it strikes with terrifying speed a bacterial disease that can kill within hours and the victims are all children and teenagers in Alberta Canada scientists must try to identify the infection and find the cause of the outbreak before it can turn into an epidemic with more and more lives on the line they'll have to take drastic measures before it's too late [Music] Christmas 1999 passed quietly for most residents in Edmonton Canada but for one family the holiday season was about to become a nightmare the day after Christmas 18 year old Matthew bolding woke up with a stiff neck and a fever his mother knew her son had been working hard in his first semester at college she assumed he had the flu until she saw his arms they were covered with strange splotches like dark purple bruises Carol bolding had no idea what she was looking at but she knew there was something terribly wrong with her son as Mathew was rushed to the hospital paramedics work to stabilize him I was very very scared that we were losing that here and it was it was really very scary time at the University of Alberta hospital Mathew was hurried into the emergency room by the time they reached the ER his mother was becoming more and more worried she headed straight for the admitting nurse she felt there was no time to waste I was going over to her and say every second counts every minute counts and we really you got to do something dr. Michael Bullard responded quickly as he examined the dazed teenager dr. Bullard knew that Matthew's body aches and stiff neck could be symptomatic of dozens of different illnesses as an emergency physician our training is such that were taught to think of the most dangerous and most lethal diagnosis that could present in this manner first when did it start did you see it just this morning oddest and most troubling the purple splotches on Matthews hands and so it's been and now the mysterious rash was spreading to his legs and feet known as petechiae they are caused by broken blood vessels under the skin you need to get some blood tests dr. Bullard couldn't be sure but he had a suspicion what these spots might mean the boy had a dangerous form of bacterial meningitis the usual initial symptoms are just sore throat headache muscle aches and low-grade fevers and sometimes a little bit of diarrhea but this can either quickly or gradually progress into a much more serious form of infection [Music] meningitis is a condition that inflames the lining of the spine and the brain but in its most severe form called meningococcemia something worse happens it triggers a so-called inflammatory cascade a runaway reaction of the immune system and widespread organ failure left untreated it is one of the few diseases that can kill within hours when we see anybody with a dangerous infection that we think is bacterial the current standard of care is to start antibiotics as soon as things like blood cultures and urine cultures are drawn [Music] dr. Bullard ordered intravenous antibiotics if Matthew was suffering from meningitis he couldn't wait 24 hours for test results in 24 hours it could be too late [Music] meningitis can be highly contagious passed by a cough or a sneeze or any contact with droplets from the nose and throat of an infected person until the diagnosis was certain Mathew needed to be kept away from other patients even those treating him needed to wear protective clothing drawing blood and spinal fluid samples the nurse sent the specimens to the laboratory at the University of Alberta state-of-the-art hospital lab dr. Greg Toro a clinical microbiologist received samples of Matthews blood for testing when the blood culture arrives in laboratory it still has to be in community to allow the organism to grow this may take anywhere from 18 to 20 hours once the blood is incubated scientists can determine if the specimens contain any foreign organisms what they're looking for is carbon dioxide a byproduct of growing bacteria blood is loaded into a blood culture file and as Lori onto machine the files themselves have detectors loaded on the bottom of the bottle and as the bacteria grow in this very nutritious environment they release co2 in Matthews case there was no doubt sensors indicated an increased level of carbon dioxide Matthew's blood was testing positive for bacteria the only question was exactly what type bacteria have distinct cell shapes even after the cells are dead and no longer infectious microbiologist can determine the cell shape and identify the bacteria when the sample is mixed with a colored solution the shape of the cell emerges a kind of fingerprint revealing the precise type of bacteria the verdict from the lab was swift and shocking Matthew had been infected by a particularly virulent and deadly form of bacterial meningitis [Music] it triggers an infection that can cause blood clots in the arms legs and brain leading to coma and shock without blood tissue in the arms and legs dyes doctors can be forced to amputate and in ten to fifteen percent of the cases it results in death for dr. Bullard it was difficult to give Matthew's parents and sister such a grim diagnosis Matthew has an infection that we think is caused by a bacteria called meningococcal Samia their son had been perfectly healthy just days before now he was fighting for his life a stun Carol Bolden coped the only way she knew how she began to educate herself on Matthew's condition I would ask what are his but take the senator what's average what's low what's normal and I felt like I knew a little bit more because it's that not knowing that that is is frightening when you're in hospital so I felt a little bit more in control that way Carol soon learned that Matthew was being given massive amounts of antibiotics but there was no guarantee they would work we wouldn't expect to see much in the way of improvement for at least 24 to 48 hours because usually it takes some time for the antibiotic to first get into system and to reach a therapeutic dose range and then to actually allow the body to start to recover all Matthews doctors and family could do was watch his condition and wait [Music] when your child is ill you have to deal with whatever you have to deal with I don't think you really breathe again until they tell you can Matthews doctors contacted dr. Gerry Preti of the Capitol Health Authority meningitis is infectious and can quickly spread out of control in a community health officials track every case Matthews was actually the second instance of meningitis reported in Edmonton that December while it was of some concern to have two cases in a week it was not not nothing that we thought was particularly out of the ordinary as a precaution doctor pretty asked his staff to issue a warning to area hospitals and clinics every doctor in the area needed to be on the lookout for cases of meningitis the disease is most prevalent in the winter the cold dry weather makes people more susceptible especially children and teenagers when your mucous membranes the linings of your nose and throat get dry they they do tend to be it tends to be easier for various germs including this one to get into the lining and then cause infections the doctors were closely tracking Matthews progress within two days the antibiotics had started to kick in slowly but steadily Matthew was starting to recover [Music] but the doctors couldn't figure out where this virulent meningitis had come from they needed a list of everyone family and friends he had come in contact with before he began showing symptoms it is transmitted through people who cough or sneeze it'll drop this form and it is can be transmitted to someone else that way or through saliva if people for example share a cigarette or share a drink then they can get it that way doctors examine Matthews family and his girlfriend no one showed signs of the disease [Music] health officials were baffled how Matthew contracted the disease and if anyone else was infected they could only hope they had seen the last meningitis case of the season but in a city near Edmonton another teenager had started to feel ill 17 year old Ryan's elky was a popular high school senior he played lead guitar in a garage band [Music] on January 7th a week after Mathew bolding became sick Ryan experienced a severe asthma attack [Music] yes he had had asthma problems for most of his life when Ryan's mother took him to the doctor he was diagnosed with the flu his parents kept a close watch on his condition but he became weaker developing severe eggs and pains he was too weak to walk to the bathroom on his own then Michels elke saw the splotches on her son's chest she didn't know what caused them but this much was certain her son was in trouble they had to get Rai into the hospital there was no time to wait for an ambulance the car would be faster on the way ryan told his mother that his chest was starting to tighten he was having difficulty breathing Michelle could feel his heartbeat weakening as she tried to find a pulse in the ER the doctors were alarmed ryan's pulse was erratic his blood pressure was plummeting he had fallen unconscious and then he started to flatline Ryan was crashing the ER staff worked frantically to revive him Michels elke went to be with her husband their son was in trouble and there was nothing they could do for over an hour the medical team tried to resuscitate the boy but in the end he couldn't be saved On January 10th 17 year-old Ryan's elky was pronounced dead and he would not be the last victim of meningitis in Edmonton that winter the outbreak was just beginning in January of 2000 a 17 year old boy came down with flu symptoms 48 hours later he was dead doctors suspected his death was caused by a dangerous strain of bacteria medical examiners performed an autopsy looking for clues to confirm the diagnosis because the bacteria and his blood was still infectious they wore protective clothing they had to figure out exactly what had happened to the young man why the disease had hit him so hard so rapidly the bacterial infection had damaged his blood vessels leading to shock and complete organ failure at the University of Alberta Hospital in Edmonton technicians examine Ryan's blood and tissue samples looking for clues the initial test confirmed that he had bacterial meningitis doctors forwarded the lab and autopsy results to the Health Authority officials feared this might be the start of an outbreak [Music] Ryan was the third case in less than a month [Music] one more medical officer of health dr. Jerry Peretti feared the worst in this case even when our number of cases was was not anywhere near what people would consider an outbreak situation it was our gut feeling that there was something unusual happening following Ryan's tragic death the Edmonton news media got a warning out to the public the group most at-risk teenagers there are probably a number of reasons why teenagers and young adults are more at risk but it's the behavior issues the behavioural types of behaviors that they engage in that put them at risk more than any other age group teenagers tend to gather in large numbers day or night in classrooms or parties they are jammed together sharing sodas cigarettes or affection in each of these exchanges the bacteria can spread from one person to another [Music] but the puzzle for investigators was that none of the meningitis patients had attended the same school they still didn't know where the outbreak originated on the hunt for clues investigators question Ryan's LG's parents there was one starting point all three victims lived within the Edmonton area investigators wondered if the victims knew one another or had attended the same party or come and contacted any type of gathering but Ryan's parents weren't certain of any specific social events their son had recently been to looking for links investigators also question Matthew bolding hoping to find out where and when he might have encountered the other two victims but there were no easy answers all three patients had never met the trail would be even harder to find the issue in tracking the source of infection is that most people who have the organism don't have any symptoms so most of the people who require the illness likely acquire it from an asymptomatic individual all over Edmonton public health nurses try to get the word out warning teenagers to go to a doctor immediately if they experienced blue-like symptoms followed by a telltale purple rash [Music] but the lethal bacterium was on the move and it couldn't be stopped the outbreak was now entering a more dangerous more baffling phase targeting even younger victims days after Michelle's elqui lost her son to meningitis another worried mother sat in the emergency room at the University of Alberta hospital four-year-old Alex Hanson seemed to have a bad case of the flu my husband had the flu the week before so I just assumed that he had caught the flu from my husband because he had you know the same symptoms not wanting to eat a little bit tired but as they waited to see a doctor Alex fell unconscious in his mother's arms doctors rushed the boy into the treatment bank to begin emergency procedures as Alex's mother helped them remove his shirt they all noticed the dark purple splotches on his chest [Music] they lied him down on the bed and within one minute they're putting masks on and gloves on and telling me to you know to just debacle eight the ER staff gave him oxygen and intravenous fluids trying to stabilize the boy but Alex's blood pressure was plummeting the nurse hurried Cheryl out of the room and the nurse said you know we're not sure what's going on but you know just let them work if you need to call anybody call them now well he's got the flu what are you doing you know I couldn't understand it the little boy was now in critical condition as they transferred him to pediatric intensive care they knew his state was precarious and then the nurse brought me to him because he had woken up a little bit and he looked me right in the eye and said mommy I feel better now I thought okay you know then obviously maybe he was just dehydrated or something and that's when the nurse said no we're gonna be knocking him out now and paralyzing him so he could put the catheter and everything in Alexes long-term prognosis was uncertain the doctor gave Alex's parents all the information he could he feared their son had contracted bacterial meningitis it would take the lab 24 hours to confirm the diagnosis and the pediatric doctor told us that he only had about a 50% chance of survival at that point and that the next 24 hours were gonna be critical and as he's telling us this the nurse ran in and told us that his blood pressure was dropping again so he took off out and my husband and I were sitting there and we didn't we didn't know what to do or anything and he came back and he said okay he's stable again but this is the way it's going to be for the next 24 hours I didn't know how I was gonna get through it I honestly didn't it was heartbreaking for the Hansons to see their little boy hook to tubes and machines massive quantities of intravenous antibiotics were being pumped into his tiny body [Music] he needed a respirator to breathe he had tubes all over the place needles all over the place and he had the purpley black spots all over his body and I couldn't believe that this had happened within an hour of me seeing him because it was it was no more than an hour that I hadn't seen him from the emergency room till when he was in the ICU the bacteria was coursing through Alex's bloodstream if his mother hadn't brought him to the emergency room early on he would have died the doctor warned the Hansons that if Alex survived he might suffer neurological damage I said I broke down so the nurse took me out of the room and said you can't do that in case he can hear you you have to be strong in front of him and for about the next three hours I don't really remember who I talked to or what I did or anything I think I was more in shock than anything the next day in the hospital lab dr. Turell verified that Alex had bacterial meningitis it was the fourth confirmed case in less than a month the same number they might expect to see in an entire year the City of Edmonton was facing a killer bacteria an epidemic was about to erupt in Canada public health officials were confronting a deadly outbreak a lethal form of bacterial meningitis had taken the life of one teenager and health officials still didn't know the source of the bacteria lady from the health department talked to me and told me how contagious this was and asked me the names of all the kids that Alex have been in contact with in the past week and I thought oh my goodness you know he's been in contact with so many people I can't even start health officials visited daycare centers all over Edmonton they distributed a warning to teachers and parents a bacteria was on the loose their children were at risk two days after four-year-old Alex Hanson had collapsed in the emergency room he was still in critical condition and now his mother faced a new fair doctors were worried Alex had suffered brain damage from his bout with the bacteria [Music] to find out electrodes were attached to the child's head to record brain activity Alex's brain had not been damaged by the infection now all he had to do was survive over the next few days scores of patients with flu-like symptoms appeared in Edmonton emergency rooms as worried parents brought in all sorts of sick children many patients with upper respiratory infections came in concerned that they had contracted the disease and wanting reassurance that in fact they did not while many did not have the disease Health Authority investigators realized that the confirmed cases of meningitis were rising rapidly in the middle of January we had over a period less than a week five cases including a 20 year old a seven year old a couple of four-year-olds and an infant the bacteria had struck eight victims in under a month the danger was escalating and investigators had no link no common thread among the patients health officials were now facing an outbreak of fatal meningitis and they needed to find out how it was continuing to infect the population because there are no links and because these cases occurred over a fairly short period of time it just started to create in our minds the idea that perhaps there might be something unusual as far as the circulation of this particular bacteria and the community at the University of Alberta Hospital dr. Greg Toro tried to pry clues from the bacteria itself Terral suspected one of two possibilities either the bacteria was a new strain never before seen in Edmonton or an existing string that had mutated becoming more virulent up to 5% of the population can carry the basic meningitis bacteria but if Edmonton was dealing with a new or mutated meningitis strain this would explain why so many people were getting sick the population had not yet developed any immunity dr. Tyrell analyzed the bacteria's DNA what he found was startling all eight patients were infected with exactly the same strain and it wasn't like anything he had seen before just like the flu he suspected the meningitis bacteria had begun to mutate now that the lab had identified the bacteria health officials had a chance of containing the outbreak a vaccine was available for this type of meningitis but they had to get it to enough people before they came down with the disease dr. Gerry 'pretty proposed a massive vaccination program to provincial health officials that point is when we really initiated the discussions with the Ministry of Health about if and when we would need to do an immunization campaign we really started to get concerned vaccination programs are expensive and difficult to implement dr. Karen Grimm's Rudd of the provincial Health Authority faced a difficult decision looking at all that information in Canadian guidelines that look at if you have 10 cases in a certain anger that's 15 to 19 year olds per 100,000 population so over a three-month period then you should start considering having a vaccine program with just under 10 cases health officials held off waiting anxiously and then a case that would change everything on February 4th 2000 Doug McGann has brought his 16 year old daughter dawn to a suburban clinic she had started feeling sick the day before dawn had the chills and a fever she had been vomiting I didn't realize what was happening I know she was really sick but I'm thinking you know I don't know maybe she got food poisoning her sumption it's so violently it's throwing up so much after a routine examination the doctor concluded that dawn had a normal case of the flu the family was told the virus would run its course in a couple of days it was an easy case to miss diagnosed that night they tended to their daughter [Music] she was lying on the coach we just kept changing her cloth and everything all night around 4:30 a.m. Doug and Deidre were awakened by a loud thud [Music] dawn had collapsed on her way to the bathroom in the dim light Deidre spotted something that took her breath away purple splotches on her daughter's skin the story of Ryan's elqui flashed into her head she had seen reports about his case on the news I noticed she had the five purple spots on her chest at that time that's when I knew that my daughter had meningitis Deidre knew the clock was ticking dawn was getting sicker by the hour there wasn't much time to act before the disease did irreparable damage in Alberta Canada a deadly strain of bacteria threatened the City of Edmonton young people were most at risk one teenager had already died when DJ and Doug McCann has spotted the dreaded purple rash on their daughter's chest they rushed her to the hospital you knew that it was serious because they didn't even ask me to do the paperwork first of all they just took care of Dawn right off the bat [Music] the ER doctor immediately suspected bacterial meningitis he gave her antibiotics right away there was just a short window to intervene to kill the bacteria before it was too late already the sixteen-year-old girl was in agony she said mom my ankles my ankles and she was in a lot of pain at that time the doctors looked at me and they said Deidre you have a very sick child [Music] the doctors decided to transfer gone to the University of Alberta Hospital where the staff was better equipped to treat her meningitis in the ambulance the paramedics gave her oxygen and a sedative to help ease the pain [Music] by the time the teenager arrived in the hospital's intensive care unit the bacterial infection had shut down both her kidneys and her lungs she needed a respirator just to breathe so they hooked her up to the machine and they were cleaning the blood to see whether we couldn't get Don healthy again they were you know it was a matter of six days of having hope but not having hope and it was just being on a roller coaster for nearly a week Dawn's family kept an around-the-clock vigil at her bedside we had to put on gloves and masks on our faces and I couldn't handle seeing my sister like that she was all hooked up to all these different machines and she just had purple dots all over her all over her body the family was startled to learn that dawn was just one of several children who had come through the hospital recently with the deadly disease I couldn't believe it I thought why isn't anyone else coming forward why didn't anyone know what this meningitis and house you know severe it is and it's a terrible disease nearly a week after she was first admitted doctors told her family dawn had developed some bleeding in the brain the news was even worse than they feared he said there's nothing you can do her kidneys shutting down her liver shut down her brain she was totally Brenda there was no way for her coming back to life now the McGann juses faced a terrible decision so they said to me we'll disconnect all the machines and see if she can function by herself they agonized and decided to take their daughter off life support I held on the dawn serve and they disconnected and she was dead [Music] [Applause] [Music] Don died February 10 2000 at 405 in the afternoon fighting her own despair Dedra makanga contacted the local television station she was determined to warn other parents a deadly bacteria was killing Edmonton's young people I said you get ahold of every news person every reported that we know in town and I want a story done I don't want other people to go through what I've just gone through Dawn's tragic story made headlines all over the province health officials learned that yet another teenager had meningitis they decided to act immediately whenever we have a minyan jacoco case and there's a death associated with it it's guaranteed to be of interest to the media and therefore the public becomes concerned so we felt there should be some action the Health Authority decided they had to launch the massive immunization campaign they'd been considering it was their only chance to stop the outbreak at a press conference health officials announced they would start vaccinating 15 to 19 year olds the highest risk group for this outbreak of meningitis but even as the orders went out many worried that they might already be too late the lethal threat was spreading and fast parents in Alberta Canada were facing their worst nightmare a deadly disease that preyed on young people and had taken the lives of two teenagers public health officials decided they had to act fast to start a mass immunization program even if they weren't 100% sure it would work dr. Jerry Pratt he mobilized the agency's resources for the enormous task ahead we didn't have much time and we had really had to do a large number of people over a very short period of time so so we did set up several sites across the region in community locations where people could come and then whether they were in school or whether they were working then this was available to them 15 to 19 year olds were targeted first because they were most at risk by mid-february just six weeks after the outbreak began the immunization program was underway long lines of teenagers streamed into the clinics to begin receiving vaccinations but to immunize over 50,000 teens the health department needed a large quantity of the vaccine a much larger supply than they had it wasn't an easy task to do get vaccine into the province to vaccinate a large number of individuals and they went out of their way to fly the vaccine from across North America and I believe they even were doing some sourcing out in Europe to get the enough vaccine here for us regional health officials also set up a hotline to talk with worried parents fear had spread through the community even faster than the disease 15,000 calls came in the first three days alone within a week the Health Authority had vaccinated 25,000 young men and women within eight weeks more than 50,000 nearly every one of the teens at risk now all they could do was wait and hope that their vaccine would work but other parents were concerned that younger children weren't being protected by the vaccination even though the initial high disease rate was in teenagers there was the potential to spread to younger children we did then quickly decide that we would announce a campaign for you know all children under the age of 19 as public pressure mounted the Health Authority added 2 to 14 year olds to the list eventually health officials would inoculate people from ages 20 to 24 as well this year is really dropped off now I think we're seeing now the full impact by the immunization program because it's eighty seventy six percent of people between the ages of 2 and 24 in this province were vaccinated in the end two months after the outbreak began the Health Authority and the people of Edmonton could breathe a sigh of relief no new reports of the disease had surfaced the vaccine had worked it had stopped an epidemic in its tracks and each shot would last three to five years today the lethal bacteria has not vanished it is still present in Edmonton still a threat to those who have not been vaccinated but now at least the people there have some protection today Alex Hansen one of the youngest victims is back to normal surviving meningitis without serious effect he's growing up happy and healthy he has made a full recovery he had one or two little scars one on his ankle and while his back from the blood clots but those have gone away in the last year or so mathew bolding also recovered completely he's now studying engineering at a local university his brush with death has given him and his family a new outlook on life I think we all changed a little bit and I think Matthew in my opinion probably changed because I think when you're 18 you feel really strong and you can do all these things you can stay out all night you could work you could study you can do everything you you just feel invincible and I think it probably made him feel less invincible it's like he could something can happen to him too maybe maybe it happened to all of us maybe all of us thought that maybe it just made us think about how fragile life is Don's parents didi and Doug McGann guess found strength and tragedy and put it to work they established the meningitis Foundation of Alberta their own loss allows them to help others as they grieve the death of a child [Music] having a child died I certainly believe that I've gone through the very worst possible thing that I possibly can go through so I'm not afraid of absolutely anything anymore I'll take on any challenge or anything in this day and age and because I honestly believe that I've been through the worst thing that could possibly happen the Edmonton outbreak of 2000 infected 49 people and claimed three lives today many mysteries remain about the deadly disease no one has been able to figure out exactly how it arose or how it spread but this much is sure in Edmonton the mass immunization program continues to save lives by keeping a killer at bay [Music] [Music]