'Not appropriate to alarm' public about W meningococcal strain in May, Northland DHB says


It would not have been “appropriate” to warn the public about a “very scary strain” of meningitis when it first came to doctors’ attention six months ago, Northland DHB says.

On Tuesday, the DHB put out a media release warning the public to be vigilant about a “significant increase” of Group W meningococcal disease in the region after three people died. The Ministry of Health also put out a warning to emergency departments and general practitioners about the rising number of cases.

But in May, clinical microbiologist David Hammer had circulated a letter to DHB staff warning of the “significant rise” in meningococcus W ST-11 cases across New Zealand.

Northland DHB’s medical officer of health, Dr José M Ortega​, said the DHB questioned assertions the public should have been warned earlier about the meningococcal W strain (MenW). 

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“In May, we had two unrelated adult cases of MenW which warranted close monitoring,” Ortega said.

“Without definite information it was not appropriate to alarm the community.”

The new strain of meningococcus presented itself as “any form of infection” and appeared randomly for no apparent reason, he said.

Hammer had raised awareness among staff because the presentation of meningococcus tended to be more atypical than other strains, he said.

In October, 16-year-old Dion Hodder died from Group W meningococcal disease.

SUPPLIED

In October, 16-year-old Dion Hodder died from Group W meningococcal disease.

“We have continued surveillance and monitored the disease incidence as is good public health practice and we are in the process of reviewing some historical epidemiological data on invasive meningococcal disease in the hope that this will inform future decisions about our response.

“The Public Health Team and Dr Hammer are in continuous dialogue with the Ministry regarding this disease and [on Thursday] will attend the Technical Advisory Group meeting hosted by the Ministry of Health to start work on ways to reduce meningococcal disease rates across New Zealand.

“The DHB will be guided by the Ministry going forward,” Ortega said. 

Twenty-four cases had already been confirmed this year. Throughout the country, six patients have died from the W strain.

Immunisation Advisory Centre research director and senior lecturer at the University of Auckland, Dr Helen Petousis-Harris, said the W strain affected people of all ages and appeared “super virulent”.

“The numbers of cases caused by this strain have doubled since 2017 from 12 to 24 so far,” Petousis-Harris said.

A letter circulated to Northland DHB staff in May warned of a "scary" strain" of meningococcal disease - six months before the public were told (file).

DANICA MACLEAN/STUFF

A letter circulated to Northland DHB staff in May warned of a “scary” strain” of meningococcal disease – six months before the public were told (file).

“People who have this strain are more likely to die.

“To make this worse, the signs and symptoms are a bit different from the usual making diagnosis harder.”

Petousis-Harris said GPs were being prompted to be on the lookout for meningococcal disease and to administer antibiotics if they suspected it.

“Meningococcal disease is rare but deadly. We have vaccines that protect against the meningococcal groups circulating in New Zealand including the new hypervirulent W and the groups B and C that cause most of the cases.”

Immunisation Advisory Centre research director Dr Helen Petousis-Harris says people with the W strain are more likely to die as it is "super virulent".

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Immunisation Advisory Centre research director Dr Helen Petousis-Harris says people with the W strain are more likely to die as it is “super virulent”.

Hammer’s internal memo said the disease tended to “spread rapidly though areas where younger people congregate, such as schools, hostels, army barracks and university campuses”.

Northland teenager Dion Hodder was one of the three people who had died from meningococcal disease this year. 

On October 20, the 16-year-old was at a St John Youth training camp on Motutapu Island when he fell ill with the disease. Hodder was airlifted to Auckland City Hospital where he died just before midnight. 

His mother Todd Horton and stepfather Lance Horton said Dion had died from the W strain.

Dion’s mother said it was hard to know how to feel about the internal memo.

“It doesn’t really make a lot of difference to us at this point,” Horton said.

“Meningococcal is one of those diseases that has been around for a long time and everyone knows the signs and symptoms but I think we just need to be made aware that with these newer strains, some of these signs and symptoms aren’t as visible and aren’t as prominent.” 

“I would hate to think of other parents going through what we’re going through right now.”



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