A wholesome little woman who doted on her cuddly Winnie-the-Pooh bear and adored the Gruffalo, Lorelei Cowmeadow had solely ever had the standard colds and coughs all babies get sometimes.
So when the vigorous toddler appeared ‘a bit beneath the climate’ with ‘cold-like signs’ one Sunday final November, her mother and father Jack and Antonia naturally assumed she had a winter bug.
Certainly, Lorelei went to nursery as regular the following day – and, though she’d wanted a dose of Calpol through the day, was dancing exuberantly in entrance of CBeebies at dwelling come teatime.
‘We actually thought it was an odd night,’ remembers Antonia, 31, a private assistant. However the couple had been abruptly woken in the course of the evening by Lorelei’s cry.
She was asking for a bottle and her nappy additionally wanted altering, each of which had been ‘a bit odd’ as she usually slept by means of the evening, they recall.
Jack modified her nappy, whereas Antonia went to organize a bottle of milk. Then instantly all the things modified: Lorelei start to slot in her father’s arms.
‘Lorelei went from being an articulate little woman – who’d been clearly saying “bottle” and “daddy” to only mumbling, virtually grunting, and making unusual noises,’ says Jack, 31 who works in gross sales.
When Lorelei Cowmeadow appeared ‘a bit beneath the climate’ final November, her mother and father Jack and Antonia naturally assumed she had a winter bug
He instantly shouted for his spouse – it was very clear to them that one thing was critically improper. Each mother and father wipe away tears on the reminiscence, as Jack remembers: ‘Her head was rolling again and her eyes had been going backwards.’
Antonia rang 999, whereas Jack desperately tried to get his daughter to reply.
‘It was surreal – just a few hours earlier than she’d been the bubbly, bossy Lorelei we cherished – but now she was clearly critically sick,’ says Antonia. ‘We simply couldn’t consider it was occurring.’
Inside hours, Lorelei was in an induced coma in hospital whereas docs ran assessments to work out what was improper. Additionally they gave her antivirals and steroids to battle off any potential an infection.
But she died three days later, on November 21, 2024 – simply three days earlier than her second birthday.
Antonia says: ‘Neither of us might take within the magnitude of what occurred; the velocity she went downhill was past perception and inside just a few hours we had been saying goodbye to our little woman.’
Lorelei died after creating encephalitis, a severe neurological situation the place the mind turns into infected and swells.
It may be precipitated both by an an infection immediately invading the mind (referred to as infectious encephalitis) or by means of the immune system going into overdrive and mistakenly attacking the mind (autoimmune encephalitis). In Lorelei’s case, it was a complication of the flu.
There are round 6,000 instances of encephalitis yearly within the UK.
Whereas it may well have an effect on anybody, there’s an elevated threat in youthful kids – like Lorelei – and older individuals whose immune techniques are much less sturdy, says Professor Benedict Michael, chair of an infection neuroscience at Liverpool College.
Between 10 to twenty per cent of instances show deadly: the overwhelming majority of those that do survive will be left with life-long disabilities, akin to reminiscence loss, language and cognitive issues, fatigue, repeated seizures and epilepsy, provides Professor Michael.
Infectious encephalitis is generally brought on by a virus – mostly herpes simplex (the chilly sore virus) and varicella zoster (chickenpox), but in addition (extra not often) flu and measles. ‘Any virus has the potential to set off encephalitis – however not everybody who’s contaminated with these viruses will develop it,’ says Dr Ava Easton, a senior analysis fellow in encephalitis at Liverpool College and chief govt of the charity, Encephalitis Worldwide.
‘It’s not identified why one particular person goes on to develop encephalitis when one other doesn’t.’
Totally different viruses invade or harm the mind in numerous methods, explains Professor Michael.
Herpes simplex and varicella zoster enter the central nervous system by travelling alongside the nerves – ‘these viruses might lie dormant for years after which turn out to be reactivated, maybe on account of weakened immunity, and might set off encephalitis’, he says.
It’s rather more uncommon for flu to trigger encephalitis, as occurred to Lorelei – it’s thought to happen if the physique’s immune response is excessively sturdy, main it to launch chemical compounds referred to as cytokines that may trigger irritation and swelling.
As Dr Easton explains: ‘The an infection causes the mind to swell – however because it’s encased within the inflexible cranium it may well’t increase, so the tissue turns into broken.’
Immediate remedy is clearly very important. But the situation is usually missed as a result of its signs are simply mistaken for different circumstances, plus these signs can begin off very gentle.
‘Signs will be flu-like or embody complications, sensitivity to the sunshine, nausea and vomiting – which may appear generic at first and might simply be mistaken for different circumstances,’ says Professor Michael. ‘And as soon as established, encephalitis progresses very quickly.’
Lorelei died after creating encephalitis, a severe neurological situation the place the mind turns into infected and swells
There are a selection of the way to diagnose it however the vital take a look at is:a lumbar puncture (the place the spinal fluid is analysed for white blood cells which point out irritation), mind scans and blood assessments.
Sufferers are initially handled with antiviral medicine on an aggressive remedy plan. As an illustration, acyclovir is efficient in opposition to the herpes simplex and chickenpox viruses – ‘it provides an 80 to 90 per cent probability of survival if administered inside the first 24 hours’, says Professor Michael. Ganciclovir, used to deal with immuno-compromised sufferers with viruses, can also be typically administered
However there are not any particular antivirals for many different viruses, so remedy is focused at relieving signs, utilizing anti-seizure medicine, for instance.
Autoimmune encephalitis is handled with medicines that calm the immune system, akin to corticosteroids.
‘Normally, there’s a window of alternative the place early intervention improves survival,’ says Professor Michael.
That’s why consciousness of the situation is so very important – ‘in any other case, all too typically it results in missed alternatives’, says Dr Easton.
‘We wish GPs, A&E workers and the general public at massive to bear in mind that encephalitis is a chance, in the identical approach that individuals are actually conscious of the risks of meningitis or sepsis – as a result of there can typically be an important 24- to 48-hour window to deal with them and it may well make the distinction between life and dying.’
It’s estimated 77 per cent of the general public within the UK have no idea what the situation is, based on a 2021 YouGov survey.
Tragically, tiny Lorelei’s situation deteriorated so quickly that there was little that could possibly be achieved. She was initially blue-lighted from her dwelling in Wokingham to the Royal Berkshire Hospital in Studying, the place involved docs ran a sequence of assessments and took the choice to place her right into a drug-induced coma.
She was then transferred to John Radcliffe Hospital in Oxford for extra specialist care.
Following an MRI scan, docs gently advised her mother and father that Lorelei had caught the flu, which had precipitated her to develop encephalitis – and her swollen mind had been broken.
Lorelei was given an antiviral medicine, ‘however that didn’t contact the edges’, remembers Antonia.
‘We had been initially advised there was an opportunity she may reside however be mind broken, however it was quickly clear that this wasn’t the case…’
Household and shut associates got here to the little woman’s bedside to say goodbye over the following couple of days. Jack and Antonia additionally took the courageous determination to donate her kidneys to assist a stranger. The couple later realized that they had been efficiently transplanted right into a 40-year-old lady.
‘We wish some good to come back out of this tragedy,’ says Jack, merely. Antonia provides: ‘Shedding Lorelei has left us heartbroken. We wish individuals to pay attention to this horrible situation and the devastation it may well trigger.’
