No One Listening to Meningitis Concerns; Early Excitement over the Success of Cochlear Implants Has Been Dampened by Evidence That the Devices May Have Led to Outbreaks of Meningitis and Even Death. (the Nation: Cochlear Implants)

Article excerpt

When surgeons placed a cochlear implant inside Rush Limbaugh's left ear two years ago they failed to provide their famous patient with an important warning. They did not tell the conservative radio celebrity that the computerized device that helped restore his hearing was believed to have contributed to several deaths and dozens of cases of meningitis, a potentially fatal, contagious infection of the tissue layers surrounding the brain and its cerebrospinal fluid. The reason for the oversight? Apparently no one knew.

But concern soon prompted angry protests from deaf communities worldwide, particularly in England, where protesters have been calling for a ban on the cochlear implant, declaring: "Better Deaf Than Dead!" Protesters went so far as to accuse hospitals and manufacturers of manipulating research data for profit at the expense of human lives. Unlike the "Deaf President Now!" protest at Washington's Gallaudet University in 1988, demanding that the leader of the university be chosen from the deaf community, the protests about the cochlear implant have had little impact or publicity. But then neither has an apparently related worldwide meningitis outbreak that seemed to come out of nowhere after the cochlear products had been on the market for nearly two decades.

The protests failed to stop Heather Whitestone, the former Miss America, from going ahead with the $35,000 to $50,000 effort to improve her hearing even after the outbreak emerged. Whitestone wanted to hear the voices of her children. Appearing on Good Morning America afterward, she reported that while she can't yet understand what her children are saying, she hears and loves "the sound of running water."

The cochlear implant has three main parts: the internal chip, external processor and a magnet. Inside the internal chip are electrodes that are positioned in the cochlea of the inner ear to activate auditory-nerve fibers needed to transmit sound signals to the brain. An external processor that runs on batteries and amplifies the sound is worn on the body or ear in the same manner as a hearing aid. It is connected by a wire to a magnet that sits snugly on the side of the skull, where it helps transmit messages from the internal chip.

While not a cure for deafness, the implant allows patients to hear sounds they otherwise would not hear, though it can take several years before the patient can interpret what is being heard. At first, speech may seem more robotic than natural, and environmental sounds may seem like a series of beeps. This changes over time. Limbaugh, however, had nearly immediate success in understanding speech, as many newly deafened people do. But he also relies on alternative listening devices, such as a telephone that displays captions, and says he is "completely deaf" when he removes the external processor.

But now the early excitement about such successful implantations is being tempered with concern. The U.S. Food and Drug Administration (FDA) warns that there is a higher risk among cochlear-implant users of contracting bacterial meningitis than among the general population. Along with other regulatory agencies such as the Centers for Disease Control and Prevention (CDC), surgeons and manufacturers are conducting a study to try to understand the outbreak of bacterial meningitis among those with cochlear implants.

Most vulnerable to the disease are children under the age of 5 and the elderly. Deaf patients who have had congenital abnormalities of the inner ear also may be more prone to the disease. Common symptoms of meningitis include fever, irritability, lethargy and loss of appetite, and it is the primary cause of children being born deaf. Adults might experience headaches, stiff necks, nausea, vomiting and confusion. Meningitis can be contagious and the bacteria can spread through the exchange of respiratory and throat secretions, such as from coughing or kissing.

As for Limbaugh, he appears not to be among those at high risk of contracting meningitis. …

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