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Hey Prime members, you can binge episodes 41 through 48 of Mr. Ballin's Medical Mysteries right now and ad-free on Amazon Music. Download the app today. Early one winter morning in 2000, an elementary school principal in Massachusetts walked into her office to prepare for the day when her phone rang. When she picked up, the state health official on the other end of the line had alarming news.
Two of the principal students had been rushed to the hospital the night before with the same life-threatening condition. Even worse, their disease was totally contagious and the two girls had attended the school the day before, meaning any students or teachers they interacted with could now also be sick.
The principal couldn't believe what she was hearing. She had 550 kids due to arrive at school in less than an hour. She knew how quickly contagious diseases could spread through a group of kids, and so containment would be nearly impossible, and it was too late to cancel school for the day.
The principal jumped up from her desk and jogged down the hall to find the head custodian. When she found him, she told him to round up his team and get to work. They had to do everything they could to minimize the spread of this disease, from disinfecting the cafeteria, to deep cleaning the bathrooms, to shutting down water fountains, whatever they had to do.
Then, the principal was speedwalking back to her office when she heard the shrill alarm of the morning bell. Then, she heard the heavy metallic sound of the front doors opening, followed by the dull roar of students surging into the building for the day. The principal tried not to panic, but she knew these students and the teachers might all be walking into a catastrophe.
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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you liked today's story, please ask the follow button to go shopping with you. But then when you go inside your first store, immediately point at the follow button and start screaming, Thief! This episode is called After the Bell.
On the afternoon of March 2nd, 2000, Kayla St. Pierre could barely keep her eyes open as she sat in class at her elementary school in Lawrence, Massachusetts. Her throat felt scratchy and her limbs felt like lead, and it took all of 10-year-old Kayla's concentration just to understand what her teacher was saying.
Kayla had woken up that morning feeling foggy and run down, but she went to school anyway because she hated to miss class. She toughed it out through a pop quiz, then PE class and lunch, but now she was fading fast. Her eyes drooped and suddenly there was a hand on her shoulder. It was Kayla's teacher gently shaking her awake. The teacher told Kayla that she needed to go see the nurse, and inside, Kayla actually felt really relieved.
Kayla stumbled out of class and shuffled down the hall to the nurse's office. She didn't understand how she could be so tired, and when she saw the nurse, she asked if she could just go home and go to bed. The nurse checked Kayla's pulse and took her temperature, then told Kayla she was going to call her mom. Kayla nodded and then curled up on her side on a cot against the wall, and she nodded off. She woke up to the sound of her mom in the hallway talking with the nurse about how Kayla might have the flu.
Kayla tried to sit up to hug her mom when she came in the room, but her body felt too heavy. So, Kayla's mom helped her to her feet, and then Kayla sort of held on to her mother as they left the school and went out to the family car. As they drove home, Kayla's mom tried to reassure her that everything was going to be fine. At home, Kayla dropped onto the couch and pulled a blanket up to her chin. Her mom turned on cartoons, gave her some aspirin, and went to warm up some soup as Kayla fell asleep again.
When Kayla opened her eyes several hours later, she was still on the couch, but the TV was off and her mother had tucked her in with a fluffy blanket and her favorite pillow. Kayla threw off the blanket so that she could go upstairs to her own bed, but something strange caught her eye. Now that the blanket was off of her, she could see that she had these bright purple spots all over one of her arms. She blinked and looked closer. They were small and dark and there were dozens of them.
As Kayla's eyes adjusted to the darkness, she suddenly noticed that her legs were covered in these purple spots too. Something was obviously wrong with her, and so she tried to yell out for her parents, but only a tiny whisper came out. She could barely make a sound. Then Kayla tried to get off the couch to go find her parents, but her legs were like jelly. She tried to wiggle her toes, but she couldn't. They didn't move. And so Kayla really began to panic as she lay there frozen.
Using all her strength, Kayla did finally slide off the couch and onto the carpet, and from there she crawled her way across the room and up the stairs and all the way into her parents' room. Once she was in there, Kayla couldn't stand and she basically couldn't speak, so she just laid there on the floor in her parents' bedroom, banging her fist against their bed frame.
Kayla's mom was initially confused about where this banging sound was coming from, but then she looked over the edge of her bed to find her daughter lying there on the floor. Kayla's mom asked Kayla, you know, what are you doing down there? Kayla looked up at her mom and even though she couldn't say the words, she mouthed the words as clearly as she could that she needed to go to the hospital.
Suddenly, Kayla's mom and her dad, who was awake at this point, both realized that their daughter was in great danger and they dove into action. Turning on lights, throwing on clothes, grabbing car keys. Kayla's mom grabbed Kayla's shoes and crouched down and put them on her because Kayla couldn't move at all. And by this point, Kayla was just crying hysterically because she was so scared. She had never been this sick before. And then Kayla felt her dad pick her up and he carried her down the stairs and put her in the backseat of the car.
Then, moments later, Kayla's parents were in the car too and they were on their way to the hospital. And as they drove, Kayla just hoped that whatever was going on with her was like all the other times she'd been sick. That a doctor would soon figure out what was wrong, they'd give her medicine, and her life would go back to normal. As Kayla's family was racing toward Lawrence General Hospital, Dr. Michelle Harris was filling out the medical chart for a 10-year-old girl named Teralyn who had been brought to the same hospital a couple of hours earlier.
Terilin's symptoms were very serious and very strange. She had a 105 degree fever, she had intense fatigue, and she had a purple spot on her shoulder. Dr. Harris had started her on antibiotics and ordered full blood work. She hoped once the tests came back that she'd have a better idea of what was going on with her young patient. Once Dr. Harris was done with the paperwork, she headed to the break room to get a cup of coffee, something she desperately needed when she worked overnight shifts in the emergency room.
But before she could take her first sip, a nurse flagged her down. A new patient named Kayla St. Pierre had just arrived in the ER and Dr. Harris was needed immediately. Dr. Harris thanked the nurse and quickly went to the ER where she found Kayla in a sweaty pale heap on a bed. Her parents stood on either side of her looking terrified and exhausted.
Dr. Harris introduced herself and asked Kayla how she was feeling, but Kayla could barely turn her head to look at the doctor. She mumbled that her body hurt and her arms and legs felt weird. Dr. Harris pushed up the sleeves on Kayla's hospital gown to get a better look at her, and when she did this, Dr. Harris did a double take. Her arms were covered in purple splotches, sort of like that one purple dot that was on her other patient's shoulder, Terralyn.
Dr. Harris studied the markings on Kayla's arms and her legs more closely and realized that she recognized the condition from medical school. These splotches were a type of blood vessel disorder called purpuric lesions, and they typically appeared in patients whose bodies were fighting off some sort of serious infection.
Next, Dr. Harris examined Kayla's hands and feet. They were cold to the touch and darker than the rest of her body, indicating poor blood circulation. Dr. Harris checked Kayla's fingers, wrists, toes, and ankles, but couldn't find a strong pulse anywhere. Dr. Harris had a sinking feeling as she recognized what was happening to this young girl. She took Kayla's parents aside and told them that Kayla's symptoms all pointed to a rare, fast-moving condition called meningococcal meningitis.
Kayla's parents did not know what this disease was, so Dr. Harris spelled out the dangers that now lay ahead for Kayla. Meningitis happens when bacteria invades the membrane that protects the spinal cord and the brain. From there, the bacteria can spread into the bloodstream and trigger a runaway infection called sepsis. The purple splotches on Kayla's skin suggested that that was already happening, and if this was left untreated, meningococcal meningitis could be fatal.
Dr. Harris told Kayla's parents that the most important next step was to determine how advanced this infection was. To do that, Kayla would need something called a spinal tap, which would allow the doctors to actually see the fluid in her spine. Kayla's parents looked completely overwhelmed by what Dr. Harris had said and they clung to each other for support. But they both nodded and told the doctor to do whatever she had to to save their daughter.
Less than an hour later, Dr. Harris delicately pulled back the plunger on a syringe stuck between two bones of Kayla's spine. The girl's spinal fluid began trickling into the syringe and then through a plastic tube on its way to a vial that would be sent to the lab for analysis.
And the moment Dr. Harris saw the liquids swirling into the vial, she knew this was a bad case. Kayla's spinal fluid was cloudy, not clear like it was supposed to be. Cloudy cerebrospinal fluid was a sign there was a serious infection in the body, which was exactly what Dr. Harris feared.
Dr. Harris handed the vial to a nurse to bring down to the lab, but to be honest, the patient herself had already told the doctor all she needed to know. Kayla was clearly getting weaker and more exhausted, and her fingers and feet were turning even darker. If Dr. Harris didn't act fast, they could lose Kayla in just the next few hours.
Dr. Harris glanced out the window and saw there was barely a hint of sunrise out on the horizon. Dr. Harris then told a nurse to bring her antibiotics, blood pressure medication, and an intubation tube, which would pump extra oxygen into Kayla's lungs. Dr. Harris hoped all these together would help get more blood to Kayla's fingers, toes, and organs.
But Dr. Harris knew that all these measures alone would not be enough to save Kayla. Dr. Harris took Kayla's parents aside again and told them that she thought it was time for Kayla to be transferred to Boston Children's Hospital, one of the country's leading pediatric medical centers.
It was always risky to move patients in such a fragile condition, but given Kayla's rapid decline, Dr. Harris felt like there was no other choice. And the doctor told Kayla's parents some very sobering news. She said they had to move quickly because their daughter very likely only had about a 10% chance of surviving the next 24 hours. When Kayla's mother heard this, she lowered her face in her hands and began to cry.
Once Kayla was safely loaded into the ambulance for the ride to Boston early on the morning of March 3rd, Dr. Harris said goodbye to Kayla and Kayla's parents and then hurried back to check on her other young patient, Terralyn. Dr. Harris hoped she was holding up better than Kayla. But as soon as Dr. Harris stepped into the hospital room, she could see that Terralyn's condition had actually worsened. She looked at the monitor and saw that Terralyn's heart rate was now much higher than it was before and her blood pressure had dropped dangerously.
Dr. Harris pulled back the neckline of Terralyn's hospital gown to check that purple spot on her shoulder, and she could see that there were now many more spots. In fact, Terralyn's entire body was now covered with these alarming bruise-like spots. And so Dr. Harris had no doubt that Terralyn and Kayla were suffering from the same disease.
Dr. Harris felt both worried and confused to have two young patients with meningococcal meningitis on the same night. The entire state of Massachusetts only reports about 75 cases of this disease in the entire year. Two cases in the same night at the same hospital just could not be a coincidence.
Dr. Harris worried that these two cases might just be the first in a whole wave of cases because of how easily meningococcal meningitis spreads. Just coughing or sharing a drink or snack or even just being close to someone carrying the bacteria is enough to spread it.
Both girls' parents had told Dr. Harris that their daughters had attended school the day before they got sick, and they both attended the James F. Hennessey Elementary School, which meant any number of students and teachers and staff at the school could now also be infected. And so Dr. Harris realized the time had come to sound the alarm. So she ran to her office and she dialed the number for the Massachusetts Department of Public Health. Mr. Ballin' Collection is sponsored by BetterHelp.
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Sign up for a $1 per month trial period at shopify.com slash mrballin, all lowercase. Go to shopify.com slash mrballin to take your retail business to the next level today. shopify.com slash mrballin That same morning, Dr. Charles Dayton was still at home getting dressed when the phone rang. It was one of his assistants at the Department of Public Health.
Two girls had been rushed to Boston Children's Pediatric Intensive Care Unit during the night with life-threatening cases of meningitis. Both girls went to the same school in Lawrence, Massachusetts, and they had both attended school the day before they got sick. The thought of hundreds of kids catching and spreading a potentially fatal disease made Dr. Dayton's heart start to race. But he had faced enough urgent healthcare crises before to know that worrying about them didn't help anybody.
He needed to take swift action, especially since school started in just 90 minutes. Dr. Dayton dialed the number for James F. Hennessy Elementary School and asked to speak to the principal. When the principal hopped on the call, Dr. Dayton explained the situation as calmly as he could manage, but the principal was obviously still alarmed to learn that two of her students were gravely ill with a contagious condition.
The doctor told the principal that he would need to know more about Kayla and Teralyn. Once he understood how these girls were connected beyond just going to the same school, he could begin to figure out how they had both contracted the meningococcal meningitis bacteria. Comparing the schedules of the girls would also help determine who they came into contact with and therefore who was at greater risk of now getting sick.
The principal put Dr. Dayton on hold while she went to get the girls' files. Moments later, she came back on the line with surprising news. Kayla and Teralyn had almost no contact in school. The girls were in different grades, so they had no classes in common, and they also took lunch and recess at different times. Except for possibly passing each other in the hall, it didn't seem like their paths ever crossed during a normal day of school.
Dr. Dayton was puzzled. If Kayla and Terrellyn were never together, then how did they both get infected with the same deadly bacteria? The doctor would have to investigate more thoroughly later, but for now, he had more pressing concerns, such as preparing a school for the arrival of 550 students, some of whom might already be carrying a deadly, highly contagious infection. If he had received the news earlier, Dr. Dayton would have considered ordering the school closed, but it was too late for that.
It would cause too much chaos. For now, it was best to take normal safety precautions. Dr. Dayton told the principal to have all the bathrooms scoured and disinfected and the water fountains turned off. Then he asked the principal to send his office a master class list so the doctor and his team could try to figure out who had come into closest contact with Kayla and Terralyn.
After Dr. Dayton hung up, he quickly finished getting dressed, then drove to his office at the health department. By the time he got there, his team was already assessing the student list that the principal had sent over, and they had discovered that 82 students and 7 teachers shared classrooms or facilities with either Terrolin or Kayla. All of them were flagged as potential carriers of meningococcal meningitis.
Dr. Dayton told his team to contact the parents of all 82 students and advise them to take their kids to a pediatrician so they could get antibiotics. Then he called the principal back and told her that all seven teachers who had taught Kayla and Terrolyn needed to be dismissed for the entire day and remain off campus until they'd been tested for meningitis.
As word of the meningitis scare trickled out into the school community, Dr. Dayton's phone rang constantly with calls from parents wanting more information. He explained as best as he could and he reassured them that if their kids took the recommended antibiotics, they'd be fine. But later that afternoon, Dr. Dayton began receiving a different type of call. Local pharmacies were contacting him to warn that they had sold through their entire stock of antibiotics.
Parents kept showing up, but there was nothing for the pharmacies to give them. At the crack of dawn the next day, Dr. Dayton's cell phone rang. It was a colleague from the state health department confirming that the state had just ordered an emergency shipment of antibiotics for Lawrence area pharmacies. A fleet of trucks had just left their warehouses loaded with drugs to fight off meningitis.
Dr. Dayton spent a long day at his desk confirming deliveries of antibiotics but also fielding calls from local reporters who had found out about the meningitis cases from parents in the area. Dr. Dayton did his best to spread a message of confidence that the situation was under control, but in reality, he didn't actually know if it was.
On the morning of March 5th, so three days after Kayla St. Pierre first got sick, Dr. Dayton got a call he'd been dreading. It was a doctor from a nearby hospital calling about a young girl who had been brought to their emergency room in the middle of the night and her lab reports had just finished processing and the doctor could now confirm that she had meningococcal meningitis.
Then the physician said something else that alarmed Dr. Dayton even more. Although this third girl with meningitis was from Lawrence, Massachusetts, she actually went to a different school than Kayla and Terrilyn. This meant that the meningitis was spreading to a new pool of victims. Dr. Dayton feared what might come next. A third school? A fourth? Then spreading to other towns and maybe even across state lines? Who knew how far this could go?
Now, it was Sunday, but Dr. Dayton knew he couldn't wait for Monday to take action. So he thanked the doctor, hung up, and then quickly called an emergency weekend meeting at the health department headquarters in Boston, Massachusetts. Once Dr. Dayton got to his office, he pinned a map up showing the two schools up on the wall.
He paced the room wondering how Kayla and Terilin could have caught the same bacteria despite not sharing any classes or activities. And now there was this third girl from a totally different school who had somehow caught the same bacteria. And so the only explanation that made sense was that these three girls had something in common, just nobody knew what it was yet.
Dr. Dayton stared at the schools on the map, lost in thought. Then an idea occurred to him: if the girls hadn't interacted at school, what if they knew each other outside of school? Dr. Dayton told his team to contact the parents of all three girls and find out every extracurricular activity they were involved in, from sports to neighborhood groups to Girl Scouts. Dr. Dayton felt certain there had to be some social thread connecting them, and if they could find it, then they had a chance to contain the outbreak.
The next morning, Dr. Dayton was working in his office when he got word that another girl from a city near Lawrence had just been admitted to the hospital with a 104-degree fever. And after taking a spinal tap, a doctor confirmed her diagnosis. She too had meningococcal meningitis. Dr. Dayton slumped in his chair. This was the fourth case in four days with no end in sight.
Dr. Dayton desperately needed to find the source of the infection, but every new patient made the puzzle more complicated. The third girl was from a different school than Kayla and Teralyn, and now today's girl, the fourth girl, was from a different community altogether. Dr. Dayton still felt like all of these girls must be connected somehow. He just needed to figure out what the connection was, and he needed to find it fast.
Dr. Dayton called his team together again for another brainstorming meeting. To him, the biggest clue was the fact that all four girls had gotten sick within a very small window of time, which suggested they might have been exposed around roughly the same timeline.
He also knew that meningococcal meningitis can take about two weeks until victims begin to show symptoms, which meant all these girls were likely exposed roughly two weeks earlier. So Dr. Dayton called in his best research assistant and told him to find out what each of the four girls were doing 14 days ago.
As his research assistant left to get started, Dr. Dayton's phone rang yet again. It was Kayla's doctor at Boston Children's Hospital, and he had some very upsetting news. The majority of Kayla's fingers and toes had been without a proper blood supply for so long that the tissue inside had died, and it looked like they would have to amputate them.
Dr. Dayton thought for a moment about poor Kayla. Less than a week ago, she was probably roller skating and riding her bike like any healthy 10-year-old, and now she was about to become permanently disabled. And the possibility that this might happen to even more kids on his watch made Dr. Dayton almost nauseous. Later that afternoon, there was a knock on Dr. Dayton's office door. His research assistant came in, and to Dr. Dayton's surprise, the assistant looked excited.
He said he had just discovered a very strong lead. It turned out all four girls were part of the same local girls club. Not only that, but exactly two weeks ago, three of the four girls had taken a girls club field trip together to go see Disney on Ice in New York City. Dr. Dayton felt so excited that he nearly cheered. This had to be where the girls were infected, but he still needed to find out how they had transmitted the bacteria to each other.
He stood up, grabbed his car keys, and went to find out. Less than an hour later, Dr. Dayton parked at Boston Children's Hospital and hurried inside. Three of the four girls were there. Kayla's case was the worst, and she had actually just been put into a medically induced coma. Doctors had decided this was her body's only chance to fight back against the disease.
Dr. Dayton went to Terrolyn's room and found her lying on her side flipping through a magazine. She looked pale and weak, but her vitals were stable. Dr. Dayton asked her about the trip to New York. Terrolyn sat up in bed and smiled at the memory.
She described how fun the long bus ride there had been and how exciting it was to cross the bridge into the city seeing it all lit up at night. Dr. Dayton asked if the girls had brought snacks or drinks along or if maybe they had stopped at some point to buy them. He assumed the bacteria had likely spread through something the girls had consumed. But Teralyn shook her head. She said they had been too excited to eat or drink anything. Besides, they hadn't wanted to spill anything on their outfits since they had dressed up in their favorite clothes.
Dr. Dayton was puzzled. If the girls hadn't shared any food or drink, then how did the bacteria spread? Terrell and told him that as their bus approached Madison Square Garden, where the show was going to take place, that she and the other girls had fixed their hair and touched up their appearance to get ready.
When Dr. Dayton asked her to describe exactly what they'd done to get ready, Terrolin mentioned something that really caught the doctor's attention. He asked a few quick follow-up questions to confirm some details about this thing she had mentioned, but as he scribbled down everything she was saying, he felt like this has to be it. This had to be the source of the sickness. Finally, Dr. Dayton thanked Terrolin and then hurried to the lobby to call his office and tell them that he'd just found the cause of the outbreak.
For the next two weeks, Dr. Dayton kept waiting for his phone to ring with news of another case. But it never happened. After 14 days with no new cases, Dr. Dayton knew the scare was over. He felt both relieved and exhausted. It would turn out his hunch had been correct. All four cases of meningococcal meningitis were due to a single isolated event.
Right before the Disney on Ice performance, Terralyn, Kayla, and one of the other girls had shared a tube of sparkly lip gloss to look extra glamorous for the night. And that lip gloss was contaminated with the meningococcal meningitis bacteria. Most likely, the one sick girl who was not on the field trip had also used that same tube of lip gloss sometime shortly before or after.
Although Dr. Dayton was grateful to have identified the bacteria's source, he was left with one question unanswered: how the bacteria got on the lip gloss in the first place? Now, Dr. Dayton was never actually able to determine this for certain, but he guessed that someone who did not know they had meningitis must have used that lip gloss at some point. Some people carry the bacteria without ever actually getting sick themselves, even though they can spread the disease.
But the bacteria was there, living on that tube of lip gloss, until the fateful day it was passed around before Disney on Ice. Three of the girls would make full recoveries, but unfortunately Kayla would lose both her legs, eight of her fingers, and all function in her kidneys. She underwent 50 operations and was bedridden in multiple hospitals for 11 months.
But thanks to a successful kidney transplant, Kayla's body did finally begin healing and today she actually works with the National Meningitis Association helping educate others about the dangers of the disease that took so much from her.
Hey, Prime members, you can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad-free on Amazon Music. Download the app today. And also, Wondery Plus subscribers can listen to Mr. Ballin's Medical Mysteries ad-free. Join Wondery Plus today. Before you go, tell us about yourself by completing a short survey at listenersurvey.com. From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin.
A quick note about our stories: we use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research. And a reminder: the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
This episode was written by Britt Brown. Our editor is Heather Dundas. Sound design is by Ryan Patesta. Our coordinating producer is Taylor Sniffen, and our managing producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson. For Ballin Studios, our head of production is Zach Levitt. Script editing is by Scott Allen and Evan Allen.
Our coordinating producer is Matub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapondo. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Moore. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery.
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