Northland project beats rheumatic fever

By CLAIRE TREVETT

When Helen Herbert's son Josh complained of a sore throat, she thought he was just trying to get a day off school.

Three days later the 8-year-old was admitted to hospital where he stayed for six weeks, unable to move because of the stress on his heart.

He had rheumatic fever, an immunological disease which attacks the heart, often causing permanent damage.

Now aged 13, Josh will have monthly penicillin injections until he is 18.

Mrs Herbert said Josh's case was mild.

"He just had a pin-prick hole. Some children are in hospital for six months. An adult I know is just 36 and he's just had major heart surgery because he had rheumatic fever as a child."

Josh lives in Whangaroa, which has traditionally had third-world rates of rheumatic fever - 363 per hundred thousand between 1999 and 2003 for 5 to 14-year-olds - among its Maori children. That's more than 10 times the national rate for Maori children of 26 per hundred thousand.

Mrs Herbert now works for a project which has virtually stamped out the disease in just two years. The rheumatic fever prevention project is a five-year pilot run by the Whangaroa health trust, Te Runanga o Whaingaroa, the Ministry of Health and Te Hauora o Tai Tokerau.

Each week Mrs Herbert visits six schools in the Whangaroa area, finds children complaining of sore throats and swabs them to check for Group A Streptococcus, the bug that leads to rheumatic fever. When the bug is found, the child's parents are given free antiobiotics to treat it.

For a programme which sounds simple and relies on parents and children in Whangaroa to buy into, it has worked with extraordinary effect.

Since it began in February 2002, only one case of rheumatic fever has been notified.

Dr Jonathan Jarman, Northland's medical officer of health, was amazed at the project's success. "I thought it would reduce it by 50 per cent, but it almost immediately eradicated it."

He said there was no clear reason why the problem was so severe in Whangaroa where problems of overcrowded housing were no worse than other parts of Northland.

Plans to take the project to other areas such as Kaitaia would be considered, he said.