Infected Babies : Stillbirths Had Doctors Fearful of an Epidemic
The neonatalogists at UC Irvine Medical Center thought they had an epidemic on their hands.
Three babies were stillborn because of a rare infection of Listeria monocytogenes. Four more were born with it, and two of them died--one just minutes after birth, the other just 10 hours after the infection was diagnosed.
Another baby, born at L.A. County-USC Medical Center and diagnosed as having the same bacterial infection, was transferred to UCI’s neonatal intensive care unit in Orange.
Usually, the neonatal unit sees only one or two cases a year of infection caused by the bacteria, said Dr. Jack Sills, an assistant professor of pediatrics. Suddenly, within two months, the doctors had seen eight.
“We were starting to see it so much we thought maybe it was an epidemic. We thought maybe it was the new organism of the ‘80s,” Sills said.
Growing Alarm
Although he could not recall the exact chronology of cases, Sills said there was a growing sense of alarm among the neonatalogists, specialists in the care of critically ill newborns.
After the third case, he said, “we recognized this was unusual.” Soon after, the neonatal unit received the baby from County-USC and it was as though a red flag had been waved, he said.
“Not until we got the transfer did we start putting things together,” Sills said, for doctors then realized they were dealing with a regionwide problem. Soon after, he said, health departments in the county were notified.
The Listeria organism is carried in the blood, and in the case of a pregnant woman it automatically infects the placenta, which provides nutrients to the fetus. The baby will get sick, often severely enough to die in the uterus, Sills said.
Babies suffer such symptoms of an infection--respiratory problems, lethargy, poor mobility, rash, disinterest in feeding and sometimes blood irregularities, Sills said.
Immediate Diagnosis Needed
But the disease must be diagnosed immediately and treated with antibiotics, he said.
“If you wait, if you’re not quick enough, even an hour can make a difference, the mortality rate can be 80% to 90%,” Sills said.
One baby born with it at the hospital died a few minutes after birth, he said.
Even babies who appear healthy and go home can develop the disease two or three weeks later, by exposure to the mother, who may still be carrying the bacteria, or by exposure to its presence in the house, or the infant has been a carrier all along. With older infants, the organism can bring on pneumonia, or it can cause spinal meningitis, he said.
All seven mothers who gave birth to the infected infants had had fevers “and when we cultured their cervix or stool, the organism was there,” Sills said. All seven were Latino, he said.
The mothers of the stillborn babies had the disease early in their pregnancy, he said.
The most recent case of listeriosis was diagnosed in an infant about 12 days ago, Sills said.
“The baby’s still here,” the neonatalogist said. “He’s going to be a survivor.”
