Epidemic linked to crammed homes

By FRANCESCA MOLD health reporter

New Zealand's decade-long epidemic of the deadly meningococcal disease is being driven by household crowding, says a major study.

The three-year investigation is the first of its kind in this country to look at the risk factors for meningococcal disease.

In the past 10 years, 3300 New Zealanders have suffered from the disease, which killed 150.

The researchers, from the Institute of Environmental Science and Research (ESR), Auckland Health Protection Service and the University of Auckland, interviewed the parents of 212 children with meningococcal disease and compared their findings with a control group of the families of 313 youngsters who had not suffered from it.

The team found that social conditions such as household overcrowding have intensified the effect of the B-strain meningococcal epidemic.

New Zealand is battling the highest rates of the disease in the developed world.

Other factors the researchers identified as risks included smoking around children and sharing food or drinks.

The research has revealed a strong link between the number of adults living in each home and the risk of children contracting the disease.

ESR public health physician Dr Michael Baker said about 10 per cent of people, most often adolescents or adults, carried the meningococcal bug in their throats without suffering symptoms.

The disease was passed by coughing or saliva contact, so if young children were exposed to many carriers, for example in their home, the risk of catching the disease was greater.

The researchers found that the presence of an extra two adults or adolescents in a six-room, average-sized house increased by 50 per cent the risk of children contracting meningococcal disease.

Several cases of extreme overcrowding were exposed during the study and showed that the risk was 10 times greater if three families were living in one home.

"The study sends a strong message to policy-makers that they need to look at policies to ensure the availability of appropriate, affordable housing," said Dr Baker.

Minister of Housing Mark Gosche responded to the research findings by blaming the previous Government for selling state houses and setting market rents.

He said this policy had led to overcrowding and "desperation," particularly in South Auckland, which has the worst rates of meningococcal disease in the country.

Mr Gosche said the present Government was working on a range of policies to improve the situation, including increasing the stock of state houses and introducing income-related rents.

Dr Lynne Lane, the Ministry of Health's director of public health, said the ministry and the study investigators would work with community groups and health workers to develop a prevention programme based on the findings.

The ministry was still searching for a vaccine against meningococcal disease and was investigating possibilities in Cuba, Norway and the Netherlands.

Dr Lane said that while there was a sense of urgency to begin vaccinations because of the epidemic, there were technical, safety and quality matters that needed to be worked through.

She said it was too early to predict when a suitable vaccine would be available for widespread use in New Zealand.