Article in Northern Advocate - Northland meningococcal death

23 February 2021

Northland meningococcal death: Leaders plead for help as 'well-loved' boy passes away

Appears in NZ Herald

Northland's first meningococcal death in more than two years, a six-year-old boy, has Kaikohe leaders pleading for more essential health services in their rohe (area).

The boy, from the Kaikohe area, was sent home from Tautoro School on February 12 by a teacher for being unwell, before being admitted to Bay of Islands Hospital and later to Whangārei Hospital.

The boy passed away the following day. He was one of 10 siblings and laid to rest last week.

Northland District Health Board (NDHB) medical officer of health Dr Catherine Jackson sent a letter to the school and parents on February 13, indicating the cause of the boy's illness was unconfirmed but suspected to be meningococcal.

In the letter, Jackson said even though the risk of another case was small, she advised parents to be aware of any symptoms of the disease.

Some common symptoms of meningococcal are fever, headache, nausea, aversion to light, neck stiffness (late symptom) and purple/dark blue rashes (late symptom).

Te Hau Ora o Ngāpuhi's Te Ropu Poa, who heads the Māori health provider based in the Kaikohe area, first learned of the boy's condition after his passing, through a Facebook notice from the school.

"We should have been contacted immediately," she said. "[It's] far too casual for my liking."

When she asked the NDHB why Te Hau Ora o Ngāpuhi hadn't been informed, Poa said DHB staff were apologetic.

However, Poa believed this experience reflected the current issues with the health sector in how a lack of coordination prevented real progress.

"It's a case-by-case approach rather than asking how well is your community, and if they're not well, how are people accessing our primary care services.

"I have to speak up for whānau that know very little about how to access good quality health services and we all have to contribute and work better together, so that we can take care of our whānau better.

Poa said some crucial health practices had been interrupted by Covid-19. Prior to the pandemic, Poa and her staff would visit eight local schools three times a week to do throat-swabbing.

This had since been reduced, removing crucial opportunities for health staff to kōrero with teachers and tamariki to identify any other health issues.

"Covid seems to take over everything and I keep trying to remind everyone that it's not just Covid here."

With another tamariki from the Hokianga recently hospitalised due to rheumatic fever, Poa said it was critical to fix these issues before more whānau suffer.

Te Hau Ora o Ngāpuhi was currently working with the boy's whānau. Poa described them as "grieving but resilient".

In a statement yesterday, Jackson said this incident indicated the unfortunate truth that even with appropriate treatment, meningococcal infections were fatal in 5-10 per cent of cases.

Tautoro School was closed briefly for a deep clean following the incident, under instruction from the NDHB.

Principal Tracey Simeon said her young pupil's death had rocked the school's 148-pupil roll and the wider community.

"We are very much a whānau school, virtually everyone is related so that's probably the shock - it's not just a student, it's whanau."

Simeon said the boy was a "well-loved" member of the school, with a passion for learning.

"Our hearts go out to our student's whānau because it's a great loss to see such potential taken away from us."

Echoing Poa, Simeon lamented the loss of regular swabbing for her pupils and the extra benefit those visits provided to rural whānau.

"We understand about Covid but ... meanwhile our children in Northland are missing out on a service that is also needed.

"We've learned now that we must take action when it comes to children's health."

Three Northlanders died of the meningococcal W strain in 2018, which sparked a mass vaccination campaign by NDHB, aimed at immunising children and youths aged 9 months to under 5 years and 13 to under 20 years.

The strain of this recent case is unknown.

Broadway Health GP Dr Taco Kistemaker, who covered the wider Kaikohe and Whangaroa area, said the boy's death was very unfortunate but he believed there wasn't an immediate risk to the local community.

"After one case, I don't think we should play to any panic," he said.

"The last thing you want from one [case] is people starting to come for every cold and cough to us."

However, Kistemaker did not downplay the very real danger meningococcal disease posed.

"There's not a moment that you see a severely sick child that you don't think about meningitis and I hear it inside my community a lot."

He advised parents to watch out for their tamariki, encouraging healthy lifestyle practices.

Meningococcal disease facts:

Meningococcal germs are carried in the back of the throat of about one in 10 people at any one time but only very rarely cause illness. Most people who carry the germs become immune to them. The germs do not spread easily. Those who have had prolonged close contact with the person, for instance by living in the same household, are at a slightly increased risk of getting sick. Children who have previously received meningococcal vaccination can still get meningococcal disease because the vaccine does not protect against all types of meningococcal bacteria. Therefore, be on the lookout for signs or symptoms of meningococcal illness even if your child has previously been vaccinated.

People with meningococcal disease may have some or all of the following symptoms:

• Babies and children:
- Fever
- Crying, unsettled, irritable
- Refusing drinks or feeds
- Vomiting
- Sleepy, floppy, harder to wake
- Stiff neck, dislike of bright lights
- Reluctant to walk
- Rash (purple/red spots or bruises)

• Adults:
- Fever
- Headache
- Vomiting
- Sleepy, confused, delirious, unconscious
- Joint pains, aching muscles
- Stiff neck
- Dislike of bright lights
- Rash (purple/red spots or bruises)