ENT surgeon and chairperson of the Northern Cochlear Implant Programme Advisory Group, Michel Neeff says the programme undertook a review after they noted “a dramatic spike” in referrals for children who had become deaf as a result of meningitis since 2015. What they found was “deeply concerning” he said.
“Between 1999-2009, 15 children needed cochlear implants as a result of deafness caused by meningitis. But since 2015 referrals have risen dramatically with 14 children requiring cochlear implants, and 10 of these children lost their hearing since mid-2018.”
Permanent hearing loss is a known complication of meningitis. Hearing loss as a result of meningitis occurs when bacteria or the chemicals our bodies produce to fight infection get into the inner ear, where they can cause damage to the hair cells of the cochlea. If a child suffers hearing loss as a result meningitis there is also a risk of excess bone growth (ossification) in their cochlea, which can make the hearing loss worse and time critical from a treatment perspective.
A cochlear implant is needed to treat severe-profound hearing loss, which is a surgically implanted electronic device that bypasses the damaged hair cells and nerve fibres to restore hearing. Ossification of the cochlea can make it more difficult or even impossible to surgically insert the electrodes of a cochlear implant into the cochlea to treat the hearing loss. Hence it is urgent that these children get treated quickly.
The review conducted by the Northern Cochlear Implant Programme (NCIP) found that of the 14 children who presented with severe-profound hearing loss as a result of meningitis, seven had meningococcal meningitis, a preventable disease through vaccination.
“We are concerned about these recent developments. Apart from the risk of neurological complications and death from meningitis, the impact of the significant hearing loss on these children and their families is huge. Families need to devote years of time and energy to get their children hearing with cochlear implants. Some of these children will continue to struggle with communication even after intensive rehabilitation. For the health system this means a life long cost due to this permanent disability,” says Michel Neeff.
Dr. Emma Best, Infectious Diseases Paediatrician says, “Reviewing the NZ immunisation schedule, the meningococcal vaccine is not funded for young children, yet vaccines are available, though only to those who can pay for it, leaving most vulnerable patients unprotected. Half of these recent cochlear implants were required due to serious consequences of meningococcal disease in young children, a vaccine preventable disease.”
The Northern Cochlear Implant Programme strongly supports the addition of the meningococcal vaccine to the vaccination schedule for under 5-year old children given the burden of severe outcomes including hearing loss requiring cochlear implants.