicaemia (blood poisoning), or both.
It is most common in infants and small children, but can occur at any age. And while most people are aware of the need to seek help if a child is unwell and is displaying a suspicious rash, this can often be one of the last symptoms of meningitis – so it is vital for people to be vigilant, particularly going into the winter months.
Mags Derrane can attest to this as almost seven years ago, her daughter Bethany (9) showed signs of a small bruise and this, combined with a listless demeanour, caused the Galway woman to seek medical advice.
“On February 15th, 2015, Bethany went to sleep normally and the following morning, after her dad changed her, she went back to sleep until 8.20am,” she says. “When I went to check on her, she was pale, with a squeaky cry and when I picked her up, I noticed a small bruise. I knew straight away something was wrong, so rang the doctor to be told an appointment was available at 10am.
“But by 8.50 I rang my husband Patrick in a panic, telling him to come home quickly as she was breaking out in more bruises. I knew it was serious, and that it was probably meningitis because of her cry, her paleness and the fact that she wouldn’t eat or drink. She had become ill so fast and she was perfect the night before.
“Patrick and I went to the doctor’s and were told that an ambulance was being called, but I said it would be faster for us to take her, so the doctor rang the hospital to tell them we were on our way and as we arrived Bethany just flopped in my arms. Thankfully, a team of doctors and nurses were waiting and started working on her straight away.
“Both Patrick and I felt sick and my heart was pounding. I got a call from the HSE in the meantime asking me loads of questions and telling me to give the other kids [Nathan, Jason and Leah] medicine to stop them getting meningitis [as was suspected that Bethany had] and both Patrick and I had to take a tablet.”
Once the little girl was diagnosed with meningococcal B meningitis and sepsis, she was given various medicines to fight the infection and her parents were told that she was in a critical condition. “I ran to the bathroom, crippled with pain,” says Mags. “I needed to be sick, but couldn’t. I felt like the walls were closing in and prayed that my baby girl wouldn’t die. I couldn’t breathe. I just wanted to hug her. But when she was stable enough, she was rushed to ICU and we were told that she needed to go to Temple Street in Dublin but might not make the journey.
“Patrick and I followed the ambulance to the hospital and it was about 6pm before we finally got to see her. But we couldn’t believe our eyes as she was covered in black spots, her fingers and toes were black and her head was swollen with fluid. At midnight, Patrick went home to get some clothes for our other children (now aged 16, 14 and 12) who were with my sister. Then at 3am, Bethany took a turn for the worse and I was taken to a parent room where I was told that they would call me if anything happened. My heart was pounding and at 6.30am, a nurse told me that Bethany had a really bad night and they nearly lost her – but thank God, they brought her back as she was a little fighter.
“But when I saw her, my heart sank as her head had swollen even more and when Patrick arrived back, he was really shocked. After 72 hours, she was still fighting and on the fourth day, while still on a machine to help her breathe, she looked around and seemed really scared. She saw myself and Patrick and wanted to be picked up, but we were asked to leave the room for an hour.”
The distraught parents went for a walk and to pick up some clothes for their little girl. They thought the worst was over, but when they arrived back they were horrified to discover that she was unable to see and hear. They soon realised that she had been given a particular medicine that she was allergic to and once this was righted, it took a few days for her to finally regain her faculties and return to some semblance of the toddler she was before.
“After three days, Bethany was put in a regular ward and began to see and hear again,” says the mother of four. “It was a week after she had been diagnosed with meningitis and we were finally able to hold her. I was afraid to do this at the start because she had lost so much weight – but she soon started eating and her feeding tube was taken out. She also lost her speech and the only words she could say were ‘no’ and ‘more’. Then after spending three more weeks in hospital, she was allowed home and we were so grateful to Temple Street hospital and everyone who supported us, including the charity, ACT for Meningitis.
“It was a tough journey but Bethany is a fighter and she overcame the obstacles. We were told that she would never talk or walk again – but right now she is walking, talking and running. We made sure we did everything we could to help her and when she was called for physio a year later, they couldn’t believe it [how mobile she was] as they had been prepared to fit her for a wheelchair. But she is a fighter and really wanted to walk so [during the year they waited for physio] she was determined.”
Thankfully Bethany, who will be 10 in December, survived her horrific ordeal, but Mags says it was touch and go and she would advise everyone to know about meningitis and get children, and young adults, vaccinated against it. “Bethany has developmental delays, epilepsy and a mild intellectual disability,” she says. “She is in third class doing senior infants work and she can read 29 words – but the Claddagh school in Galway is brilliant with her. This experience has taught me that we should always trust our instincts – and if we feel like something is wrong, we should get it checked. If I had left Bethany for another 10 minutes, she wouldn’t be here today.
“So please all parents, grandparents, uncles, aunties and friends, if you think that something is not right ring the doctor straight away. And make sure all your kids are fully vaccinated.”
Siobhán Carroll is the CEO of the charity ACT for Meningitis. She has personal experience of the virus, having tragically lost her four-year-old daughter Aoibhe to an aggressive form of meningitis in 2008. She would encourage everyone to know the symptoms and act as quickly as possible.
“On World Meningitis Day (October 5th), we urge people to get to know the signs and symptoms of meningitis,” she says. “Babies and children up to the age of five are the most at risk, with 16- to 24-year-olds being the second highest risk age group and then over-65s. But anyone of any age can contract meningitis.
“While early symptoms, which include headache, fever, vomiting and muscle pain, are flu-like, someone with meningitis or septicaemia can get a lot worse very quickly, so keep checking them.
“Further specific symptoms of meningitis include fever with cold hands and feet, stiff neck, dislike to bright lights, drowsiness and confusion. But meningitis does not always produce a rash – however, if it does appear, it will not fade under pressure and is a medical emergency. In babies, it can also include being irritable, refusing to feed, high-pitched crying, rapid breathing, cold hands and feet and a bulging fontanelle (soft spot on the top of the head). The symptoms may appear in any order or some may not appear at all.
“So the signs may be difficult to spot as many of the early symptoms can be similar to those of flu, so we ask people to trust their instincts and if they suspect meningitis, seek medical help immediately.”