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Charlotte Cleverley-Bisman

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At 1-2 years old

Charlotte Lucy Cleverley-Bisman (born November 2003, Waiheke Island) became famous as the face of a New Zealand campaign to encourage vaccination against meningococcal disease after contracting and surviving the disease.[1] She was nicknamed "Miraculous Baby Charlotte" by her countrymen and women as a result of making headlines worldwide after recuperating from a series of life-threatening complications. She is believed to be the smallest baby to have ever survived such a full-blown infection and the subsequent quadruple amputations.[2]

Cleverley-Bisman is the daughter of Pam Cleverley and Perry Bisman.[3]

Meningococcal disease in New Zealand

In 2004, New Zealand was in the thirteenth year of an epidemic of meningococcal disease, a bacterial infection which can cause meningitis and blood poisoning. Most Western countries have fewer than three cases for every 100,000 people each year, with New Zealand averaging 1.5 before the epidemic started in 1991; in 2001, the worst year of the epidemic in New Zealand, the rate hit 17. 5400 New Zealanders had caught the disease, 220 had died, and 1080 had suffered serious disabilities, such as limb amputations or brain damage. Eight out of 10 victims were under 20 and half were under 5 years of age. The internationally low proportion of deaths from the disease had been credited to wide publicity of the disease and its symptoms. In June 2004, Charlotte Cleverley-Bisman became the face of the epidemic.[4]

Disease onset

Charlotte Cleverley-Bisman, showing meningococcal disease effect on arms

The morning of June 17, 2004, Cleverley-Bisman vomited and was unhappy, but the parents took it as anticipated teething pains. By mid-morning she developed a small blemish on her neck, and her mother rushed her to Waiheke Ostend Medical Centre, where staff diagnosed meningitis. In ten minutes she was covered with small spots. She was injected with penicillin, and rushed to Starship Children's Health by helicopter. Half an hour after the first spots were noticed, she was blistered, swollen, and purple over her entire body, with her extremities blackening. She was not expected to survive, and needed to be resuscitated twice during her first half hour at Starship. She was connected to life support systems which fed her, transfused blood and drugs, and assisted her breathing.[5][2]

The second day, Starship doctors said that if she lived at all, Cleverley-Bisman would need to have at least both legs and most of her left hand amputated, to save her life from gangrene. During the three weeks while doctors waited for demarcation between dead and living flesh to become clearer, her catheters became clogged several times and needed to be replaced with additional surgery. By the end of June, it was clear that all four limbs would need to be amputated.[5] This was done on July 2, amputating both legs and left arm "optimistically", through the knee joints, rather than above them, hoping to preserve the growth plates at the end of the long bones, which would allow for better use of prosthetics later in life.[6][2]

Cleverley-Bisman's parents helped the case to be publicised nationwide to raise parents' awareness of the speed of the disease, and to highlight the need for a vaccine.[4] Charitable donors gave money to defray their expenses, beginning with NZ$1000 from the Jassy Dean Trust, set up in 1992 after another girl died from meningococcal disease.[7]

Junior Uluvula

On July 8, 2004, nine-month-old Sakiusa "Junior" Uluvula, from Mangere, had his right hand, right foot, half his left foot and the tip of his nose amputated at Starship Children's Health. His twin brother Nasoni had escaped infection, despite always being with Sakiusa. After the disease struck, the twins looked nothing alike. The Uluvulas were of Pacific Island ancestry, mother Tima Uluvula having moved to New Zealand from Fiji 17 years before.[8] Meningococcal disease affected Māori at twice the rate and Pacific Islanders at four times the rate of New Zealand residents of European descent.[4]

For a month, Uluvula joined Cleverley-Bisman as the national face of the epidemic.[4] The Cleverley-Bisman and Uluvula families supported each other emotionally, and in spreading awareness of the disease.[8][9] The babies were reported on together.[10] Both babies lost more of their limbs to surgery, Uluvula losing both legs, and Cleverley-Bisman losing her right leg and right arm above the joints.[11] But while Cleverley-Bisman grew stronger, Uluvula lost function in his kidneys, and fought fever and infection.[8][10] Uluvula died at midnight on 19 July, 2004.[12][13][14]

Recovery

With mother Pam Cleverley, showing prosthetic arms and rehabilitation equipment

After two and a half months at Starship Hospital, Cleverley-Bisman was well enough to move to the Wilson Home in Takapuna, North Shore City for three months of rehabilitation. Wriggling had kept her muscles relatively fit; she was able to roll over, and even put a cup to her mouth using her amputated stumps. She returned to her home in Waiheke in November, just in time to celebrate her first birthday.[2][15]

During Cleverley-Bisman's hospital stay, donors had given hundreds of gifts and around NZ$60,000 for her care; however expenses were such that this would last less than a year.[16] Following Cleverley-Bisman's hospitalisation, a trust was set up in her name. The primary mission of the trust was to provide for Cleverley-Bisman's life necessities, and the secondary goal of the foundation is to increase awareness of meningitis/meningococcal disease.[17]

Cleverley-Bisman's illness and the surrounding interest generated plenty of exposure of the issue of immunisation for meningococcal disease,[18] and her case has been cited as helping spur immunisation drives. As a result of her case, her father has helped publicise the availability of vaccination to help ensure as many people are vaccinated as possible.[19]

In August 2004, she was measured for artificial limbs, which she is expected to be fitted with shortly after.[needs update] As part of her rehabilitation process, she plays with toys and exercises on a daily basis.

References

  1. ^ Martin Johnston (July 03, 2006). "Vaccine campaign beating meningococcal epidemic". The New Zealand Herald. {{cite news}}: Check date values in: |date= (help)
  2. ^ a b c d "The story of 'Baby' Charlotte - a meningococcal survivor", as told by her father, Perry Bisman. Official site. Retrieved 2007-08-09.
  3. ^ Amanda Cameron (June 12, 2005). "Disease baby's dad lashes vaccine 'hate-speech'". The New Zealand Herald. {{cite news}}: Check date values in: |date= (help)
  4. ^ a b c d "Tracking down a killer disease", by Martin Johnston, New Zealand Herald, July 11, 2004. Retrieved 2007-09-05.
  5. ^ a b "Family's diary of a nightmare", Perry Bisman, published by the New Zealand Herald, 28 June, 2004. Retrieved 2007-08-09.
  6. ^ "Baby Charlotte's limbs amputated in marathon operation", by Rebecca Walsh, New Zealand Herald, July 03, 2004. Retrieved 2007-09-05.
  7. ^ "Over $2000 raised for baby Charlotte", July 01, 2004. Retrieved 2007-09-05.
  8. ^ a b c "Another baby loses limbs to killer disease", by Juliet Rowan and Rebecca Walsh, New Zealand Herald, July 09, 2004. Retrieved 2007-09-05.
  9. ^ "Three-year-old Isabella protected against meningococcal disease", By Renee Kiriona, New Zealand Herald, July 12, 2004. Retrieved 2007-09-05.
  10. ^ a b "Babies endure more surgery", by Rebecca Walsh and Renee Kiriona, New Zealand Herald, July 10, 2004. Retrieved 2007-09-05.
  11. ^ "Two babies battling disease face more surgery", by Stuart Dye, New Zealand Herald, July 14, 2004. Retrieved 2007-09-05.
  12. ^ "Meningococcal baby dies in hospital", New Zealand Herald, July 19, 2004. Retrieved 2007-09-05.
  13. ^ "Junior at peace, says mother", by Alan Perrot, New Zealand Herald, July 20, 2004. Retrieved 2007-09-05.
  14. ^ "Meningitis stole Junior from his family", by Tima Uluvula, mother. Hosted by Kids Friendly New Zealand. Retrieved 2007-09-05.
  15. ^ Rebecca Walsh (November 25, 2004). "Baby Charlotte comes home". The New Zealand Herald. Retrieved 2007-09-05. {{cite news}}: Check date values in: |date= (help); Italic or bold markup not allowed in: |publisher= (help)
  16. ^ "Baby wins meningococcal fight", Television New Zealand, August 10, 2004. Retrieved 2007-09-05.
  17. ^ "Charlotte Lucy Trust".
  18. ^ "Student's Poster to Promote MeNZB Message". Partnership Health Canterbury. February 18, 2006. {{cite web}}: Check date values in: |date= (help)
  19. ^ "Parents urged to take up vaccine". TVNZ. July 8, 2004. {{cite web}}: Check date values in: |date= (help)


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