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The late Madison Small

Over two years ago, our daughter, sister, and friend, Madison Small, died from meningitis, just shy of her high school graduation. Madison was the picture of health and vitality, and had spent the weekend practicing softball with her dad. On Monday, Madison started to experience some flu-like symptoms, and by Tuesday she was gone.

Madison was the kind of child that every parent hopes to have. She was kind, thoughtful, intelligent, and hard-working. She was heading to Virginia Tech in the fall, and was a four-year varsity softball player for the Broad Run High School Spartans, a National Honor Society member, a great student and active in many school and community organizations. The world was a much better place with her in it.

Since Madison’s sudden death, our family has been dedicated to raising awareness about the dangers of meningitis so that other families do not have to experience the nightmare of losing a child. We have held seminars, walks, and rallies to educate students, their families, and university officials about meningitis and the importance of vaccination to stop the spread of this deadly disease.

Meningitis is an infection of the meninges – the protective membranes that cover your brain and spinal cord – that results in swelling of the brain. Although initial symptoms may present as the flu, the disease can turn deadly within hours. For others, meningococcal disease can have serious or permanent consequences such as brain damage, hearing loss, or loss of limbs.

Meningitis is spread person-to-person through respiratory or throat secretions, such as those transmitted via coughs, kissing, and sharing drinks or utensils. Activities that involve close contact, like participating on a sports team, or living in close quarters, like college dorms, can also put adolescents at increased risk.

The U.S. Centers for Disease Control (CDC) estimates that the fatality rate for meningococcal disease is between 10 and 15 percent, and as many as 19 percent of survivors suffer permanent complications, even when promptly treated. According to the CDC, there are about 4,100 cases of bacterial meningitis reported each year, and approximately five hundred of those cases result in death.

We do not know exactly how Madison contracted meningitis, but we do know that other kids her age – and their parents – should be aware of the disease and what can be done to help prevent it.

Fortunately, there are safe and effective vaccines available to help protect against all strains of meningitis, including meningitis B. The best way to stop the spread of meningitis is by preventing it in the first place, which is why it is so important to make sure our teens are up-to-date on their vaccines and any booster doses of older vaccines.

Our family has devoted countless hours stressing the need for these vaccines and boosters. We have worked with James Madison University (JMU), where there was a case of bacterial meningitis last year, to help educate students and the administration and raise awareness around the dangers of meningitis and to encourage them to get vaccinated against all strains of the disease. Because of our work and that of other health advocates, JMU has since updated their immunization form to include meningitis B as a recommended vaccination. We urge all Virginia colleges and universities follow JMU’s lead.

As we head into the back-to-school season, Virginia families with a teen or college-aged student in the house should have a conversation with their health care provider about the most appropriate vaccine schedule to help protect against meningitis B.

No family should have to experience the sudden loss of a child. Because of the available meningitis vaccines, fewer families will have to.


Rachel Small is Madison Small’s mother and Jordan Small is her sister.


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