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June 23, 2003

Meningitis a Concern in Kids with Cochlear Implants

From: Yahoo News - Jun 23, 2003

By Megan Rauscher

NEW YORK (Reuters Health) - Preliminary results suggest a high rate of bacterial meningitis among Canadian children with surgically implanted hearing devices called cochlear implants.

Many of these cases could have been prevented, according to Dr. Samantha D. Wilson of Health Canada in Ottawa who reported the findings during the 80th annual meeting of the Canadian Pediatric Society in Calgary, which ended Sunday.

"All children should be up to date on their immunizations but especially children considered to be at risk for certain infections, such as those with cochlear implants who are at high risk for both Haemophilus influenzae type B and streptococcus pneumonia or invasive pneumococcal disease," she told Reuters Health.

Cochlear implants go beyond the sound amplification of traditional hearing aids ( news -web sites ) by translating sounds into electrical impulses that stimulate auditory nerves in the inner ear. The brain unscrambles the information, restoring some measure of hearing to the deaf.

Bacterial meningitis occurs when meningococcal or other bacteria cause an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. Symptoms such as headache, intolerance for light, a stiff neck and vomiting can develop rapidly. The infection can be life threatening, and urgent treatment with antibiotics is essential.

A possible link between cochlear implants and subsequent bacterial meningitis surfaced in Europe in July 2002 with a cluster of cases reported. To see whether such a link existed in Canadian cochlear implant recipients, Wilson and colleagues sent questionnaires to all 1,432 Canadian cochlear implant recipients who received implants between January 1995 and July 2002.

They identified four cases of bacterial meningitis (two were pneumococcal, 1 meningococcal and 1 unknown) among recipients who responded to the survey.

None of the three cases for which the causative agent was identified had been immunized against these agents. Overall, there was a "low" rate of immunization against pneumococcal and meningococcal disease, 46 percent and 52 percent, respectively, in the cochlear implant recipients surveyed.

Time between cochlear implant and bacterial meningitis ranged from 7 months to over 7 years. The researchers were unable to identify any risk factors for bacterial meningitis among cochlear recipients.

"Unfortunately, we don't have a baseline population to compare this specialized group with," Wilson said. "What's really important," she added, "is that some of these bacteria that cause meningitis could be prevented through immunization."

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