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Did bacterial meningitis cause Helen Keller’s deafblindness?
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In 1882, Helen Keller was struck deaf and blind at age 19 months by a febrile illness that she said her doctors described as “acute congestion of the stomach and brain.” Historical accounts of Keller’s life have speculated that the illness was rubella, scarlet fever, encephalitis or meningitis, but the exact cause of her deafblindness remains a mystery.
According to a modern-day medical analysis of the case, bacterial meningitis is the likeliest culprit.
Writing in Clinical Infectious Diseases, Janet R. Gilsdorf, MD, professor at the University of Michigan Medical School, suggested the longtime social reform advocate was infected with either Neisseria meningitidis or Haemophilus influenzae, another cause of meningitis. According to Gilsdorf, hearing loss is a common complication of bacterial meningitis, and loss of vision was occasionally seen in patients before 1940. Both were more common in younger children than in older children.
“Fortunately, because of the widespread use of vaccines against H. influenzae and [Streptococcus] pneumoniae, along with the use of meningococcal vaccines in at-risk individuals, bacterial meningitis among children in the United States today is rare,” Gilsdorf wrote.
Narrowing down the illnesses
Through research, Gilsdorf narrowed down the potential causes of Keller’s deafblindness. She said rubella encephalitis was “extremely unlikely” because it is rare and nearly always associated with a full recovery. She also ruled out congenital rubella syndrome, which can cause vision loss and deafness, because Keller was reportedly healthy before her illness.
Although a scarlet fever pandemic was just ending at the time of Keller’s illness, Gilsdorf said vision or hearing loss were rarely reported among scarlet fever patients — in fact, the largest report of sequelae did not include a single case of either. Also, Gilsdorf said Keller’s physician would easily have been able to diagnose the bacterial illness.
Keller also was unlikely to have had tuberculosis, pneumococcal or group B streptococcus meningitis because, in 1882, these diseases probably would have killed her, Gilsdorf said.
Likely causes
In a study completed 40 years after Keller’s illness, the mortality rate was 97% among children with H. influenzae meningitis. But Gilsdorf said the disease could have been responsible for her condition “based on the reported sequelae of deafness or blindness among untreated patients and a deafblind child among treated patients” in a study completed in 1949 that explored the effect of various combinations of drugs for H. influenzae infection.
Gilsdorf concluded N. meningitidis was “a credible cause” based on studies conducted in the early 1900s that showed it produced mortality rates up to 80% but also left 12% of survivors deaf and 10% blind while rarely causing intellectual deficits. She noted that Keller’s intellect was “remarkably intact” and that she became an internationally recognized author and lecturer who remained a dedicated advocate for social reform and persons with disabilities until her death in 1968 at age 87 years.
According to Gilsdorf, Keller’s physician expected her to die and told her family that she had “‘congestion of the stomach and brain.’” Gilsdorf called this diagnosis “obscure,” writing that “congestion of the stomach” was a meaningless term and that “congestion of the brain” referred to altered cerebral blood flow.
“If she had meningitis, she very likely would have experienced vomiting from increased intracranial pressure, which may have been interpreted as ‘congestion of the stomach,’” Gilsdorf wrote. “Further, at that time physicians knew that patients who died of ‘brain fever’ had congestion of the cerebral vessels upon autopsy and her doctor may have used the term ‘congestion of the brain’ to reflect the process that he suspected was occurring in her head.” – by Gerard Gallagher
Disclosure: Gilsdorf reports no relevant financial disclosures.
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