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25 Latest News Articles
Monday 17 July, 2017

 

Dengue fever

There has been an increase (~120%) in the number of cases of dengue fever for the three months between April and June. A lesser increase (~50%) has occurred if the last quarter results are compared with the corresponding quarter in the last three years. Dengue is endemic in much of Asia, including India, and South East Asia, so consider the diagnosis in febrile patients returning from these regions.  The incidence of dengue fever in many of the South Pacific islands is rising (including Cook Islands, Federated States of Micronesia, French Polynesia, Fiji, New Caledonia, Niue, Samoa, Tonga and Vanuatu). Since 2014 there have been an increase in confirmed cases from these islands.

Mumps 
The mumps outbreak in Auckland continues, with the majority of cases occurring among  those aged 10 to 19 years and arising in West Auckland. Overseas incursions continue (15%), however the majority of transmission is occurring in the community. Low levels of immunity among cases (73% who have not received two mumps containing vaccines) are likely to be responsible.

Typhoid
The large increase in typhoid cases seen in Q2 was driven by a well-publicised outbreak in a Samoan community. It is believed to have been spread from a point source, ultimately leading to 23 notifications in the Auckland region, including one death. The outbreak is now considered over, but it is a timely reminder of the need for vigilance in considering the diagnosis since the disease is frequently imported from the Pacific and Asia.  

Pertussis
Pertussis case numbers have increased compared to the same period in 2016, however the increase is not unusual, considering the number notifications that have occurred over the same three month period during the last three years.
Wednesday 05 July, 2017
Auckland Regional Public Health Service (ARPHS) is investigating five new cases of mumps every day, as the number of notifications of the disease continues to rise.

The latest figures show 148 cases, up from 138 cases on Monday 3 July. This is compared with 13 cases for 2016 (see note to editor below).

ARPHS Clinical Director Dr Julia Peters is urging parents to check with their doctor to ensure their families’ measles mumps and rubella (MMR) vaccinations are up to date. The vaccination is free.

“The majority of cases are aged 10 to 29 years as this age group has had lower than average immunisation rates,“ says Dr Peters.  Around 80 percent of the current cases were not fully vaccinated.

Out of 126 locally acquired cases, 78 of these are Pacific Island people and 26 are Maori. The balance is Pakeha or other ethnicities.

“Most recover from this disease.  Eight people have been hospitalised, however, mostly males for pain and swelling in their testicles.  Some females have experienced ovarian inflammation and another person developed meningitis. 

Non immune pregnant women who catch the disease risk miscarriage in the first three months. In rare cases mumps can cause permanent hearing loss. 

Mumps can spread quickly among those who are not immune, particularly in schools.  Thirty schools around Auckland have seen 67 cases and non immunised students have also had to be kept at home for weeks.

“If parents do not organise vaccination quickly, their child may be excluded from school,” says Dr Peters.

Note to editor – please note the number of mumps cases in 2016 was 13, not 35 cases as previously released. There were 35 notifications in 2016.

If you suspect mumps call your doctor or Healthline for advice on 0800 611 116. 

For a mumps fact sheet click here, for a vaccination fact sheet click  here.  
 
For questions about vaccination call the Immunisation Advisory Centre on 0800 Immune or visit www.immune.org.nz.

Monday 03 July, 2017
Auckland Regional Public Health Service (ARPHS) is concerned not enough young Aucklanders are immunised in the face of an unrelenting mumps outbreak.

“This year we have had over 130 mumps cases in Auckland compared with 35 investigations last year. Unfortunately 80% of the current cases were not fully vaccinated.  It is disappointing because mumps is a preventable and serious disease,” says ARPHS Clinical Director Dr Julia Peters.

“Most recover from this disease. However in the last six months a number of people have suffered from severe complications caused by mumps.”  

This year some adolescent males have been hospitalized for pain and swelling in their testicles, which in rare cases can result in infertility. Some females have experienced ovarian inflammation and another person developed meningitis. 

Non immune pregnant women who catch the disease risk miscarriage in the first three months. In rare cases mumps can cause permanent hearing loss. 

“I urge parents to check with their doctor to ensure their families’ measles mumps and rubella (MMR) vaccinations are up to date.  The vaccination is free,” says Dr Peters.

Almost 70% of the cases are occurring in children and teens aged 10-19 years.  Mumps can spread quickly among those who are not immune, particularly in schools.  An individual with mumps at a secondary school could cause an outbreak, because immunity in that age group is well below the national average.

“If parents do not organise vaccination quickly, their child may be excluded from school. We are in the midst of an outbreak and already many students are scrambling to catch up on school work after missing school for several weeks,” says Dr Peters. 

ARPHS is working with primary care, early childhood, schools and tertiary institutions to provide support and resources to minimise the spread of mumps. 

See attached graph for history of mumps cases in Auckland, Jan-June 2014-2017.

If you suspect mumps call your doctor or Healthline for advice on 0800 611 116. 

For a mumps fact sheet click here, for a vaccination fact sheet click  here.  
 
For questions about vaccination call the Immunisation Advisory Centre on 0800 Immune or visit www.immune.org.nz.


Thursday 15 June, 2017
The Auckland Regional Public Health Service (ARPHS) welcomes the findings of the review into the recent typhoid outbreak in Auckland. The review’s recommendations have either already been implemented, or are in the process of being implemented.

The review was prepared by the Office of the Chairman of Auckland, Counties Manukau and Waitematā DHBs at the request of the Ministry of Health. It concludes ARPHS performed well with respect to the clinical management of the outbreak, which was brought under control relatively quickly. 

It also identifies shortcomings in ARPHS’s performance, especially with respect to communication and engagement issues, as well as broader issues relating to culture and management practice. 

Steps were already being taken before the outbreak to change and improve ARPHS’s culture and strengthen its management capability. The review also recommends these efforts be further strengthened, and accelerated with external support. 

The review also recommends closer working relationships between ARPHS and Auckland DHB to improve capability and collaboration, in particular with respect to communications and human resource practice. 

The full report is available here

If you have a media enquiry, please call the ARPHS Media line on 021 243 2421.

Tuesday 23 May, 2017
For typhoid information and resources, including
translations in Samoan, please click here.

As at 23 May 2017, two new cases have been identified that are associated with the Auckland typhoid outbreak, bringing the number of confirmed cases to 24. There is one probable case.  There are no cases under investigation.  

The new cases are being managed outside of Auckland, but are linked to the same families and church group as the other cases associated with this outbreak. There is no evidence of anyone from outside these groups being infected.  

The new cases are in line with the expected pattern of a typhoid outbreak.  ARPHS still considers the outbreak is waning but the two new cases do reinforce the importance of continued vigilance and follow up. Good hand hygiene and food safety practices are very effective in stopping the spread of the disease.

Typhoid has a typical incubation period of 8-14 days but incubation can be up to 80 days. This means cases associated with an outbreak can emerge over the course of several weeks as testing continues. 

APRHS continues to work with colleagues in the wider health sector and those affected by the outbreak, ensuring appropriate testing, advice and treatment.  

Clarification of how typhoid spreads

It is important to understand typhoid is mainly spread by eating food or drinking water that is contaminated with faeces or urine from a person who has the illness, or who may be a carrier of the bacteria.

Casual social contact, such as hugging and kissing a person, is not a significant risk. People can go about their daily activities as normal, including attending church and other gatherings.

Good hygiene and food safety is always important when sharing and handling food. Wash hands with soapy water for 20 seconds, then dry well with a clean cloth or paper towel every time: 

  • after going to the toilet 
  • before preparing food, eating or drinking 
  • after changing babies’ nappies
Once people are being effectively treated in hospital, the risk of them spreading the disease is significantly minimised. No cases linked with this outbreak have emerged in the wider public population.

Members of the public who have concerns should visit their GP, or call Healthline on 0800 611 116. Healthline has translation services available 24/7.   

For information and resources on typhoid including translations in Samoan please visit www.arphs.govt.nz/typhoid-response
Friday 19 May, 2017
19/05/2017

Public health responding to E. coli contamination on Waiheke

The Auckland Regional Public Health Service (ARPHS) has been notified on May 18 2017 of E coli bacteria in the water supply for two schools on Waiheke Island – Waiheke High School and Te Huruhi Primary School.

ARPHS has provided the schools with information and advice on how to respond to the situation and is liaising closely with the Ministry of Education on this issue. ARPHS will continue to work with both schools to verify that they have completed remedial actions to ensure the water supply can return to normal operation.

The role of ARPHS is to provide technical advice to schools about providing safe drinking water and how to respond to contamination incidents. Public health has not received any recent notifications of gastroenteritis among school children from medical services on the island. From the information received so far there is currently no indication of a gastroenteritis outbreak.

ARPHS website has more information on drinking water safety in the Auckland region. 
http://www.arphs.govt.nz/health-information/healthy-environments/drinking-w

Waiheke High School and Te Huruhi School is classified as a self-supply drinking water system. The Ministry of Education and the schools take the lead role for the operation and maintenance of schools that have a self-supply water system. 
https://education.govt.nz/school/property/state-schools/day-to-day-management/drinking-water-quality/self-supplying-schools/

What is E. coli? 
https://www.healthed.govt.nz/resource/campylobacter-ecoli-and-salmonella

ENDS
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