LITTLE ROCK, Ark. - A kind of meningitis caused by a brain-eating amoeba called Naegleria fowleri is incredibly rare, but it's almost always fatal.
So it's remarkable that 12-year-old Kali Hardig is alive and responsive after she was diagnosed with such a case last month in Arkansas.
"Up to Kali's case, there were only two reported survivors," said Dr. Mark Heulitt, one of the doctors who treated her. "Now, Kali's the third."
There have been nearly 130 cases reported in the United States since 1962, according to the Centers for Disease Control and Prevention. Before Kali, there was only one known U.S. survivor, plus another nonfatal case documented in Mexico.
Health officials say Kali's success is due in large part to experimental treatment and early detection and diagnosis.
Kali's mother, Traci Hardig, brought her to Arkansas Children's Hospital with a nasty fever on July 19 — not long after Kali went swimming at a water park in central Arkansas.
The state Department of Health has said that now-shuttered park, which features a sandy-bottomed lake, is likely where Kali came into contact with the amoeba.
Naegleria fowleri (pronounced nuh-GLEER'-ee-uh FOW'-lur-ee) is often found in warm bodies of freshwater, such as lakes, rivers and hot springs. The amoeba typically enters the body through the nose as people are swimming or diving. It can then travel to the brain, causing a devastating infection called primary amebic meningoencephalitis, or PAM. That's what Kali has been battling.
Initial symptoms usually start within one to seven days and may include headache, fever, nausea and vomiting. The disease progresses rapidly, and other symptoms can include stiff neck, confusion, loss of balance, seizures and hallucinations.
Moreover, the infection destroys brain tissue and can cause brain swelling and death.
So, in Kali's case, doctors cooled her body down to try to reduce the swelling. They also won clearance to treat her with a breast-cancer drug, Heulitt said.
"She wound up being on the ventilator for over two weeks," Heulitt said. But she's since made incredible progress.
Kali (pronounced KAY'-lee) can now breathe on her own. Though she can't talk yet, she's able to write her name and respond to doctors and her family. And tests show no signs of the parasite in her system.
She still has weeks of rehabilitation ahead of her, but for now, her family is celebrating her triumphs.
"We've went from being told that our little girl wouldn't survive this amoeba to now they're saying that Kali is going to be the third survivor and going to get to go home," Traci Hardig said.
Hardig, who lives in the nearby suburb of Benton, beamed as she talked the strength and perseverance Kali has shown in the past few weeks.
It's not hard to see where Kali gets it from.
While Kali has been recovering from her rare case of meningitis, Traci Hardig has been battling breast cancer.
"It's kind of a battle to decide that you want to put your health on hold because you want to totally focus on Kali, but I know I have to try to get myself better too, because Kali's coming home and I'm going to get to take care of her," she said.
But Hardig doesn't dwell on her own challenges.
Instead, she thanks the people around the world who have sent prayers and good wishes to Kali, and she's trying to raise awareness for another 12-year-old battling PAM in Florida.
Zachary Reyna is being treated in the intensive care unit at Miami Children's Hospital. Family members told reporters that he was infected while knee boarding with friends in a ditch near his family's home in LaBelle earlier this month.
"We're praying for him to be survivor number four," Hardig said.
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Yes, the black plague -- responsible for <a href="http://www.smithsonianmag.com/people-places/mall_aug99.html?c=y&page=2" target="_hplink">killing 56 million people in Europe the 14th century</a> -- is still around, but it isn't as deadly or prevalent as it was in Medieval times. Dr. Robert Gaynes, an infectious disease expert at Emory University and author of the book <a href="http://estore.asm.org/viewItemDetails.asp?ItemID=1036" target="_hplink">Germ Theory: Medical Pioneers in Infectious Diseases</a>, said that people contract the disease when they gain access to previously undistrubed ecosystems, thereby making "these types of diseases become evident as a result of animal contact." These days, the disease is most commonly spread by bites from fleas that are infected with Yersinia pestis. When the bacteria enters into a person's skin, it leads to headache, chills, and <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">swollen lymph glands</a>, according to the CDC. Early <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">treatment with antibiotics</a> is essential for survival, as the disease can cause respiratory failure and shock if left untreated. Every year, about 1,000 to 3,000 <a href="http://healthland.time.com/2011/05/10/first-case-of-bubonic-plague-in-2011-appears-in-new-mexico/" target="_hplink">bubonic plague cases</a> occur around the world, with 10 to 20 of those cases in the United States, <em>TIME</em> reported. The first 2011 case of bubonic plague was confirmed in May in a New Mexico man. The reason is murky for why black plague seems to be less deadly today than in the Medieval times, Weinberg said, but it probably has to do with more rats and unclean living conditions back then, as well as a lack of appropriate medicines. In addition, the bacteria back then may be different from the current form, he added.
<a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">Scarlet fever</a> was among the rash of diseases that commonly afflicted people in the 19th century (alongside yellow fever, rubella and measles), according to MedicineNet. Scarlet fever most often afflicts children, causing rash and fever. Fortunately, scarlet fever is a lot less common today than it was centuries ago, but it still can be deadly. Today, we now know that scarlet fever is just a form of group A streptococcus (strep), Weinberg said. But instead of just turning into a regular case of strep throat, scarlet fever manifests as a red skin rash. With antibiotics, the disease is easily treated, though complications can occur that <a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">can lead to sepsis</a> (bacteria in the blood, tissue or bone), according to MedicineNet. Just this summer, Reuters reported that a Hong Kong kindergarten was closed after tests revealed that a child there may have <a href="http://www.reuters.com/article/2011/06/21/us-scarletfever-china-idUSTRE75K14Q20110621" target="_hplink">died from scarlet fever</a>. Scarlet fever is relatively common in that part of the world, but this year a Hong Kong health department spokesman told Reuters that there seem to be more cases of it this year than in past years.
<a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">Whooping cough</a>, caused by the Bordetella pertussis bacteria, was a common illness among children in the early 1900s, according to HealthCentral. However, when the vaccine for whooping cough was introduced in the 1940s, cases dropped. But while whooping cough cases are still dramatically lower than 50 years ago, there are still cases that persist today possibly because the vaccine against the disease doesn't provide lasting protection later in life, Weinberg said. Another reason is that older people seem to be able to carry whooping cough in their throats without actually getting sick (due to being vaccinated at a younger age), but that whooping cough is then passed on to infants who haven't yet been vaccinated against the disease, Gaynes said. "This problem has led to a recent recommendation by [the] CDC to have adults get TDAP once as adults (it contains pertussis in the vaccine) and not just a tetanus booster, which is needed every ten years," Gaynes told HuffPost. Recent research presented just last month shows that the <a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">protection from the whooping cough vaccine</a> is decreased dramatically once a child reaches age 8 or 9, the <em>San Francisco Chronicle</em> reported. <a href="http://www.cdc.gov/features/pertussis/" target="_hplink">Whooping cough is very contagious</a> -- spread by cough and sneezing -- and is so named because of the sound people who have it make when they cough. Last year, 27,550 people had whooping cough in the United States, according to the CDC. The disease is the deadliest for babies, as it can lead to pneumonia, convulsions and even death.
Polio, the paralysis-causing disease that afflicted former president Franklin D. Roosevelt, isn't completely gone from the world today. However, it has been eliminated from the western world, Weinberg said. The Mayo Clinic reports that the last known <a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink">case of polio in the U.S.</a> was in 1979. Polio is still present in <a href="http://www.who.int/mediacentre/factsheets/fs114/en/" target="_hplink">Afghanistan, Pakistan, India and Nigeria</a>, where unrest and dangerous conditions can make it more difficult to get everyone vaccinated against the disease, according to the World Health Organization. Recently, the WHO reported that a dangerous strain of polio -- called wild poliovirus type 1 -- had <a href="http://www.huffingtonpost.com/2011/09/20/polio-china-pakistan_n_971787.html" target="_hplink">made its way from Pakistan to China</a>. Polio<a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink"> causes paralysis</a> and can make it hard to breathe, the Mayo Clinic reported. It can even lead to death.
Gout has been known throughout history as the "<a href="http://www.bl.uk/learning/langlit/booksforcooks/1700s/1700sfood.html" target="_hplink">disease of kings</a>" and the "rich man's disease," as it was most commonly seem among the gluttonous rich in the 1700 and 1800s, according to the British Library. Gout is considered an ancient form of <a href="http://www.cdc.gov/arthritis/basics/gout.htm" target="_hplink">inflammatory arthritis</a>, and is caused by metabolic disorder that has not been properly controlled. It occurs when uric acid crystals build up in tissues and fluids, thereby leading to a red, swollen joint that is very painful, according to the Centers for Disease Control and Prevention. The condition is most common in overweight men and women who have gone through menopause. Gout rates have <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">been on the rise</a> since the 1960s, with cases doubling between 1960 and 1990 and then continuing to rise through 2008, according to WebMD. More than 8 million Americans currently have gout. WebMD reported that the <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">rise in gout cases</a> may be due to people living longer, as the condition is seen in women only after they have passed menopause. In addition, "you can go years with hyperuricemia and no symptoms. But at some point, enough uric acid accumulates to have a flare-up of gout, so if you're living longer you are more likely to reach that threshold," gout expert Dr. John S. Sundy told WebMD. In addition, Gaynes speculated that it may not even be that gout rates are actually rising -- rather, detection and diagnosis may have improved throughout the years.