Local Toddler Shows Strength in Strep Fight

By Joseph Anderson, M.D. | Aug 03, 2012
Hailey Mello

Local toddler Hailey Mello attracted local attention recently following her sudden illness and hospital stay at Eastern Maine Medical Center. The germ responsible is Group A Strep, the same germ that is known for causing common "strep throat" in kids all over the world. Belfast Pediatrics has been getting questions from many of our patients about her welfare and if there’s anything they should look out for in their own families.

Hailey’s mother Melody and the EMMC staff said that Hailey was showing steady improvement. She suddenly got sick last weekend with a fever and foot pain, but no sore throat. Hailey’s strep infection was not in her throat but instead in her foot where it caused a blood clot. This is a rare and dangerous form of the infection, but one the EMMC team has dealt with before. When this strain of strep gets under the skin, it can cause more serious infections, like Hailey’s, or the infamous "flesh-eating" necrotizing fasciitis.

Hailey has needed a lot of medical help since she arrived at EMMC, but fortunately her condition is stabilizing. The blood clot stopped the flow of blood to her foot and she will need to have the dead tissue surgically removed.

Melody thanked everyone in the area for the outpouring of support for her family. The Angler’s Restaurant benefit dinner was a huge success, and restaurant manager, Amy Nickerson and staff deserve a big thank you. Hailey has a long recovery ahead and she and her family will continue to need help in the coming weeks and months. Hailey’s family and EMMC care team have already made arrangements with Shriner’s organization to help with her rehabilitation.

Melody knew right away that Hailey was sick, and brought her to her pediatrician, Dr. Jan Gorton. Dr. Gorton. After evaluating Hailey, Dr. Gorton ordered a blood culture, which showed the infection. The Waldo County Hospital Emergency Room team wasted no time in getting intravenous antibiotics into her. When they recognized how serious her condition was they sent her via Life Flight to EMMC. Nothing could have been done differently in Hailey’s case, but how can we prevent this from happening to other children?

Streptococcus pyogenes is one of the most common infections in children, but it can be unpredictable. Someone infected with this germ can fall on a wide spectrum — from completely asymptomatic to deathly ill. Some can carry the germ in their throats for months, with no fever or sore throat at all. Most commonly, Strep causes sore throats with fever and swollen glands under the jaw. This infection can also cause a sand-paper-like red rash on the trunk — a combination known as "scarlet fever." In addition, some Strep patients can get impetigo — a blistering weepy rash commonly on the face. Others have kidney damage, which results in bloody urine. The serious forms of Group A Strep infection, called "invasive strep," occur when the germ gets under the skin, where it can cause rapid tissue destruction and blood clots. Streptococcal toxins also cause Toxic Shock Syndrome, which causes cardiovascular collapse.

There are thousands of cases of Strep infection every year in Maine. When interviewed about this strep strain, former State of Maine epidemiologist Dr. Dora Anne Mills reported, “On average we see about 19 people in Maine with invasive group A strep every year." While some types of infections come from overseas travelers and are vaccine-preventable, neither is the case for homegrown strep.

The best way for any parent to identify a serious infection is to do just what Melody did. She watched her daughter carefully, especially when she knew she had a fever. She took her temperature, and made sure she drank plenty of fluids. Even though it wasn’t an especially high fever, Melody told me there were two things that were different about this illness: she was shivering a lot, and she had foot pain. These are not common signs of typical childhood viral infections. Dr. Gorton decided to do the extra blood testing because of these unusual symptoms. “Listen to your gut” seems to be the most valuable lesson here.

Kids with regular strep throat do not turn into what Hailey has. Typical strep throat, often identified by a quick office throat swab, goes away within a day or two of starting antibiotics. Even strep impetigo rash responds quickly to antibiotic creams. However, here are some warning signs of more serious disease: fever over 104 degrees, sore throat with noisy breathing, inability to drink liquids. Any of these signs should prompt a visit to the doctor. Skin infections with fever, an expanding area of redness or drainage also warrant a check-up.

Most infections that people get come from our hands, so good old hand washing is the best way to protect yourself and your family from any germ. Every kid gets a few cuts and scrapes, but any of these could be an open door for an infection. Each wound should be cleaned right away with water to prevent this.

Hailey has a long road ahead of her but she and her family know they have all of us in Waldo County looking out for her. Why she got more than simple strep throat is a mystery to everyone, but hopefully these simple tips will help us identify this rare condition.

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