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Ready, Steady, Vaccinate!

Wednesday 9 February 2005

Ready, Steady, Vaccinate!

Baby Kyson is now fit and well thanks to the vigilance of his parents and nanny, Gayle Pomana (pictured)

Puhi Kaiti is among 16 Tairawhiti GP practices gearing-up to vaccinate the district’s 3500 pre-schoolers against Meningococcal B from Valentines Day Monday 14 February.

Puhi Kaiti Practice Nurse Nga Kay says at least 500 six-month to four-year-olds are expected to be vaccinated by Puhi Kaiti staff alone.

“We are preparing for a peak in workload from February 14 all the way through to the middle of the year. By that time we expect most under-fives will have received the three, free and safe injections they need for best protection,” she said.

Mrs Kay said from February 14 Puhi Kaiti will open extra hours allowing everyone to have their children and mokopuna vaccinated.

Each child will need three Meningococcal vaccinations spaced six weeks apart to ensure best protection against the deadly disease.

“The sooner we start fighting back against this deadly disease the sooner we can stop hearing about our mokopuna falling ill.”

Mrs Kay said Puhi Kaiti has employed one additional nurse to assist with the expected increase in work. To further ensure everyone can be seen, in the first two weeks Puhi Kaiti will be open until 8pm Monday, Tuesday Wednesday and Friday, as well as 9.30am-5pm Saturday and Sunday.

“Our advice to people is to get along to us as soon as you can to ensure mokopuna are protected from Meningococcal disease.” City Medical in Derby Street has also employed extra staff so all their under-five-year-old patients can be immunised quickly and smoothly.

Practice Manager Jill Davidson said Meningococcal B clinics will run from 11am-2pm every day except Fridays. People are encouraged to visit with their children, or phone ahead and make an appointment. Vaccinations can also be done on Saturday 19 February between 9am and 12 noon.

“It’s all hands on deck for the first few weeks and we are encouraging parents and caregivers to bring their kids in as soon as they can. By now parents and caregivers should have received information and a reminder from our practice about the need to be vaccinated.”

Both GP practices have started to fill their waiting rooms with the distinctive yellow posters, pamphlets and in some cases balloons being used nationally to advertise the campaign.

Tairawhiti Meningococcal Vaccine Programme Project Manager Jan Ewart said Puhi Kaiti and City Medical’s approach was similar to many of the district’s other GP practices. She encouraged the public to contact their local GP Practice for more information on individual opening hours.

“Vaccination is the most effective way to combat this Meningococcal B epidemic and there are people working together all over the district to get this programme off the ground and make it a success,” she said.

“Maori and Pacific Island people are most affected by the disease and our Maori health providers are preparing for the challenge of reaching children in the most far-flung corners of Tairawhiti. They will be pivotal to the programme’s success in this region.”

At Te Whare Hauora o Ngati Porou in Te Puia Springs this week the Meningococcal B Vaccination campaign was launched with a local song about the campaign and support from Tairawhiti District Health Board member Lois McCarthy Robinson.

Free Meningococcal B immunisations will be available for school-age children from 4 April 2005. School leavers aged up to 19 years are also eligible for the free vaccination from their GP Practice any time from February 14.

The Tairawhiti programme is part of a national $200 million vaccination programme targeting more than a million New Zealanders. The programme is planned to combat the Meningococcal B epidemic which has gripped New Zealand for more than 10 years.

Backgrounder: Frequently Asked Questions

Thursday 10 February 2005

What you need to know By Tairawhiti District Health Medical Officer Of Health Dr Bruce Duncan

What is meningococcal disease?

Meningococcal disease is a serious infection caused by bacteria. It can cause septicaemia (a severe infection of the bloodstream) or meningitis (infection of the membranes that cover the brain and spinal cord).

Meningitis is often the name people call meningococcal disease. However this can be confusing as other germs can cause meningitis. For example amoebic meningitis is the meningitis our mothers used to warn us about when swimming in hot pools.

The symptoms of meningococcal disease can develop very quickly and can lead to death within 24 hours. Permanent disability such as deafness, epilepsy or disfigurement can be an outcome for those who survive. The ability to cause life-threatening illness in a healthy person in a short period of time is very unusual for an infectious disease.

What are the symptoms of meningococcal disease?

It can be hard at first to tell meningococcal disease from illnesses such as influenza. Many of the symptoms, such as headache and achy limbs, are similar. But meningococcal disease can get worse very quickly.

A baby or child may have a fever, cry a lot, be unsettled, refuse food or drink, vomit, appear sleepy, floppy or harder to wake, have a rash or spots and dislike bright lights.

An adult may have a fever and headache, vomit, have a stiff neck and dislike bright lights, experience joint pain and aching muscles, be sleepy, confused, delirious or unconscious, have a rash or spots.

Seek medical help immediately for anyone with these symptoms and keep a close eye on their condition. For example, if they are sleeping, wake them frequently to check on them. Early treatment saves lives.

How is meningococcal disease spread?

People can carry the meningococcal bacteria harmlessly in the back of their throat and nose without getting sick (it is estimated that one in five people carry the germ at some stage).

The meningococcal germs are spread in droplet form and people usually catch the disease when there is close prolonged contact with other people. The biggest risk factor is living in a house with lots of other people. Living in the same house as a smoker is another important risk factor.

Who gets sick with meningococcal disease?

Most of our cases of meningococcal disease in Tairawhiti are young children. Between 1999 and 2004, 51 Tairawhiti have people contracted the disease. Two have died.

Of the 51 cases, testing confirmed that 41 were definitely the Meningococcal B strain. Maori children have the highest rates of disease in Tairawhiti.

How many people are affected by meningococcal disease in New Zealand?

Since 1991 when the epidemic began, more than 5400 people have become sick with the disease and 220 people have died. (An average of about 400 cases and 16 deaths a year.) For every 100 people who get the disease, four will die and a further 20 will be left with some degree of serious disability such as brain damage, hearing loss, loss of limbs or damaged skin. Some will have learning or behavioural difficulties.

Although a high number of New Zealanders catch the disease, compared with other countries the proportion who die is among the lowest in the world – something attributed to high levels of community awareness and rapid, effective treatment. Most people now will have heard the meningococcal disease message “if your child is sick, take them to the doctor”.

Why do we need a vaccine for meningococcal B disease?

Meningococcal disease causes more hospital admissions and deaths than any other notifiable disease in New Zealand. Since the group B epidemic began in 1991 it is estimated to have cost the country more than $935 million in health costs and lost work time.

In New Zealand, 80 out of 100 cases of meningococcal disease are the group B strain of the disease.

It is estimated that if we did nothing the epidemic would last another 10 years.

What is the vaccine made from and how does it work?

The meningococcal vaccine is not a “live” vaccine like that used for measles. It is made from a piece of protein from the outer membrane of the bacteria. The body recognises it as being foreign and responds as if it were exposed to the bug, developing an immunity.

The meningococcal B vaccine works differently from others such as the measles vaccine. Once an individual is immune to measles he or she cannot spread it to anyone else, developing what is referred to as a herd or community immunity.

The meningococcal vaccine only offers protection to the person who received the vaccine. “If you are not vaccinated then you are not protected”. Being vaccinated will not offer protection to people who are not vaccinated as happens with other vaccines like measles.

Full protection only develops after three injections.

The vaccine, which is effective only against the epidemic group B strain, does hurt and some children may have sore arms and legs.

The rollout of the meningococcal vaccine will begin in Tairawhiti for children aged between 6 months and 5 years on Valentines Day 14 February 2004.

For more information about the vaccination programme, visit www.immunise.moh.govt.nz or phone 0800 203-090.

What is happening in Tairawhiti?

Around 3500 Tairawhiti pre-school children are eligible for the vaccine which is to be administered through GP practices from Valentines Day Monday 14 February 2005.

Each child will need three Meningococcal vaccinations spaced six weeks apart to ensure best protection against the deadly disease.

Free Meningococcal B immunisations will be available for school-age children from 4 April 2005.

School leavers aged up to 19 years are also eligible for the free vaccination. These are available from GP Practices from Valentines Day Monday 14 February 2005.


Kyson’s Story By Hayley Redpath

When construction worker Rocky Pomana returned home to an empty house and a simple note on the dining room table one September Monday last year – the blood drained from his body.

“It’s so scary. I wouldn’t wish it on anyone,” said the 25-year-old father of baby Kyson Pomana-Pokai.

The normally vibrant bungalow was silent and empty. His son’s toys including the much loved Pooh Bear Tree were discarded. The note left on the dining room table said not to worry. But Rocky knew something was very wrong.

He started looking for his car keys. Probably around the same time Rocky had returned to the family home in Kaiti – 9km away in Gisborne Hospital’s Children’s Ward all hell had broken lose.

Rocky’s four-month-old son Kyson Pomana-Pokai had just been whipped from the arms of his mother Carmel and hooked up to fluids and antibiotics. The tell-tale vicious purple rash on the toddler’s inner thigh had come as a thundering shock to everyone.

Meningococcal sceptaceamia.

Dr Mary Stonehouse was the paediatrician (children’s doctor) on duty and remembers the afternoon well.

“If Kyson hadn’t been brought in until the following day, had no one noticed his deterioration, he would have been much more poorly than he was, and he would have run the risk of dying. This family did everything right.”

For the next five days baby Kyson remained hooked up to hospital monitors and was given antibiotics via an intravenous drip. He had blood tests early on and for the majority of the time remained on a drip to increase his fluids.

Everyone who had been in close contact with him was prescribed antibiotics to help prevent the possibility of spreading the disease.

Rocky explains that it was a difficult time for everyone.

“I was shocked when I saw him. I saw all the spots on him and broke down. His Nanny who works three jobs would come up to the hospital and help us.”

The story of baby Kyson, his whanau, and the Gisborne Hospital staff who worked to make him well is a stark reminder about the dangers of meningococcal disease.

Currently New Zealand is in the grip of an epidemic of meningococcal B disease. To combat the problem, the Ministry of Health is offering free immunisation to all babies, children and young people aged from 0-19 years to help prevent the disease.

The meningococcal B vaccination will be available in Tairawhiti in February 2005. The vaccine will help prevent diseases caused by the Meningococcal B bacteria including meningococcal sceptaecemia – which is what baby Kyson had.

Carmel and Rocky wish the vaccine had been available sooner. When they look back to that day in September they are shaken at the speed the disease took hold of their baby boy.

The day before Kyson’s grandmother Gayle Pomana (Nanny to everyone) had insisted Carmel take their feverish mokopuna to Gisborne Hospital’s Emergency Department. As is so often the case with meningococcal disease it can be difficult to detect early as the rash may not be typical. This was the case for Kyson who had his early symptoms missed by both the ED staff and his GP who he saw the next day

But by midday and now back at home Carmel had grown extremely concerned. “He had developed a couple of spots on his face but the next time I looked they were all over [his body]. He was droopy and every time I touched him or moved him he cried. It was like his bones were sore.”

With help from her cousin Lady Caroline Pokai, Carmel and Kyson headed straight for the hospital again, where in the Children’s Ward the disease finally exposed itself in its frightening reality. The purplish spots were now appearing.

All this time the one family member who may have best been able to spot the advance of Meningococcal disease was working her day job at Matapuna Training Centre.

Nanny Gayle Pomana had recently read up about Meningococcal disease. She had heard about it in the media and was fearful it could easily take one of her family.

“I had read everything. When I went to a health expo I picked up every pamphlet I could about it and what I was seeing in Kyson was what I had read. It was scary. That’s why I made them go to the hospital the first time.”

Carmel and Rocky say they had heard only a tiny amount about the meningococcal vaccine due in Tairawhiti in February. Now they are enthusiastic supporters of the programme.

“I say get you’re A into G and get your babies immunised before it’s too late,” says Rocky.

“Better safe than sorry” adds Carmel.

Two months on from Kyson’s discharge from the Children’s Ward Kyson bears no physical scars from the disease. He bangs loudly on his Pooh Bear tree and chirrups enthusiastically about the arrival home of daddy. He drinks from his bottle with relish and loves being kissed and cuddled by his Nanny.

His parents say he is a blessing. Dr Stonehouse says it is a blessing the family reacted the way they did.

“They did everything they could over those two days and made all the right decisions. Their baby is alive today because of they way they reacted.”

ENDS



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