Paracetamol Meningitis Drug Induced Meningitis (DIAM)
[When John awoke at 3am with a temperature, Di gave him some Paracetamol and he went back to sleep. ...Di gave John more paracetamol and then went out to buy some vegetables for the family's Christmas dinner.]
GP killed by the deadly meningitis that's spread by teenagers: Ten hours after John called in sick from work thinking he had the flu, the disease claimed his life
By Lucy Benyon For The Daily Mail
6 March 2017
When John Spalding woke up with a temperature and nausea, he reluctantly decided to stay in bed rather than going in to the surgery where he worked as a GP.
His wife, Di, a physiotherapist, called the practice manager to say John was ill — only for John to call out from under the duvet: 'Don't worry, I'll be in later.'
John and Di assumed he had a virus or maybe the flu.
But just ten hours after he had begun to feel unwell, John was dead.
The 56-year-old had contracted a particularly virulent form of meningitis, the ST-11 strain of meningitis W, otherwise known as MenW.
Two years on from her husband's death on December 23, 2014, Di is still reeling. 'The shock was overwhelming,' says Di, 56, who met John at university.
'One minute he was there, cheerful and excited about Christmas, and the next, he was gone.'
MenW first arrived in the UK in 2008 and there's since been a fivefold increase in cases. It is highly dangerous, even for perfectly healthy people.
There are six different strains of meningococcal meningitis, the most common type of bacterial meningitis.
The death rate for most is 5 per cent, but it's around 13 per cent for MenW, says the Meningitis Research Foundation, rising to 40 per cent among teenagers.
Meningitis is typically associated with babies, but more than half of MenW cases occur in people over the age of 45.
However, it is usually spread by teenagers and younger people — those aged between 14 and 25 are more likely to carry meningococcal bacteria as they mix more and are in closer proximity to new people (one in four in this age group carries the bacteria, compared to one in ten in the rest of the population).
Concerns about the rising incidence of MenW led to the introduction, two years ago, of a vaccine against it (and three other strains, A, C and Y): this ACWY jab is now given to school-age children in Year 9 and upwards.
The free jab is also available to students up to the age of 25 and Di is urging all young people to have the vaccine, not only to keep them safe from the disease, but to protect everyone else.
The night before he died, John had come home from work as usual at 7.30pm.
There was nothing to suggest anything was wrong with the energetic father of three, who was a keen squash player.
After a meal, he and Di spent a 'pleasant evening' wrapping their sons' Christmas presents, recalls Di.
When John awoke at 3am with a temperature, Di gave him some paracetamol and he went back to sleep.
By the morning, he still had a fever and was feeling nauseous. Di called the practice to say he wouldn't be in first thing, but John insisted he would go in that afternoon, 'which was typical of him, as he hated to let anyone down,' she says.
Di gave John more paracetamol and then went out to buy some vegetables for the family's Christmas dinner.
When she returned to their home in Kidderminster, Worcestershire, at 10.30am, John was fast asleep.
Two hours later, Di heard movement upstairs and went to check on him.
The couple's youngest son Tim, now 22, who was home from university for the holidays, followed her into the bedroom.
They found John swaying at the end of the bed, struggling to breathe. 'He was an awful colour and was gasping,' says Di.
'He said: 'Call an ambulance,' which I did. A paramedic instructed Tim and me to get John on the floor and he talked us through CPR, but John quickly became delirious, and we knew we'd lost him after about three minutes.'
The air ambulance service was called to assist, but John was pronounced dead two hours later at Worcestershire Royal Hospital.
The couple's eldest son Phil, 28, who worked locally, managed to get to the hospital to meet his family, but Di had to break the news to her middle son Richard, 26, who was away working in Doncaster, over the phone.
'As a mother, that was the hardest thing I have ever had to do,' she says.
Although the family was told at the time that the cause of John's death was likely to be meningitis, it was another ten days before a post-mortem revealed that his internal organs had been covered in a rash.
He had died from MenW, something Di admits she hadn't ever heard of. No one knew how John had contracted the illness.
'I still struggle with the fact there was no time to say goodbye,' says Di. 'John died only hours after becoming ill, and there were no obvious warning signs.'
MenW can be notoriously difficult to spot because it doesn't always present with a rash or other typical symptoms.
This was certainly true for John, because even as a GP with 30 years of experience, he did not recognise his fever and nausea as meningitis.
'Well, how could he?' says Di. 'There was no rash or aversion to the light. He didn't have cold hands or feet, and we both assumed he was just coming down with flu.'
Cases of MenW with no obvious symptoms like John's are not uncommon, explains Dr Shamez Ladhani, an infectious disease consultant from Public Health England.
'Often there is extreme sickness or diarrhoea, or it could even present in a similar way to a chest infection or pneumonia, but the meningococcal rash doesn't appear until much later, if at all,' he says.
'It is easy to confuse these symptoms with sickness bugs, food poisoning or excessive alcohol consumption, particularly in younger people.
'If caught early enough, it can be treated successfully with intravenous antibiotics, but it tends to work through the body very quickly, with most deaths occurring within 24 hours.'
Despite the availability of a free meningitis vaccine, the take-up among university students has been worryingly low — at less than 30 per cent.
'It is a question of herd immunity,' explains Linda Glennie, head of research and medical information at the Meningitis Research Foundation.
'If we immunise people aged between 14 and 25, it will help to protect everyone else.
The school programme has been a real success with more than 70 per cent take-up.
Ideally, we'd like 100 per cent, but we are not doing so well with young people who have left school, as only around 30 per cent of them have gone to get their vaccine.
'The minute a student sets foot on campus, their exposure to the bacteria rockets as they mix so closely with other young people, for example, in university accommodation and crowded pubs.'
Students can have the jab either at their college medical centre or at their GP surgery at home.
'Ideally, they should be immunised before they start university or college, and if they haven't had the jab already, we would encourage them to do so as soon as possible,' stresses Linda Glennie.
At the moment, younger children are not offered the MenW vaccine, although all babies under the age of one are offered the MenB vaccination, Bexsero, which is believed to offer some protection against MenW, as the strains are similar (MenB is more prevalent among the under-fives).
The ACWY vaccination is available privately, but as Dr Ladhani points out, with reported cases of MenW still relatively low, it is not viable to offer a free vaccination to everyone.
Di is now working with the Meningitis Research Foundation to raise awareness of MenW.
She and two of her sons have now been immunised privately. She believes the jab is a small price for young people to pay to protect themselves and others.
'I completely understand that the NHS can't afford to vaccinate everyone,' she says. 'But if students and teenagers are immunised it could make a real difference — it will save lives.
'Our life is not the same without John, and he has missed out on so much. Phil has started a master's degree, Richard has a new job and Tim got a first-class degree.
'John was a devoted dad who was passionate about medicine, and he had this incredible sense of fun and adventure. His life was cruelly cut short by this illness.
'I would hate to see another family suffer as we have done, which is why I want young people to understand the importance of having the vaccine.'
'John was technically a low risk, but he still died from MenW, and even as a doctor he didn't see the signs.
'If it can happen to him, it could happen to anyone. We need to stop this illness spreading.'
For more information, go to meningitis.org or call 080 8800 3344
Read more: http://www.dailymail.co.uk/health/article-4287278/GP-killed-deadly-meningitis-spread-teenagers.html#ixzz4akmTC8TQ
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