Evan Bozof, a healthy baseball player and pre-med student at Georgia Southwestern University, thought he was suffering from a migraine when he called his mother one afternoon in 1998.
Just 26 days later, the 20-year-old was dead. Meningococcal meningitis had ravaged his body — both his legs and arms had been amputated, he had lost all liver and kidney function and seizures finally caused irreversible brain damage.
A vaccine for the rare, but deadly disease has been around since 1971, but his parents had no idea he could have been saved.
"You've already lost your child," said his mother, Lynn Bozof, of Marietta, Ga. "You can't go back and rewind the tape. It wasn't on the health forms. We didn't know and other parents did not know either. So we got started to raise awareness of the disease and its symptoms."
After her son's death, Bozof founded the National Meningitis Association and has been tirelessly working to promote universal vaccination and education about the disease that primarily affects otherwise healthy college students.
"It's relatively rare, but a scary disease," said Curtis Allen, a spokesman for the Centers for Disease Control and Prevention, which in June recommended that all children ages 11-18 and college freshmen be vaccinated for this highly infectious disease.
Meningitis is an inflammation of the membranes and cerebrospinal fluid surrounding the brain and spinal cord. In the past, most meningitis cases occurred in children younger than 5 years of age. As a result of the protection offered by current childhood vaccines, though, most meningitis cases now occur in young people between the ages of 15 and 24.
The cause of most cases of meningitis is a viral infection, but bacterial and fungal infections also can lead to meningitis. Evan contracted so-called "bacterial" meningitis, which is far more dangerous than the viral form.
There are 1,400 to 2,800 cases of bacterial meningitis each year in the United States. The death rate — around 13 percent — is more than 20 times higher than measles, the No. 1 childhood killer worldwide, according to the CDC.
Of those who survive, up to 20 percent can have serious medical consequences like deafness, neurological disorders and loss of limbs.
Those living in close contact in dormitories and lifestyle choices that compromise the immune system — like drinking and smoking — can make students vulnerable to the disease, which is transmitted by saliva, either by sneezing, coughing or kissing.
For bacterial meningitis, treatment must begin quickly, because, as in Evan's case, a delay of only a few hours can be deadly. Often, as in his case, it is initially misdiagnosed because of its flulike symptoms: high fever, headache, nausea, vomiting and a stiff neck.
"Evan was the picture of health," said his mother, "but that day, he didn't want to go to baseball and he never missed a game."
As Bozof checked in on Evan throughout the afternoon, his headache got worse and he began vomiting. She told him to go to the emergency room, "but they told him he had nothing to be concerned about and kept him overnight."
By morning, Evan was in the intensive-care unit with a 5 percent chance of survival. He fought the disease in three different hospitals. In the end, 10 hours of grand mal seizures caused irreversible brain damage and his parents took him off life support.