The parents of a 10-year old girl who died as a result of a serious Strep-A infection have urged other parents to be vigilant about the danger of the condition.
Vivienne Murphy, from Millstreet in Co Cork, died in March 2019, just two weeks after complaining of a sore throat. The child’s heartbroken parents said the nightmare for the family began on St Valentine's Day 2019.
Her dad Dermot told told RTE's This Week that when he collected his daughter from school he noticed she was more subdued than usual and had less energy. She later started complaining of being unwell and having a sore throat. Dermot and Vivienne's mother Lilly went to attend a funeral that evening but got an urgent call from their son Stephen who was minding his sister, telling them to get home quickly.
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Dermot said: "We both got a bit of a shock. When we opened her shirt and took off her school clothes, we saw this rash." They immediately took her to the out-of-hours GP service where a doctor told them she believed that Vivienne had a viral illness.
After two days they still couldn’t keep her temperature down and returned to the doctor. A second doctor told them she also believed Vivienne had a viral illness, but asked for a urine sample, which Vivienne was unable to provide.
By Monday, Vivienne's condition had not improved and she was brought to the family's GP, who told them she too considered their daughter's illness to be viral. Despite being told the same thing by three different doctors, the Murphys still had their doubts. Lilly said: "We said it can't be, there must be something else, it's been going on for days."
Vivienne's condition then deteriorated further. Dermot said: "We realised she was still getting worse, and the rash was really angry looking. By the evening she had pain and we noticed that her right leg started swelling at the knee.
We were panicking now, and spoke to the doctor we had spoken to originally and told her our child was getting worse not better. We were told this could still be a flu virus, and we explained about the knee, and said the child couldn’t stand at all."
The doctor advised the family to bring their daughter to the emergency department later that night or in the morning, if they were not happy. Vivienne's mother recalled: "Later on that night we carried her up the stairs to her little room, and the two of us were in the room with her and she was just miserable, and we said there something not right, let's just go."
Dermot carried the child down the stairs, put her in the car, and headed for Cork University Hospital (CUH). When she was examined it was noticed that there was a black mark on her leg.
Lilly said: "The nurse said, 'What's that?'" And we said: "We don't know. She went into a panic mode, and called the doctor who came and asked us if she had fallen, and we said 'no.'"
Lilly said the medical team at CUH carried out a blood test on Vivienne, and when the results returned "all hell broke loose". She said: "They were showing us numbers, and we were looking at the nurse, and the nurse said 'your daughter is critically ill'."
Dermot noticed that the black mark on Vivienne's leg was getting bigger. "The doctor marked it with a skin marker, but we could see it was growing outside the mark."
"We [were told] at that stage the black mark meant that Vivienne had sepsis and was going into shock," said Lilly, who wanted the doctors to operate on their daughter to stop the infection.
The black mark indicated the presence of a disease called necrotising fasciitis, a rare bacterial infection that spreads quickly through the body, which can cause death. It is sometimes referred to as the 'flesh-eating disease'.
Dermot said: "We knew then that something really bad was going on, the black mark was moving up her body."
The Murphys were prepared for doctors to amputate their daughter's leg if it meant her life could be saved, but they were told that surgery could not be done in Cork because there was no Paediatric Critical Care Unit at Cork University Hospital to care for her after surgery.
They were told Vivienne would have to be taken to Temple Street in Dublin for an operation. "That took hours. We had to wait for an ambulance to come from Dublin with specialists to look after her. It took ages," said Lilly.
As Vivienne's condition deteriorated, doctors decided to put her under anaesthetic. Lilly and Dermot recall the final words she spoke before she was made unconscious. Dermot recalled: "She said 'thank you, nurse, I'm sorry for crying. I know you're only trying to help me'.
"That was the dignity she had. They were her last words on this planet. She had so much empathy. The world is a sadder place without her."
Vivienne was transferred to Temple Street in a specialist ambulance. Her parents had to travel separately by car. On the road, they received a phone call from the medical team who told the Murphys that if Vivienne had any chance of survival they would have to operate, and they asked if they could have permission. "I said go ahead, just take care of her," said Lilly.
At Temple Street, they waited for news of her surgery. Dermot explained that the surgeon met them at about 11 pm that night and told them what happened. "The words he told us were shocking.
"He said I think I have stopped the disease from spreading, but I had to cut away 17 per cent of your daughter's body. When I heard 17 per cent... I thought when we were in Cork we would probably have got away with 1 per cent, the black mark, cut it out there.
"17 per cent is burned into my brain. The disease had gone where we thought it would go, it had gone up her leg, onto her buttocks, across her abdomen, and it had slowly started creeping down her left leg."
The Murphys said the black mark started out as Strep A, which led to sepsis, which led to shock, and that led to necrotising fasciitis. But the extent of the surgery, and the disease she had battled caused her heart to stop beating, and she went into cardiac arrest.
Dermot said: "There was an alert put out for us to come quickly to her bedside. We ran into the room. There were six or seven nurses there, doctors, professors. The head professor was there, and they were trying to bring her back, and they're pumping and pushing and trying hard to save Vivienne and he was really going hard."
"At one stage he turned to Lilly and me, and said: 'Parents scream at your daughter, call her back! Call her back! Bring her back!' And Lilly started screaming, please come back to us, please come back to us, and it went back a long time, and he said 'call her - she will know your voice'."
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"And she did come back to us. And we thought wow - we have her." But, because of the cardiac arrest, Vivienne suffered brain damage and after tests the parents were told that their child was brain dead.
"It was the longest night of our lives," said Lilly. "Then they told us that she was brain dead, and there was no hope."
Lilly said the decision to end Vivienne's life support was made because they wanted to protect her dignity. However, the final moments of Vivienne's life were among the most distressing they experienced.
"The poor little thing kept fighting, it was 35 or 40 minutes, and even then, she came back again. It was torture, on top of torture, on top of torture."
"It was shocking, one day we are begging her to stay alive, the next day we are begging her to die."
Since their daughter’s death on March 1, 2019 her parents said they experience the lowest depths of despair every day but they are determined to make people aware of the dangers of Strep-A. They said: "If your child has a fever, or a rash, be vigilant, these things can change so quickly. Our daughter started off with signs and symptoms and within ten days she was gone.
"We are just begging and pleading that parents look out for these things, don’t be submissive, and don’t ever think that you are being an overreacting parent, because you are not."
In a statement to RTE, the HSE said that it wanted to express its deepest sympathy to the Murphy family for the loss of Vivienne but that it could not comment on any individual case.
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