Tracking a viral time-bomb

By MARTIN JOHNSTON health reporter

Martin Rakuraku never lets anyone use his toothbrush or razor because he wants to avoid giving them a potentially fatal hepatitis virus.

He is also careful not to share towels, soap, cups or drink bottles.

"In the family you've just got to know that yours is yours and mine is mine," he said yesterday.

The 46-year-old Rotorua journalist is a carrier of both hepatitis B and hepatitis C.

Two of his children and five of his 11 siblings have hepatitis B.

His family have joined the Government's free hepatitis B control programme, which provides him with regular checks in case liver disease flares, plus vaccine injections for his wife and third child.

The $16 million scheme aims to screen 350,000 people - 70 per cent of the North Island's Maori, Pacific and Asian adults. They are the high-risk group, with 5 to 10 per cent thought to be carriers, compared with less than 0.5 per cent of Pakeha.

Known carriers and the target group's households and sexual contacts - of any age or ethnicity - are also eligible.

The programme has been run south of Auckland since 1999 by the Hepatitis Foundation. Today, after years of planning, a consortium led by the Auckland District Health Board launches the programme in Northland and Auckland.

The foundation has tested blood from 50,000 people. Of the 38,000 Maori screened, it has newly diagnosed 5.2 per cent as carriers.

At least 100 New Zealanders die each year from liver cancer or liver failure caused by hepatitis B.

Around 50,000 people may be carriers, although the rate is expected to decline as a result of the free childhood vaccine introduced in the 1980s.

The virus, capable of surviving outside the body for up to 10 days and 100 times more contagious than HIV, is transmitted mainly by unprotected sex or by blood, even tiny amounts on a toothbrush or comb.

Infants who catch it are more likely than adults to become carriers. Up to a fifth of carriers - who often do not know they are infected - develop serious liver disease, but often not until 10 or 20 years later.

"It's like a time-bomb," said Dr Chris Bullen, the clinical director of the Northern Region Hepatitis Consortium.

The tragedy of many liver cancer cases was that when victims noticed the symptoms, it was oftentoo late for treatment.

The foundation uses mobile clinics, but people in Auckland and Northland wanting tests will need to visit a general practitioner tied to the programme.

Last year, Race Relations Conciliator Dr Rajen Prasad said the programme was racially divisive. Yesterday, he said that after six complaints to his office, the foundation had clarified its access criteria to his satisfaction.

The foundation's chief executive, David Winterbourn, said people had been turned away because they were not at high risk of infection, not because they were Pakeha. Some staff had not adequately explained that to them.

* For information on screening in Auckland and Northland call 0800-437-284, or for the rest of the North Island 0800-332-010.