Fingers pointed over hepatitis outbreak
January 20, 2006
Kamala Hayman
www.stuff.co.nz
Families and health officials are blaming each other for the rapid spread of hepatitis A through a Christchurch suburb.
The ABC Ferrymead Learning Centre is the hub of an outbreak of the highly infectious liver disease that has struck 30 people. More cases are expected.
Health officials have blamed inadequate handwashing for the outbreak as the illness can be spread only by contact with the faeces of infected people. Families have also been criticised for not following public-health advice.
But ABC families are demanding to know why infectious children were allowed to keep going to the centre.
The focus has narrowed to a family whose father and young son fell ill from the disease after a trip to Fiji. The family's three-year-old daughter also contracted hepatitis.
The three cases were reported to Canterbury medical officer of health Mel Brieseman in the week to December 9. This was "family one".
Brieseman said hepatitis A patients were usually advised to stay home from work or school, to limit social contact and not to prepare food.
On December 10, the family held a birthday party at their Mount Pleasant home for their three-year-old daughter.
They told friends they believed they were no longer infectious. Their daughter continued to go to the ABC centre.
Brieseman said that when a family was advised not to send children to school, "we would assume that that happened".
"We do not police it because the majority of people are sensible," he said.
He said officials may now be more proactive. "If we get a case where a child suffering the disease was attending a childcare centre, we might, because of the now appreciated risk, consider immunising the kids there."
Brieseman advised against blaming any one family as "a whole series of families" had not followed official advice.
"Whether people do not understand what is expected of them, only hear part of the instruction, or choose to ignore it ... obviously something went wrong."
Will Harvie, whose two children attend the ABC centre, said health officials claimed to have given good advice to families, but nobody knew if that was the case.
"It's pretty one-sided public health got it right and everybody else got it wrong. I'm not convinced," he said.
"Family one" declined to comment, although the father said his family had "followed everything we were told". He said health officials had done "a fantastic job".
"Family two" were not so sure. Three members of this family fell ill late last month and the parents believed their child got the disease at the Ferrymead centre.
The mother, who developed jaundice, said health officials advised her to be careful about hygiene but did not suggest she call friends, family or other recent contacts to warn about their possible exposure to hepatitis.
"They said, `No, we'll do that for you'."
She said she was not asked if her children went to preschool. "They were very intent on asking me a lot of questions about food and restaurants, but the creche should have been contacted. I think there was a breakdown right at the beginning."
An ABC parent, whose three-year-old daughter was confirmed hepatitis-positive on Wednesday, said "family one" believed they were no longer contagious at the time of their birthday party. "I guess like the rest of us, we didn't really know the gravity of the whole thing. I think the main blame does lie with the health department."
Brieseman said the common link with the centre was not recognised until January 12, the day ABC says it first knew of its involvement.
Community and Public Health arranged blood tests for ABC families on Tuesday. This saw three new cases confirmed yesterday, with further results expected today.
Brieseman said the latest families were advised to limit social contact and not to swim in public pools, but were not told to keep away from the ABC centre because of the already prolonged exposure.
Those who returned negative results were advised to exercise caution for about four weeks, when immunity from their vaccination jabs would have kicked in.
ABC Ferrymead licensee Lynda Cumming would not comment on whether places would be kept open for children whose parents opted to keep them at home.
