April 10, 2006
The Press (new Zealand)
Joanna Davis
All childcare workers in Canterbury may need to be vaccinated against debilitating and highly contagious hepatitis A after a recent outbreak of the illness.
Medical Officer of Health Dr Mel Brieseman has made the suggestion in an Environmental Science and Research review of Christchurch’s outbreak in January and December, in which 32 people were infected.
The Ministry of Health is also warning of the disease’s increased prevalence in the Pacific Islands.
Twenty cases have been diagnosed in people returning from Samoa recently.
Thirty of the cases in Christchurch’s December and January outbreak were linked to a childcare centre — the ABC Learning Centre in Ferrymead.

The family at the centre of the outbreak had recently returned from a holiday to Fiji where it is believed they contracted the disease.
Hepatitis A — a short-term illness with symptoms of tiredness, nausea, abdominal pain and sometimes jaundice — is spread through bowel to mouth contact, particularly through poor handwashing after going to the toilet.
Brieseman told The Press he had advised the ABC Learning Centre’s parent company to consider offering vaccinations to staff, as was the practice for childcare and healthcare workers in some overseas countries.
Brieseman said the suggestion needed further investigation before it became general and firm advice.
He expected some employers and childcare workers would meet the suggestion with reluctance because of a widespread dislike of injections and the costs involved.
Immunisation against hepatitis A normally costs the public about $70 for each of two required injections.
In January, the Canterbury District Health Board (CDHB) funded the vaccination of more than 500 family members and contacts of children at the ABC centre.
Brieseman said the high number of vaccinations had been required because hepatitis A did not show symptoms in many children and had an incubation period of several weeks.
Hepatitis A vaccination for childcare workers could become an occupational safety and health issue if increasing prevalence of the disease meant it was judged a “reasonable precaution” for an employer to take, he said.
Early Childhood Council chief executive Sue Thorne said she would not like to see a heavy-handed approach to hepatitis A vaccination.
She said childcare centres and preschools would require more advice and information about the risks and benefits of vaccination.
However, she said childcare staff were aware of the risks and of increasing cases of hepatitis A. “We’re high-risk places for getting bacterial and viral infections. In a communal environment and particularly with small children there are lots of bugs going around.
“It’s also quite a stressful job so staff immunity gets a bit low, especially with staff shortages which are so common.”
Thorne said she would promote the choice of vaccination for childcare workers if public health experts could provide evidence of the need for it.
People associated with the Ferrymead ABC Learning Centre who received the free hepatitis A vaccination in January need a booster shot to protect their immunity.
The CDHB has arranged for this to be provided free during September from the 24-hour surgery.