Rheumatic fever fears

Leggett wants screen­ing of Porirua chil­dren to be re­sumed

Kapi-Mana News - - FRONT PAGE - By KRIS DANDO

Porirua chil­dren could be walk­ing around with a time­bomb in their chests un­less screen­ing for rheumatic fever is re­sumed, says Nick Leggett.

The Cap­i­tal & Coast Dis­trict Health Board mem­ber and Porirua mayor said at a board meet­ing on June 12 there were ‘‘at least 200’’ peo­ple walk­ing around the dis­trict health board catch­ment area with po­ten­tial se­ri­ous heart dis­ease be­cause of un­di­ag­nosed rheumatic fever.

The dis­ease starts with a strep­to­coc­cal in­fec­tion, has symp­toms of sore or swollen joints and can cause per­ma­nent dam­age to heart valves. Poverty and over­crowded and sub­stan­dard hous­ing are root causes.

Porirua has the high­est rate of rheumatic fever in­ci­dents in the de­vel­oped world, ac­cord­ing to re­cent sta­tis­tics, and there is no sign of im­prove­ment.

A $40,000 echo screen­ing pro­gramme for rheumatic fever was tri­alled on 621 year 7 and 8 Porirua chil­dren in 2012. It de­tected eight cases.

But it was shelved this year when Health Min­is­ter Jonathan Coleman said the screen­ing could pick up less se­ri­ous heart ab­nor­mal­i­ties, up­set­ting some fam­i­lies.

A fo­cus on preven­tion was nec­es­sary in­stead, Min­istry of Health act­ing chief med­i­cal of­fi­cer Dr John Crawshaw said.

At the dis­trict health board meet­ing, Leggett said the echo screen­ing had to con­tinue.

‘‘The eight cases de­tected in the trial were not bor­der­line cases. These are real kids in our com­mu­nity, not just sta­tis­tics,’’ he said.

He called for an ur­gent re­port on the im­ple­men­ta­tion of an echo screen­ing pro­gramme for year 7 and 8 chil­dren in decile 1 to 3 schools in the dis­trict health board catch­ment, and he re­ceived unan­i­mous sup­port.

It was im­por­tant to in­clude data on re­port­ing rates for Maori and Pa­cific chil­dren – who are 23 per cent and 50 per cent more likely to catch rheumatic fever than other eth­nic groups – and up­date it against gov­ern­ment ac­tions such as im­prov­ing hous­ing and other so­cial con­di­tions, Leggett said.

Later, he said he didn’t ac­cept the po­ten­tial pyscho­log­i­cal risk of a ‘‘false pos­i­tive’’ from the screen­ings, be­cause of the mag­ni­tude of risk in­volved.

‘‘Some­thing is needed, be­cause the pre­vi­ous pro­gramme was not work­ing. Un­de­tected and un­treated, this dis­ease has high per­sonal, so­cial and eco­nomic costs.

‘‘Mea­sure the $40,000 a year against a child hav­ing time in hos­pi­tal, a costly op­er­a­tion and a less pro­duc­tive life,’’ he said.

Pae­di­atric sur­geon Bren­don Bowkett fully sup­ported a re­newed screen­ing pro­gramme.

He said rheumatic fever cases in the Welling­ton re­gion tre­bled be­tween 2004 and 2006, but it took till 2012 for the Gov­ern­ment to ad­dress it.

‘‘If a pro­gramme goes ahead it will need to be watched closely. If the find­ings are proven to be cor­rect, kids who have al­ready passed that year 7 and 8 stage will need to be con­tacted,’’ Bowkett said.

Leggett said a fo­cus on Porirua schools was too lim­ited, be­cause some Porirua chil­dren trav­elled out­side the city to school.

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