COLLETT Geoff
07/17/2002

Advertisement: Explore Within This Space

Meningococcal disease has claimed the lives of almost 200 New Zealanders in the last 10 years. The Ministry of Health is seeking international help to vaccinate everyone aged under 20.

Death from meningococcal disease seems inevitable for dozens more young New Zealanders in the next decade, unless a high-cost gamble now under way by health authorities pays off.

The disease which last week claimed its latest victim in Christchurch, 17-year-old Terrill McKerrow, has been at epidemic levels for the last 10 years and is picked to stay there for another 10 if allowed to run its course.

But with almost 200 people now dead because of it since 1991, and 4400 more having suffered but survived, the Ministry of Health is racing to introduce an ambitious vaccination programme targeting every New Zealander aged under 20.

Meningococcal disease is commonly referred to as meningitis, but in fact meningitis is just one of the illnesses that can develop from the meningococcal bacteria. Meningococcal disease can also lead to septicaemia, or blood poisoning, and in its various manifestations can cause serious permanent injuries such as deafness or disfigurement.

The epidemic is estimated to have cost New Zealand $630 million since it started, with $300 million of that being direct costs to the health sector.

The ministry has decided that the best hope of attacking the epidemic is a mass vaccination programme, one of the most ambitious launched in this country. It could cost up to $200 million to develop the vaccine, with the Government so far committing $149 million to be spent in the next three years.

There are risks as well as costs, particularly in whether an effective vaccine can be found. Because the strain of the disease afflicting New Zealand is unusual to this country, a new vaccine needs to be developed to fight it. The ministry has had to call in international advice, contracting a Norwegian public health agency -- Norway being one country that has dealt with a similar strain of the disease -- and an Italian-based vaccine company, Chiron, to develop the vaccine for introduction.

The ministry considers time to be of the essence. Clinical trials of the proposed vaccine are already under way in a group of adults in Auckland. If that proceeds satisfactorily, trials will then start on varying groups of the under 20-year-olds the vaccine is ultimately intended for. It then hopes to start making the vaccine available to the highest-risk group, South Auckland youngsters, as early as next year.

Longer term, to be effective the proposed vaccination programme will require three doses of the vaccine to be delivered to every New Zealander under 20.

That is a major challenge in a country which has struggled to meet high levels of participation in other established vaccination programmes, such as for measles and mumps, particularly among the group most at risk of meningococcal disease, Maori and Pacific Islanders.

In discussion documents on its plans, the ministry acknowledges that it will need good information systems, and good systems in place with primary health providers to ensure that the programme achieves its necessary coverage.

Until now, the ministry has been trying to fight the epidemic with such tools as education and publicity about the disease to raise public awareness; treating victims of the disease and their near-associates (primarily with antibiotics) when a case emerges; and promoting initiatives to reduce some of the risk factors, such as tackling sub-standard housing and cigarette smoking.

It warns that, if the epidemic remains unresolved, over the next decade 600 people a year could be expected to contract the disease, with 24 of them dying as a result.

The worst-hit group would be babies under one. More than half of all victims would be Maori and Pacific Islanders, and almost all would be young people.

Copyright 2002.  All Rights Reserved.

Financial Times Information Limited - Asia Africa Intelligence Wire

http://www.chiron.com/