Urgent vaccination programme for Northland

Dr David Clark made the announcement with Prime Minister Jacinda Ardern. Image: NZ Herald
Dr David Clark made the announcement with Prime Minister Jacinda Ardern. Image: NZ Herald

The Government is launching an urgent immunisation programme to fight an outbreak of meningococcal disease in Northland, which has had the highest number of cases and deaths of the new meningococcal strain MenW.

Three of the seven nationwide MenW-related deaths this year were in Northland, including a 7-year-old girl and a teenage boy.

"The advice from clinical experts is that MenW has reached outbreak levels in Northland and we should urgently launch an immunisation programme to prevent further spread of the disease," Health Minister David Clark said today.

The number of MenW cases jumped from five in 2016 to 29 this year, including seven in Northland.

Northland residents will not have to pay for the vaccine.

The vaccination programme will start on December 5 in selected high schools and community centres across Northland. It will target people aged 9 months to four years (inclusive), and those aged 13 to 19 years (inclusive).

Pharmac and the Ministry of Health had sourced 20,000 doses covering four types of meningococcal disease, including A, C, W and Y. The cost is commercially sensitive, but it would cost $700,000 to roll out the vaccination programme.

Director-General of Health Ashley Bloomfield said Northland was advised on November 6 about the possibility of an outbreak, and a technical advisory group reported two days later that there was in fact an outbreak.

He said people had died from MenW as young as 11 months and as old as 61 years, but teenagers had the highest chances of carrying the disease, and under 5s were at the highest risk.

To be eligible the child will need to be a Northland resident.

"The best way to protect all age groups is stop the carriage of the bacterium," Bloomfield said.

"If we get advice that we need to roll it out further, we will be looking closely at that advice."

He defended the time it took to announce the response, saying it took time to secure 20,000 vaccine doses - as both Australia and the US were already dealing with outbreaks - and to put in place the programme.

"It's certainly enough to vaccinate these two populations this side of Christmas, and obviously we will be watching very closely to see what happens."

MenW was carried in the throat and spread by close contact, and Bloomfield said people in Northland were exposed to conditions to made them more susceptible to MenW, such as poverty, overcrowding, and close-quarter living.

He said people could not be compelled to be immunised but he hoped that 80 per cent of people in the target groups would be vaccinated, which would stop it being carried.

Pharmac was keep a close eye on further sources of the vaccine in case more are needed, he added.

There have been 10 deaths since January due to meningococcal disease, seven of them from MenW.

They have included Whangarei seven-year-old Alexis Albert, whose grieving mother pleaded for a nationwide vaccination and awareness programme, and Kerikeri 16-year-old Dion Hodder, who died in Auckland City Hospital soon after becoming ill during a Motutapu Island youth camp.

Northland DHB chief executive Nick Chamberlain said there had been four cases in the region in September and October.

"There has been no link between cases, and they are from a range of ages, geographical areas and both Māori and NZ European.

"We are hopeful that more vaccine will become available so we can vaccinate the entire population under 20 years as we did in 2011 with the meningococcal C vaccination programme.

"However, with Christmas approaching, it will be a huge logistical feat to vaccinate 20,000 children and youth before they go on holiday."

The location of the clinics will be confirmed as soon as possible, he said.

Meningococcal disease is a bacterial infection that causes meningitis - an infection of the membranes that covers the brain - and septicaemia, or blood poisoning.

While meningococcal B (MenB) has long been the dominant strain in New Zealand, causing two thirds of cases of the disease, there were growing concerns over the rise of MenW.

The proportion of MenB cases dropped from 67% in 2017 to 49% over the year to date, while rates of MenW climbed from 11% to 28%.

Medical experts say MenW can present differently to other strains, including severe respiratory tract infection such as pneumonia and, more so in adults, gastrointestinal symptoms.

Meningococcal bacteria are difficult to catch as they don't live for long outside of the body but are passed from one person to another through secretions from the nose or throat.

Within three to seven days after being exposed to the virus, meningococcal disease is typically first felt by the onset of a sudden high fever and is easily mistaken for other common flus and illnesses.

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