January 13, 2006
New Zealand Press Association
Christchurch – An outbreak of highly infectious hepatitis A in Christchurch that has infected 21 people has been traced to a suburban children’s daycare centre.
Canterbury medical officer of health Mel Brieseman said today eight of the cases had a direct association with the ABC Learning Centre in Ferrymead.
Dr Brieseman said a series of other functions was involved in spreading the notifiable disease.
Hepatitis A affects the liver and is contracted either by contact with the faeces of an infected person, contamination of food or directly from person to person through poor hygiene.
He emphasised the association with the daycare centre did not mean that it was the cause of the outbreak that has had health officials in Christchurch worried.
Since 2001, only two or three cases have been notified each year.

“It is probable that the disease was initially introduced from outside, probably from someone returning from overseas during the incubation period,”
he said.
“It spread among those attending the centre and the situation multiplied during other gatherings.”
Dr Brieseman said because of the disease’s long incubation period — between two weeks and a month — exposure would have occurred some time ago and nothing would be gained by closing the centre, although that had been considered.
A number of functions outside the centre’s control had accounted for many of the cases — such as birthday parties, Christmas functions and barbecues.
Some situations involved children who attended the daycare centre, while other cases involved people who had been at functions where the children were present.
Associations were among small family-type “clusters” — aunties, uncles, cousins and boyfriends.
Dr Brieseman said two adults had been hospitalised since the disease was first detected last month, and although some children had been infected, most of the patients were adults. Only one daycare centre staff member had been affected.
Most of those who caught the disease earlier had recovered, but some were still “quite unwell in the acute stage of the disease”. It was a “moderately serious disease” but deaths were rare.
The outbreak showed clearly that hygiene in the community was “not as good as it should be”.
Everyone involved, including the patients, their contacts, the daycare centre staff and management and general practitioners had been very co-operative in helping pin down the source of the outbreak, he said.
Canterbury District Health Board medical officers were now arranging to meet daycare centre staff, attendants and families to discuss any possible further spread and offer vaccination.
“Although the value of immunisation is less certain after this interval, it is nonetheless worth considering because of the possibility of others incubating the disease,” Dr Brieseman said.
While every effort was being made to contain the disease, because of the highly infectious nature of the virus the board would continue to monitor for additional cases, he said.
“It would appear that although we keep putting out a message of `wash your hands, wash your hands, wash your hands’, it doesn’t happen,” Dr Brieseman said. “Hygiene in the community is nowhere near as good as it should be.”
ABC centre manager Cindy Paul told reporters she was “most definitely” shocked by the centre’s involvement in the outbreak.
“The centre prides itself on maintaining high standards and has strict health and hygiene policies in place,” she said.
“Our staff are given quite strict training on health and hygiene protocols and procedures and we ensure at all times that those policies and procedures are adhered to.”
The centre had contacted all parents of children who attended and had been “really pleased with the support from our families”.
“A lot of the comments had been that they’ve appreciated our openness in approaching them and, like us they are working closely with the (health
authorities) to treat those who have been infected.”
No children had been withdrawn from the centre “at this stage”, Ms Paul said.