Source: Andrea Vance
Rheumatic fever rates are on the up despite $65 million being
spent on prevention, new figures reveal.
A report by crown research unit ESR (Environmental
Science and Research) shows a "significant increase" in cases
of the disease in the year to September, with 235 notified
acute cases, up 75 on the previous 12 months.
The fever is an inflammation of the heart, which can leave
scarring on valves, and is linked to poverty, poor and overcrowded
housing, and a lack of access to healthcare.
Maori and Pasifika children aged 5-14 years are most
The Government has pumped resources into the combating the
illness with free drop-in clinics, healthy homes initiatives and
public information campaigns, and wants to reduce incidences by
two-thirds by June 2017.
Labour's health spokeswoman Annette King said the Government
was failing with rates of the disease rising in the last three
One child a week, with a heart badly damaged by the fever,
underwent surgery at Starship children's hospital in Auckland, she
Estimates put 140 adult deaths a year down to the illness.
"As former health minister Tony Ryall himself said:
'We are the only developed country in the world with levels of
rheumatic fever you would see in the third world'," King said.
She wanted the Government to tackle the causes.
Acute rheumatic fever is
largely a disease of poverty, overcrowding,
and healthcare inequality," she said.
"Preventing it requires more than throat-swabbing and publicity
campaigns, it requires a health system that provides services that
are accessible for all and a co-ordinated effort to address social
factors that impact on health, such as housing."
Health Minister Jonathan Coleman referred questions to his
Dr Chrissie Pickin, who leads the health ministry's
rheumatic fever programme, said notified cases of acute
rheumatic were not the best way to measure progress on stamping out
"We know that there can be considerable volatility in cases
reported year on year. A case reported in 2014 could have actually
been diagnosed in prior years. Almost a quarter (23%) of the cases
reported in 2014 occurred in earlier years."
Instead, officials focussed on cases where patients were sent to
hospital. "The most recent hospitalisation data available is from
July 2013 to June 2014 and shows a slight decrease. Updated data is
currently being finalised and is expected to show a further
decrease in hospitalisation rates," she said.
Green party health spokesman Kevin Hague echoed King's comments,
saying it was "ridiculous" to set a target to reduce rates while
refusing to put one in place to tackle child poverty.
"Rheumatic fever is a disease of poverty," he said. "The
most deprived kids are almost 30 times as likely to get the
However, he said throat-swabbing clinics were "important" in
improving access to health care.
The ESR figures also show a significant increase in
measles, hepatitis, Hib disease (a flu that affects
children), yersiniosis (a type of gastroenteritis), dengue
fever and chikungunya fever, a viral disease transmitted
By contrast, cases of cryptosporidiosis,
malaria, meningococcal disease, poisoning from toxic
shellfish and salmonella, whooping cough and e-coli infections
were down in the same period.
ESR was also monitoring syphilis rates after the number of
cases soared between 2002 and 2009.
There were 81 reported infectious cases, up from 72 identified
in 2011. Officials noted their statistics came only from
family planning and sexual health clinics and did not include those
treated by GPs and
other healthcare providers.
The report said that between 2011 and 2013 cases were
concentrated among men who had sex with men living in the main
The highest numbers were in Auckland and Christchurch.
In 2013 73 out of the 81 cases were men, with 86.3 per cent
among gay men.
The highest number of cases was in the 45-49 age group. The
report noted concerns that some women remained undiagnosed as most
cases were discovered from health checks and screening rather than
because of symptoms.
Also analysed in the report is an outbreak of typhoid in an
extended family in Auckland. Five people aged between 5 and 63, in
eight homes contracted the disease between November 2013 and March
Recent visitors from Tonga and Samoa had brought raw
fish, sea slugs, cooked yams and raw coconuts.
"The self-reported Pacific foods were recognised as potential
sources of infection for the outbreak," it said.
* 235 cases in the year to September 2014, up from 160 in the
* Three were in children aged between 1-4 years old
* 19 were in children aged between 5-9
* 22 in ages between 10-14
* 34 cases in those aged 15 and over
* 68 cases were acute, 10 were recurrent