Haitian Child

Haitian Child

Monday, December 24, 2012

Killer Incubators

Over the last 24 hours, three infants in the neonatal unit died. They were all premature, all were stable for several days, and each one deteriorated and died over about 6 to 10 hours, all notwithstanding modern and timely interventions.
The sequence of events was the same in every infant. I learned today that about ten days ago another infant died in the same fashion.

Each child developed signs of sepsis (poor feeding or difficult breathing) and within hours the heart rate and blood pressure started to fall and the child stopped peeing. The lab tests confirmed Disseminated Intravascular Coagulation (DIC) a clotting problem in the blood that develops with severe sepsis. Notwithstanding intubation and ventilation with a machine, multiple medications to support heart function, and changes in antibiotic coverage, these children progressed relentlessly and rapidly downhill to death.

Three children dying in a very similar fashion in 24 hours is not a coincidence. This was almost certainly the result of a very aggressive bacteria or fungus. The similar sequence of events leading to rapid death was the signature of one deadly organism. We will never know the name of this organism. There are no culture facilities for this sort of test at the hospital.

One possibility is that the child who died ten days ago was the source of the infection. Once this organism became established in the unit, it was only a matter of time before the germ affected other children. Who knows how the transfer occurred. Perhaps the germ was on a piece of equipment shared by the children. Regardless of how this happened, the end result is that the unit and especially the incubators that were home to the babies who died, are contaminated with a deadly germ. Today the remaining child will be moved out of the unit and the entire unit will be cleaned from top to bottom, as best as this can happen in Haiti. Once this is accomplished we can start to admit other children to the neonatal unit. Then we hold our breath.  

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