Vaccinated N.J. teen's death from bacterial meningitis shocks family

January 24, 2011 http://www.nj.com/news/index.ssf/2011/01/vaccinated_monmouth_county_tee.html

ABERDEEN — Chris Dhume woke up on his family’s couch early Friday morning and couldn’t move.

The 17-year-old — the all-time leading scorer of Matawan Regional High School’s soccer team — was frozen in place, although he was awake. Fearing the worst, his father carried him to the car and drove him to Jersey Shore Medical Center in Neptune.

For 24 hours the teenager fought for life, still immobile, before slipping into unconsciousness and dying at 2 a.m. Saturday.

Tests revealed the day after it was bacterial meningitis.

Dhume’s quick death was a shock to the family, especially because the healthy teenager had previously been vaccinated for bacterial meningitis, his sister, Nichole Lester, said yesterday. The family knew the odds were long against getting the infection after being inoculated, she said.

"They said, ‘One out of every 400,000,’" said Nichole Lester, 26, Dhume’s sister. "He was the healthiest person I’ve ever known … They don’t know where he got it from, or how he got it."

Dhume, of Aberdeen, is one of the handful of tragic, isolated cases of meningitis in New Jersey every year. The affliction is rare and unpredictable, but very rarely spreads beyond a single case, according to health experts.

According to state health department records, there were 14 cases and no deaths in 2007; 17 cases with three deaths in 2008; 19 cases and two deaths in 2009, and 18 cases with three deaths last year.

But doctors take the precautions once meningitis is diagnosed. Dhume’s family and friends are now taking antibiotics, just in case. The Monmouth County Health Department is also backtracking the teenager’s close contacts in the days leading up to his death, according to Tina Tan, epidemiologist with the state’s Department of Health and Senior Services.

Tan said Dhume’s bacterial strain was confirmed as Neisseria meningitidis, one of several bacterial strains which can cause severe infection of the meninges, the covering of the brain and spinal cord — and one which, according to his sister, that defied the vaccine.

Dhume’s sister said he died while the bacteria was in his blood, but hadn’t yet reached his spinal cord or brain.

However, chances of an outbreak at Dhume’s school — or even at his home — are slim, given the microbiology of the bacteria involved, according to experts.

The bacterial form of meningitis is passed from person to person through saliva and other respiratory fluids, said Tan. The close contact needed to transfer the fragile baccilus includes living with a person, kissing, sharing food or eating utensils, sharing drinks or cigarettes, or face-to-face sneezing or coughing.

There is no need for public alarm about the possibility of an outbreak, because the germs would have to be directly transmitted in one of these ways, Tan said.

"You have to be in close contact with a sick person’s fluids," she said.

Health officials sanitized the building’s most-touched areas including doorknobs and water fountains over the weekend with bleach, said Michael Meddis, public health coordinator for the Monmouth County Health Department. However, that might be overkill, the bacteria is fragile and is readily transmitted directly only through fluids, Meddis added.

Although as much as 20 percent of the general population carry the bacteria that causes meningitis in their nose or throat, the disease is rare, said Tan.

The vaccine covers 90 percent of the most common strains of meningococcal infection, according to the state department of health and senior services.

But there are the rare exceptions to the vaccine, like Dhume’s, according to Peter Wenger, a pediatrician at the University of Medicine and Dentistry of New Jersey. He said there are a whole variety of factors, including a person’s immune system, the presence of the bacteria, and even vaccine-resistant variations within strains, determining whether someone is struck by the quick-moving disease. It has to be a perfect storm of factors, he said.

"It’s a multi-factorial thing, whether somebody gets sick or doesn’t," he said. "In the U.S., outbreaks are not that common. Unfortunately, isolated cases do happen."