Rheumatic fever fears

Leggett wants screening of Porirua children to be resumed

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.