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Charlotte Lucy Cleverley-Bisman (born 24 November 2003) is a child known as the face of a
New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...
campaign to encourage
vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...
against
meningococcal disease Meningococcal disease describes infections caused by the bacterium ''Neisseria meningitidis'' (also termed meningococcus). It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can al ...
after contracting and surviving severe meningococcal
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
. She was nicknamed "Miraculous Baby Charlotte" by her fellow New Zealanders as a result of making headlines worldwide after recuperating from a series of life-threatening complications. She is the daughter of Pam Cleverley and Perry Bisman.


Meningococcal disease in New Zealand

In 2004, New Zealand was in the thirteenth year of an epidemic of
meningococcal disease Meningococcal disease describes infections caused by the bacterium ''Neisseria meningitidis'' (also termed meningococcus). It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can al ...
, a bacterial infection which can cause
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...
and
blood poisoning Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is foll ...
. Most Western countries have fewer than three cases for every 100,000 people each year, with New Zealand averaging 1.5 before the epidemic started in 1991; in 2001, the worst year of the epidemic in New Zealand, the rate hit 17. 5,400 New Zealanders had caught the disease, 220 had died, and 1080 had developed serious disabilities, such as limb amputations or brain damage. Eight out of ten cases were under 20 and half were under 5 years of age. The internationally low proportion of deaths from the disease had been credited to wide publicity of the disease and its symptoms. In June 2004, Charlotte Cleverley-Bisman became the face of the epidemic.


Disease onset

The morning of 17 June 2004, Cleverley-Bisman vomited and was unhappy, but the parents took it as anticipated
teething Teething is the process by which an infant's first teeth (the deciduous teeth, often called "baby teeth" or "milk teeth") appear by emerging through the gums, typically arriving in pairs. The mandibular central incisors are the first primary te ...
pains. By mid-morning she developed a small blemish on her neck, and her mother rushed her to Waiheke Ostend Medical Centre, where staff diagnosed meningococcemia. In ten minutes she was covered with small spots. She was injected with
penicillin Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from ''Penicillium'' moulds, principally '' P. chrysogenum'' and '' P. rubens''. Most penicillins in clinical use are synthesised by P. chrysogenum using ...
, and rushed to
Starship Children's Health Starship Children's Hospital is a public children's hospital in Auckland, New Zealand. Opened on 18 November 1991, it was one of the first purpose-built children's hospitals in New Zealand, and is the largest such facility in the country. Altho ...
by helicopter. Half an hour after the first spots were noticed, she was blistered, swollen, and purple over her entire body, with her extremities blackening. She was not expected to survive, and needed to be resuscitated twice during her first half-hour at Starship. She was connected to life support systems which fed her, transfused blood and drugs, and assisted her breathing. On the second day, Starship doctors said that if she lived at all, Cleverley-Bisman would need to have at least both legs and most of her left hand
amputated Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on indiv ...
in order to save her life from
gangrene Gangrene is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness. The feet and hands are most commonly affected. If the ga ...
. During the three weeks while doctors waited for demarcation between dead and living flesh to become clearer, her
catheter In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
s became clogged several times and needed to be replaced with additional surgery. By the end of June, it was clear that all four limbs would need to be amputated. This was done on 2 July, amputating both legs and left arm "optimistically", through the knee joints, rather than above them, hoping to preserve the
growth plate The epiphyseal plate (or epiphysial plate, physis, or growth plate) is a hyaline cartilage plate in the metaphysis at each end of a long bone. It is the part of a long bone where new bone growth takes place; that is, the whole bone is alive, wi ...
s at the end of the
long bones The long bones are those that are longer than they are wide. They are one of five types of bones: long, short, flat, irregular and sesamoid. Long bones, especially the femur and tibia, are subjected to most of the load during daily activities a ...
, which would allow for better use of
prosthetics In medicine, a prosthesis (plural: prostheses; from grc, πρόσθεσις, prósthesis, addition, application, attachment), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through trau ...
later in life. Cleverley-Bisman's parents helped the case to be publicised nationwide to raise parents' awareness of the speed of the disease, and to highlight the need for a vaccine. Charitable donors gave money to defray their expenses, beginning with NZ$1000 from the Jassy Dean Trust, set up in 1992 after another girl died from meningococcal disease.


Recovery

After two and a half months at Starship Hospital, Cleverley-Bisman was well enough to move to the Wilson Home in
Takapuna Takapuna is a suburb located on the North Shore of Auckland, New Zealand. The suburb is situated at the beginning of a south-east-facing peninsula forming the northern side of the Waitematā Harbour. While very small in terms of population, it ...
,
North Shore City North is one of the four compass points or cardinal directions. It is the opposite of south and is perpendicular to east and west. ''North'' is a noun, adjective, or adverb indicating direction or geography. Etymology The word ''north'' is ...
, for three months of
rehabilitation Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be retur ...
. Wriggling had kept her muscles relatively fit; she was able to roll over, and even put a cup to her mouth without the use of prosthetics. She returned to her home in Waiheke in November, just in time to celebrate her first birthday. As part of her rehabilitation process, she played with toys and exercised on a daily basis. She took her first solo steps using prosthetic legs and crutches in September 2008, and no longer needed crutches by October 2009. In December 2008, then aged five, Charlotte won TVNZ's inaugural Attitude Spirit award.


Later life

By 2010, Charlotte had outgrown her prosthetic limbs and the family made a plea for help. In August 2011, Charlotte and her parents made a fourth trip to Camp No Limits, a camp for children with limb loss that also includes the parents, where she received physical therapy and learned to walk on new limbs. According to ''The New Zealand Herald'' the father stated that "the process would be an annual event, given Charlotte is still growing and therefore growing out of her prosthetics in a matter of a few months." During her 2013 stay at Camp No Limits, Charlotte mentored other young meningitis amputees. By the age of 13, Charlotte took up several sports, such as surfing, skydiving and boxing.


Public awareness and support

During Cleverley-Bisman's hospital stay, donors had given hundreds of gifts and around NZ$60,000 for her care; however, expenses were such that this would last less than a year. Following her hospitalisation, a trust was set up in her name. The primary mission of the trust was to provide for Cleverley-Bisman's life necessities, and the secondary goal of the foundation is to increase awareness of meningitis/meningococcal disease. Cleverley-Bisman's illness and the surrounding interest generated much exposure of the issue of immunisation for meningococcal disease, and her case has been cited as helping spur immunisation drives. As a result of her case, her father has helped publicise the availability of vaccination to help ensure that as many people are vaccinated as possible.


References


External links

*
Vaccine campaign beating meningococcal epidemic
3 July 2006 {{DEFAULTSORT:Cleverley-Bisman, Charlotte 2003 births Living people New Zealand amputees New Zealand children Quadruple amputees People from Auckland