Killer disease leaves trail of broken hearts

MENINGOCOCCAL disease - an infection that favours the young - usually starts with flu-like symptoms but can take a life within hours.

IT is a killer that strikes quickly and often fatally. Meningococcal disease - an infection that favours the young - usually starts with flu-like symptoms but can take a life within hours.

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IN the small hours of May 25, 2009, Jack Klemich's grandmother was woken by the sound of breaking glass coming from his bedroom.

With his parents, real estate agent Oren and Gill, celebrating their 25th wedding anniversary in New York, Jack and sisters Sophie and Georgie were being cared for by their grandparents.

Although he'd had a bad headache the day before, his grandma figured Jack must have just knocked over in his sleep one of the numerous water glasses cluttering his bedside table.

What she found was much, much worse. Jack, 18, was unconscious and could not be roused.

An ambulance was called to the College Park address and he was taken to the Royal Adelaide Hospital and placed in the intensive care unit - before the end of the day he was dead.

Since 2007, 116 cases of meningococcal disease have been reported in South Australia. Of those, 28 per cent were in children under five, and 36 per cent people aged between 12 and 23.

SA Health says it does not keep a record on the number of deaths from the disease.

Of the 116 struck down by the disease, 90 lived in the metropolitan area.

The most recent fatality was 18-year-old Murray Bridge apprentice electrician Alex Aunger who died on June 18.

The promising Jervois Football Club player initially thought he had a cold. Five days later he was dead.

The introduction in 2003 of a vaccine for the C strain of the disease has been very successful, but researchers continue to search for a vaccine for the B strain - responsible for most of the cases.

Doctors at the Women's and Children's Hospital are involved in a last stage trial for a vaccine for the killer bug. Sadly, it will come too late for the Klemich family.

Each day they question why their healthy, fun-loving son fell victim to such an insidious disease.

Oren and Gill Klemich were on a stopover in Hawaii on their way home when they received the call every parent dreads.

"We were told Jack was in intensive care but that they didn't know what was wrong with him," Oren recalls.

"We rushed to an early flight that morning and called the hospital from the airport.

"They said that he might have meningococcal infection. That flight was agony, complete agony."

Just 24 hours earlier, Jack was returning home from his best mate's 18th birthday, having played footy at Sacred Heart College for his beloved St Peter's earlier that day.

He was a popular Year 12 student, a great sportsman who excelled in Aussie Rules and water polo and was a cracking left-arm bowler on the cricket pitch.

As well, he always had a smile that those who knew him still talk about.

When the Klemichs finally arrived at the RAH on the evening of May 25, they were met by friend Dr Robert Young, a director of the ICU.

Just weeks earlier, Jack had played cricket against the doctor's son.

"Rob said, `I'm very sorry but Jack has died'," Mr Klemich said. "He was on life support, his heart was beating, but he was dead.

"To tell you the truth, I knew it was coming; all the conversations we'd had with the hospital, I just knew. But to hear it was just dreadful, and even after three years it still hasn't really sunk in.

"Everyone talks well of the dead but he was genuinely a gorgeous boy, not a mean bone in his body. It was his smile that all the bereavement cards talked about. He was always smiling, this thumping great grin on his face."

Jack died from complications arising from Meningococcus B, the strain which accounts for 85 per cent of cases in Australia. And it is young people who are most often affected.

No one knows why Jack got sick. All they know is that he appeared perfectly well on Saturday, and was dead less than 48 hours later.

Dr Young, who has worked in intensive care for more than 20 years, said the ambiguity of the disease's early symptoms, and the rapidity with which it becomes serious, made meningococcal infection difficult to conquer.

"I once had a young girl who had dinner, went out to play at 5pm, and was on a mechanical ventilator by 8pm," he said.

"It means you are often left with the tragic situation that someone who sees the person earlier on feels that they have missed something. It can leave them feeling guilty when they shouldn't.

"The poor GP may only see one case in their entire career, it can be very hard to spot."

When a suspected meningococcal infection case presents at the hospital, the patient is given intravenous antibiotics, fluids and oxygen immediately and, as they can deteriorate so quickly and the organs can fail, they are placed in ICU so staff can watch for the need for mechanical ventilation, dialysis, or poor circulation which can lead to amputation. Every moment is critical, with patients often in ICU for weeks or even months.

"As a doctor it doesn't scare me except that you never get desensitised to the grief of the people around them," Dr Young says.

"As a father, it absolutely worries me. When I looked after Jack, all I could see in the bed was one of my children. I find it very scary.

"Just recently my wife asked if I thought one of the kids could have it. It can strike them the same as it can strike any other. I've seen it and I find it as terrifying as anyone else."

The images that so many are familiar with when it comes to meningococcal infection are the people who have lost a limb due to the disease.

Jay Dohnt, 22, lost both legs below the knee and four fingers on his right hand after contracting invasive meningococcal infection in February, 2003.

The Ferryden Park university student and paralympics swimmer was 13 when a night of illness forced him to stay home with his nanna for the day rather than go to school.

"I was fine the next morning and almost went to school, but about lunchtime I went downhill and nanna started to get worried," he recalls.

"I had joint soreness in my knees, and asked nan to wind down the blinds because of the light. She put two and two together and suspected meningococcal infection and went over me with a torch and found a tiny spot on my back."

She drove him to a GP who, recognising the symptoms, called an ambulance.

Jay was taken to the Women's and Children's Hospital, where he would spend the next 3½ months.

"I had to be told a few times that they had done amputations on my legs, because of all the drugs," he said.

"My ear was purple but came good, and my left arm was also purple but it recovered. "When I was told about my fingers I was devastated. My hand was wrapped up for so long I had kind of forgotten and I was pretty devo I wouldn't be able to play PlayStation."

Jay was in a wheelchair for 12 months, and then it took him a further five years to become totally comfortable with his new, prosthetic legs.

A wish granted by the Starlight Children's Foundation - tickets to the AFL Grand Final had an unexpected boon - the hotel pool.

"I took to it straight away, even without my legs," Jay said."I started to swim twice a week through school and that just got more and more frequent. By the end of 2003 I was competing."

Today, Jay spends 30 hours a week in the pool, gym, and on the bike, in preparation for his second Olympics.

He won bronze in Beijing in the 400m freestyle, and will compete in the 400m free, 100m breast and 200m medley at the London Games.

"After I got sick I was always determined and would set higher and higher goals for myself," he said.

"One of my early goals was to shop with mum at Arndale in my wheelchair and be able to push myself to the top of the ramp. I did it.

"Not so much these days, but I definitely had tough days, wondering, `Why me?', when I was younger. But then you always think that there are people worse off.

"Any loss of life is tragic. I feel like one of the lucky ones."

Oren and Gill Klemich - like others who have lost loved ones to this insidious disease - say they still don't understand why their fun-loving son was snatched from them in such a cruel way.

"Contracting the bacteria is bad luck, no one's fault, just bad luck," Mr Klemich says.

Jack donated his kidneys, pancreas, liver and lungs after agreeing to be an organ donor on his driver's licence just a couple of months before. On what would have been Jack's 21st birthday on September 17 last year, his mum, dad, sisters Georgie, 18, and Sophie, 15, and 50 of his friends ran the City to Bay Fun Run and raised $50,000. They gave half to DonateLife and the other half to the RAH Research Fund.

"You just have to get on with your life," Mr Klemich says. "The sadness never leaves you but you live on. We often laugh about Jack now, all those good memories. Gill and I are so lucky - we've got the two most gorgeous daughters. Without them, I don't know how we would have gotten through losing Jack."

For more information check out these websites

www.meningococcalaustralia.org.au

www.meningococcal-australia.org.au

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