Friday, August 9, 2013

Why has Kali Hardig survived?

Posted By on Fri, Aug 9, 2013 at 10:13 AM

Kali Hardig
  • Kali Hardig

If the “brain-eating parasite” that has made the Benton child so sick is common, why don’t more people have it? Should I be careful swimming in Arkansas’s lakes and streams? Why did she survive when so few do?

Kali Hardig, the 12-year-old girl being treated at Arkansas Children’s Hospital for primary amoebic meningoencephalits (PAM), caused by the parasite Naegleria fowleri , is “very blessed,” ACH intensivist Dr. Mark Heulitt said Thursday.

Kali, who was admitted to Children's July 19 with a high fever and vomiting, apparently contracted the amoeba while swimming at Willow Springs Water Park in south Little Rock. Only two people in North America have survived infection by the amoeba; Kali will be the third. (A child in California and one in Mexico also survived.) She is no longer in critical condition; she will leave the intensive care unit today and begin rehabilitation. She is able to follow commands and make thumbs up or down responses, which is a good indicator of higher brain function, Heulitt said, but she is not yet talking.

While the amoeba is not rare — it lives in the mud under warm lakes and slow rivers — infection is: Only 128 cases of PAM have been reported in the United States since 1962. Because the disease kills quickly — as soon as within a week — it may go undetected. Doctors don’t know why some people are vulnerable and some aren’t.

The amoeba moves through the porous plate behind the sinuses to reach the brain, where it damages tissue. “The risky behavior is not just getting wet but forcibly pushing water up the nose,” state Health Department epidemiologist Dr. Dirk T. Haselow said, the way it might be if you fall face forward off water skis or kick up mud from the bottom of a pond. It can also live in water pipes; two Louisiana women who used tap water to perform a nasal wash with a neti pot became infected and died.

Heulitt got a call from a Miami hospital on Thursday after another child was admitted there with PAM. The federal Centers for Disease Control had recommended that the hospital contact Kali’s doctors to discuss their protocol.

Kali was treated with antibiotics and antifungals and a catheter was placed in her brain to reduce swelling. Her condition worsened and she had to be intubated, Heulitt said. At that point, ACH critical care Dr. Jerril W. Green lowered her body temperature to 34 degrees C. (93.2 F.) to further reduce swelling, and, with the OK of the CDC, doctors gave Kali the anti-parasite drug miltefosine, a German drug not approved for use in the U.S. by the Federal Drug Administration. Miltefosine was developed to treat breast cancer but has been found to be effective against the water-borne parasite that causes leishmaniasis.

Why Kali has survived is unknown. “With a single case, it’s hard to draw much of a conclusion,” Heulitt said. “We don’t know if she had as much exposure as other people.”

Heulitt did not credit the German drug for Kali’s recovery altogether; he said her mother’s speedy action in getting her to the hospital was a factor. A 7-year-old boy admitted to Children’s with PAM in 2010 — he’d also been swimming at Willow Springs — was also treated with miltefosine, the Health Department’s Haselow said, but he died. The owners of Willow Springs have closed the park.

Naegleria also occurs in hot springs. A spokesman for the Centers for Disease Control said it has done no testing for the bacteria in Arkansas other than the one that confirmed its presence in the water at Willow Springs.

The state Health Department does test swimming beaches for the presence of fecal coliforms, which can cause gastrointestinal distress. While the odds of contracting PAM are about 1 in 33 million, Haselow said, people are “many thousands of times” more likely to be sickened by fecal bacteria.

Haselow said if parents have a child “who can’t get in water without being overly vigorous,” he would recommend they choose a chlorinated pool for swimming. The amoeba can live in low concentrations of chlorine, but not what would found in a public pool. Willow Springs was chlorinated, but had a sandy bottom.

"Recreational water users should assume that there is a low level of risk when entering all warm freshwater, particularly in southern-tier states," the CDC says.


Heulitt said it's theorized that some people may have a genetic malformation in the sinuses that makes them more vulnerable to the passage of the amoeba.

Tags: , , ,

Favorite

Speaking of...

Comments (4)

Showing 1-4 of 4

Add a comment

 
Subscribe to this thread:
Showing 1-4 of 4

Add a comment

More by Leslie Newell Peacock

  • Ahoy! Blue Sail launches Saturday on Main Street

    Blue Sail Coffee Roasters opens its shop Saturday, March 25, in the Little Rock Technology Park, 417 Main St. The grand opening announcement says the shop will be in business at 7 a.m. and stay open until 7 p.m. Monday through Saturday.
    • Mar 23, 2017
  • Mo' MoMo

    Katmandu Momo, the food truck created by Nepal native Saroja Shrestha, will open a sit-down eatery in April in the River Market’s Ottenheimer Hall.
    • Mar 22, 2017
  • Buenos Aires Grill opens in the River Market

    The Bruzatori family, Little Rock residents for 14 years, are serving up their family recipes of grilled meats, empanadas, Graciela’s chimichurri (named for the matriarch, Graciela Bruzatori) and other dishes reflective of their Argentinian-Italian heritage at Buenos Aires Grill and Cafe. Head cook is Paul Hohnbaum.
    • Mar 21, 2017
  • More »

Readers also liked…

  • In defense of Planned Parenthood and abortion rights

    An op-ed in today's New York Time by Katha Pollitt says what I've been struggling to say about the reaction to the attack on women's reproductive rights launched by means of the undercover videos made by anti-abortion activists.
    • Aug 5, 2015
  • A response to police arrests becomes a tutorial on race, class and policing in Little Rock

    John Walker, the 79-year-old civil rights lawyer, and his associate, Omavi Shukur, 29, a young lawyer devoted to criminal justice reform, talked to press this afternoon about their arrests Monday by Little Rock police for supposedly obstructing governmental operations in observing and attempting to film a routine police traffic stop. It was a tutorial on sharp views of race, class and governance in Little Rock.
    • Sep 29, 2016
  • Transgender electrician may sue employer over her firing

    Federal Judge Susan Webber Wright has ruled that Patricia Dawson, a transgender woman, may pursue her lawsuit that she was wrongfully fired by her employer, H & H Electric, because of her sex.
    • Sep 16, 2015

People who saved…

Most Shared

Visit Arkansas

Forest bathing is the Next Big Thing

Forest bathing is the Next Big Thing

Arkansas is the perfect place to try out this new health trend. Read all about the what, why, where and how here.

Most Recent Comments

Blogroll

 

© 2017 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation