'It was my first and only experience with meningitis,' says nursery nurse Debbie Smith, 'and touch wood it will be my last.'
Debbie is referring to the day in early January 2005 when baby Katie fell ill with baffling symptoms on only her second stay at Three Bears Nursery in Renfrew, Scotland. What followed is a reminder of how quickly a child can become ill and how difficult it can be to recognise the disease. The alertness of staff at Three Bears ensured the five-month-old girl was quickly taken to hospital. Katie made a full recovery from a case of meningococcal septicaemia, an infection of the blood commonly known as blood poisoning. It's one of the most dangerous forms of meningitis.
'Katie had settled the week before, so because she was new we were keeping a close eye on her,' says Debbie. 'She was quite upset on her first day, but we explained to her mother that this was understandable, and that it's common for a child to be upset when they are first parted from their family.'
The second day began the same as the first, with Katie kicking, screaming and crying. 'She was quite a vocal wee girl, very teary and loud, so we put her in her own pram so that she'd have something familiar around her. Then we brought her pram into the main room. I was sitting beside her in a chair because I was worried about her,' says Debbie.
By early afternoon, Debbie and two of her colleagues noticed a massive change in the girl's behaviour and became concerned. 'We realised Katie was really quiet all of a sudden. I was bending over her and talking to her and just got no response. She was very, very grey and quite clammy.'
Realising there must be something wrong for the child to go from one extreme to the other, Debbie alerted the nursery manager Anne-Marie McLaughlin. Having informed Katie's mother, who had already signed a medicine consent form, the staff decided to give her some Calpol, as she was warm to the touch.
After about 40 minutes, the medicine had still not had any effect, so Katie's mother came to pick her up. Debbie remembers, 'I said to her, the only advice I can give you is to take her to the hospital, straightaway.'
It was clear something was seriously wrong. 'Katie was showing no emotion at all and she was a colour I've never seen before on a child,' says Debbie. 'She was very limp as well, her wee body was just lifeless.'
The next day her mother phoned Three Bears to let them know that the hospital was testing for meningitis. 'We hadn't really wanted to consider the possibility,' said Debbie, 'but later on that day her mother called to confirm that it was meningococcal septicaemia.'
Manager Anne-Marie immediately started to telephone parents, to inform and reassure them. 'We didn't have a lot of scaremongering from the parents, which I had been slightly concerned about. They were all supportive and worried about Katie.'
The Health Board was a constant point of contact for the nursery in the days that followed. A letter was faxed through to give to the parents of the under-twos who had been in the room that week. Because Katie had not been on the floor, the children were highly unlikely to be at risk.
However, the three members of staff who had changed her nappy all had to be immunised over the weekend. 'We felt we handled it very well,' says Anne-Marie. 'The girls were all very professional.'
The Health Board contacted the Meningitis Trust, and on Monday a volunteer arrived at the nursery with a package of leaflets. 'They gave us some very helpful information, especially for first-time mums who may have been panicking,' says Debbie.
Since Katie's illness, the Three Bears staff feel they are more aware of the symptoms and dangers of meningitis. 'We're very cautious now with any rash, and do the glass test. It's always at the back of your mind really,'
says Debbie. 'We need to feel more prepared and informed because no two children are the same and it's not as if another case would be the same as this one.'
Katie is now attending Three Bears Day Nursery full-time, and looking forward to celebrating her second birthday next month. Debbie's conscientiousness may have saved Katie's life. 'She was in hospital for three weeks and was back at nursery in April. What a difference we saw in her when she got back,' says Debbie. 'To look at Katie crawling around now you would never imagine she'd had meningitis at such a young age.'
Toddle Waddle 2006
* Each year the Meningitis Trust raises money through its Toddle Waddle event, which is organised with nurseries nationwide each October. To get involved, contact David Wood at the Meningitis Trust on 01453 769022 or see www.meningitis-trust.org
