Rheumatic fever tests are vital

The clearest image you should keep in your mind when it comes to rheumatic fever should be a barechested Robbie Fruean at rugby training.

There is no starker example of the ravages of this Third World disease and what effect it can have later in life than the ever- smiling Fruean with a huge scar running down the middle of his chest.

The disease – which starts as a cough, develops into a streptococcal infection and can lead to permanent damage to the heart valves – has held the Porirua rugby player back from achieving his All Black dream. He has had heart operations and other symptoms that have interrupted his career.

Throat swabbing and echo screening of children at about year 7 and 8 began in Porirua in 2012, but was shelved this year by the Health ministry.

The small number of children who were diagnosed with rheumatic fever, coupled with the pyschological harm on families when small abnormalities were detected, were the reasons given.

Porirua mayor Nick Leggett and some notable paediatricians have been rightly outraged. Based on the data collected from the trial, there could be as many as 200 young people in the region with undiagnosed rheumatic fever.

To continue the echo screening will cost about $ 40,000, which seems well worth it when you consider the social, personal and economic cost of one child having to go through what Fruean did. Or worse.

Porirua has the worst record with rheumatic fever in the developed world. It’s a disease that hangs around, largely in eastern Porirua, because of overcrowded living conditions and substandard housing.

Places like Opotiki, South Waikato and Manukau have poor records, but Porirua has consistently had the worst numbers of reported cases since 1998.

The number of cases in Wellington trebled between 2004 and 2006, but it took at least six years to address the issue.

At the root of it all is the children’s living conditions. Their homes must be made more livable and drier.

That’s the ambulance at the top of the cliff.

Halfway down the cliff, as maybe a branch hooking the T-shirts of the children who are contracting rheumatic fever, is the echo screening and the throat swabbing.

Caught at that point, cases can be treated.

Right at the bottom of the cliff is the hospital system for the children whose hearts are damaged and who have become part of the system, requiring surgery, hospital stays and the painful flow-on effect that has on families.

The Government needs to continue upgrading the social housing stock. Better housing equals healthier families.

Leggett has sought a report from officers at Capital & Coast District Health Board. It will surely conclude that echo screening for year 7 and 8 children in Porirua must be supported and funded. The report will be worth every penny.

The excuse that the echo screening can sometimes give a ‘‘ false positive’’ and provide families with unnecessary stress is weak. Which parent would not want to know every piece of information, good or bad, that was available about their child’s health?

Surely it’s better to know, than not. In the circumstances, the cost of continuing the echo programme is minimal.