Rheumatic fever rates in Northland: "It's so sad"

Northland doctors say the Ministry of Health's one-year audited figures were underestimated by half the actual burden of rheumatic fever in the region.

The results of their study are published in this day's issue of Medical Journal of New Zealand.

Rheumatic fever is an autoimmune disease triggered by Strep A infection, often but not always a sore throat. The disease can sometimes progress to the stage where the heart is damaged.

Last year, 171 people were hospitalized for the first episode of rheumatic fever, a national rate of 3.6 cases per 100,000 population.

For their research, physicians at the Northland District Health Board audited local rheumatic fever registries from 2012 to 2017 and compared these cases with ministry numbers.

One of the team members, Kate Walcott, said in 2017 that she had discovered that Northland had five additional cases that were not among the six cases of the department.

She added that the ministry was relying on cases of hospitalization and lacked information for people diagnosed in front-line and emergency departments of hospitals.

Listen to an Insight documentary on the impact of rheumatic fever on New Zealanders.

Dr. Walcott stated that rheumatic fever was generally considered a childhood disease, but their audit revealed 10 cases in people over 20 years old.

"It was a pretty unexpected discovery." Seven patients were diagnosed in the outpatient clinic and two of those over the age of 20 with this diagnosis had moderate to severe carditis at the time of diagnosis, which is a bit worrisome in meaning in their diagnosis. "

Dr. Walcott said that 6% of cases were cases in Pasifika when they accounted for only 2% of the Northland population. When this was combined with the significant impact of the disease on the Maori community, it was unacceptable. "And if you look at individual cases, it's so sad to see that it's what's going on in people's lives and that it's an illness." preventable. "

Professor of Public Health at the Otago University of Wellington, Michael Baker is of the same opinion.

"We need to identify people with the disease so that they can receive regular long-term treatment with penicillin.We plan monthly injections of penicillin for about 10 years to stop or reduce the risk that these children develop from it's a rheumatic heart disease ".

He added that a national registry of all cases was urgently needed for 10 years. He said that it was ridiculous that $ 65 million would be spent in a national prevention program without any real way to count the cases of illness.

The Ministry of Health did not want to be interviewed, but acknowledged that the current reporting method does not capture the full burden of the disease and that the number of cases that fell between 2013 and 2015 was new up.