Preventing Meningitis in Children with Cochlear Implants

Editor: The FDA is again telling people that kids who have or will be getting CIs need to be vaccinated for meningitis. Here's the press release.

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FDA is reminding healthcare practitioners about the importance of vaccinating children with cochlear implants against bacterial meningitis caused by Streptococcus pneumoniae. Two deaths from meningitis have been reported over the past year in children with cochlear implants. Neither of them had completed the recommended vaccinations against pneumococcus.

Many parents of cochlear implant patients are not getting the message about immunizing these children against pneumococcus. A recent survey at Johns Hopkins revealed that despite repeated efforts to educate parents, up to 40 percent did not know their child's vaccination status. This suggests that at least some cochlear implant patients are not getting vital preventive care that can reduce the risk of a potentially life-threatening illness.

To improve this situation, there are several recommendations that healthcare professionals should follow. Here are a few:

• When caring for patients who have or will be getting cochlear implants, review their vaccination records to be sure they are current on all the immunizations recommended by CDC for this special patient population. Note that CDC considers children with cochlear implants as a high-risk group when it comes to invasive pneumococcal infections.

• Teach parents and caregivers to recognize and report the signs of meningitis. It is important to identify and treat this illness promptly in order to avoid permanent neurological damage. Early signs of meningitis may include high fever, headache, stiff neck, nausea or vomiting, photophobia, somnolence, confusion, ear pain and ear infection. Young children with meningitis can be sleepy, cranky and eat less.

• Diagnose and treat middle ear infections promptly. In some of the cases reported to FDA, patients with meningitis had shown signs of otitis media prior to the implant surgery or before the meningitis developed. According to the American Academy of Pediatrics, practitioners treating otitis media in patients with cochlear implants should consider antibiotic therapy more readily than they might for other patients.

• Consider prophylactic antibiotic treatment perioperatively in children receiving cochlear implants.