Agonising decision over baby Charlotte

By REBECCA WALSH

The parents of baby Charlotte Cleverley-Bisman, seriously ill with meningococcal disease, are preparing themselves for a decision on whether her right leg will need to be amputated tomorrow.

The seven-month-old could face a life without her legs and hands after contracting the disease more than 10 days ago. She may also suffer brain damage.

Perry Bisman said his daughter underwent an hour-long operation at the Starship hospital yesterday to insert a line into her chest for pain-relieving drugs. It would also be used to take blood samples to monitor her condition.

Charlotte was heavily sedated and had a constant fever. It was hoped her condition would stabilise before surgery.

Mr Bisman said surgeons would perform exploratory surgery tomorrow to check the tissue on Charlotte's right leg to see if any of the calf muscle was salvageable.

"It may lead to amputation there and then.

"It's looking highly likely that is the case ... and our trauma will start again," he said.

"The initial shock has worn off but Wednesday will be a big day for us if they come back and tell us her leg will have to come off."

Mr Bisman said further surgery would be scheduled for her left leg and hands.

The Waiheke Island family, who made Charlotte's case public to highlight the urgent need for a vaccine, have received faxes and cards of support.

Yesterday Dr Jane O'Hallahan, director of the meningococcal vaccine strategy for the Ministry of Health, said the ministry was committed to immunising children from meningococcal B disease as soon as possible but could not be certain about a start date or a date that a licensing decision would be made.

If licensing happened by July 5 the first stage of the $200 million vaccination programme could start in two to four weeks.

Dr Carol Smylie, of the Ostend Medical Centre on Waiheke, said that after news of Charlotte's condition became known on the island a number of worried parents had brought children with a slight fever in for checks.

Although most did not believe their child had meningococcal disease they were seeking reassurance.

Other Waiheke Island residents had phoned to see if they were more at risk.

"I think people realise it's a sporadic disease and unless you have had close contact with the baby you are not at increased risk yourself."

Dr Greg Simmons, medical officer of health for Auckland Regional Public Health, said meningococcal disease was spread in droplet form - through coughing or kissing - but was not highly contagious like whooping cough or chicken pox.

The biggest risk was living in overcrowded housing.

Other factors such as sharing food and drinks and contact through kissing increased risk.

Dr Simmons said that research he completed in 2001 showed that about 20 per cent of people who had household contact with a person with the disease carried the meningococcal germ in the back of the throat and nose but that did not mean they became ill.

"The immune system identifies it, produces an immune reaction to stop it from invading and in the end it knocks it off and it goes away. That is a normal infection."

Very young children were more prone to the disease as their immune system was immature.

Dealing with the dread disease

Meningococcal disease is spread in droplet form - for example through coughing or kissing - but is not highly contagious like whooping cough or chicken pox.

Symptoms include fever, headache, vomiting, rash, drowsiness and joint or muscle pain. Babies may refuse food or drink, cry a lot and appear sleepy and floppy.

Early medical attention is essential. Even if your baby has only one or two symptoms you should see a doctor.