Health workers in partnership targeting Rheumatic Heart Disease in Far North

Health workers in the Far North are joining together to tackle a serious health issue which affects Northland children.

Northland DHB is working in partnership with Te Hauora O Te Hiku O Te Ika and the Green Lane Paediatric and Congenital Cardiac Service, undertaking a research project which involves taking echocardiograms (a heart scan) from children at Kaitaia schools.

Under the project, using portable echocardiogram scanners, health workers will target all children aged from Kaitaia year 6 to 8 children (children aged between 10 years and 13 years).

Te Hauora O Te Hiku O Te Ika general practitioner, Dr Lance O'Sullivan says that the aim of the research project is to identify children with undiagnosed rheumatic heart disease.

"Detecting children with early heart damage will mean that they can be assessed and treated minimising the chances of their condition worsening."

Dr O'Sullivan says that the Kaitaia project will contribute data to other heart screening research projects that have been carried out in New Zealand.

The heart scanning research project will run at the Kaitaia Primary and Intermediate Schools from Monday, July 19 to Friday, July 30.

Over recent weeks public health nurses have been working through Kaitaia schools to send out information and to collect consent forms.

The response in the Far North has been swift, with 95% of all consent forms returned and the parents of 618 students consenting to the scan.

Rheumatic fever follows an untreated throat infection caused by the Streptococcus A bacterium. Antibiotics prevent rheumatic fever from developing, and a throat swab is the only way to distinguish between a "Strep A" throat and a viral sore throat.

A person with a Group A Strep sore throat which is left untreated, can have up to a one in 30 chance of developing rheumatic fever. The average time between the sore throat and the onset of rheumatic fever is 19 days, so it is very important to start antibiotic treatment as early as possible, and to complete the course.

The common symptoms of rheumatic fever are a high fever and painful arthritis. Up to 50 per cent of sufferers also experience inflammation of the heart, which can cause permanent heart damage.

"An echocardiography is an established tool in the diagnosis of children with acute rheumatic carditis, and the recent availability of compact portable echocardiolography has led to a growing use of this technology for rheumatic heart disease screening," said Dr Roger Tuck a paediatrician from Whangarei Hospital.

"While we are hoping to detect children with early heart damage caused by rheumatic fever it is important to remember that rheumatic fever is a preventable disease."

"Sore throats matter and they are treatable.  A course of penicillin to get rid of a strep throat is far more cost-effective than the $30,000 spent for a heart operation."

Between five and 10 Northlanders die prematurely each year from chronic rheumatic heart disease caused by rheumatic fever, usually when they are aged in their 30s or 40s, and up to 20 years after having the illness.

Northland DHB's medical officer of health, Dr Jonathan Jarman says rheumatic fever can lead to rheumatic heart disease, a serious condition that can damage the heart and sometimes cause premature death.

"Rheumatic fever is considered a ‘third world' disease and while it is very uncommon in most developed countries, in Northland the rates of rheumatic fever are very high.  In the past five years there have been 56 cases of acute rheumatic fever in Northland, most affected are school aged children," said Dr Jarman

A study using portable echocardiography of 1142 school children in South Auckland which also has very high levels of rheumatic fever found that one in 40 children had evidence of undiagnosed rheumatic heart disease.

Rheumatic fever and rheumatic heat disease are important health problems in the Northland Community.

Each year in Kaitaia about one to two children get rheumatic fever.  A small number have serious heart valve damage and need heart surgery.

Each year in New Zealand about 130 adults die as a result of heart valve damage caused by rheumatic fever when they were young.

Rheumatic fever is cased by "strep throat' infection - after this type of sore throat, the body reacts and cases inflammation and damage to the heart and joints.

It is very important that children and teenagers see a doctor every time they have a sore throat.  Antibiotics (penicillin) kill the "strep throat" germ and this greatly reduces the chance of getting rheumatic fever.

You can get rheumatic fever more than once.  Children and young people who have more than one attack of rheumatic fever are more likely to have serious heart valve damage.

RHEUMATIC FEVER TREATMENT

Once a person has been diagnosed with rheumatic fever or rheumatic heart disease, monthly penicillin injections are very effective at preventing heart valve damage.

KAITAIA SCHOOLS INVOLVED IN THE PROJECT (year 6 to 8 children)

Ahipara Primary, Pukepoto Primary, Herekino Primary, Te Kura Kaupapa Maori O Pukemiro, Kaitaia Primary, Kaitaia Intermediate, Pompallier Convent, Abundant Life Year, Oturu Primary, Te Rangi Aniwaniwa, Kaingaroa Primary, Awanui Primary and Pamapuria Primary.