Prevalence of skin trouble has Kiwi doctors stumped

By MONIQUE DEVEREUX health reporter

Paediatricians are baffled why thousands of New Zealand children are in hospital with a severe skin infection that children in other developed countries do not commonly suffer.

More than 2000 children will be studied in the next year to try to find out why cellulitis is so prevalent here and why it is on the increase.

Cellulitis - a severe but preventable infection that develops around sores, cuts and bites - sends hundreds of children to hospital.

At Starship children's hospital alone more than 700 cases are seen every year, half of those requiring surgery to clear the infection.

Between 1995 and 1997 the number of cases seen at Starship rose by 65 per cent and at Middlemore Hospital by 83 per cent.

Last year it was the third most common reason for admitting children to Starship, and their treatment cost more than $1 million. But the disease seems to be common only in New Zealand. In other countries with similar climates and social conditions, including Australia, it does not rank as one of the 20 most common child ailments.

A $250,000 study financed by the Health Research Council will look at 2100 children to try to establish how they contract the infection and why the rates are increasing.

The study is headed by Starship paediatrician Dr Alison Leversha and will start next month.

Threegroups of 700 children will be targeted - those who were admitted to hospital with cellulitis, those treated by GPs and a control group of healthy children.

The central questionnaire covers a range of topics from treatment of the child's original cut or sore to whether the child was breastfed and how many people live in the child's house.

The research group will enlist the help of GPs to find their case studies.

Dr Leversha said the huge number of New Zealand cases was baffling. Research from other countries was difficult to find because the condition was not common.

She said parents might be unaware their child had cellulitis until the area around a cut, sore or bite became so swollen and tender the child was obviously uncomfortable.

Left untreated, the infection can spread to the bone and in a worst-case scenario lead to amputation of the limb. But this is rare.

The infection can be treated with antibiotics or, in more serious cases, the wound cut open so the pus can be drained.

Six-month-old Isaac Hippolite was admitted to Starship last week with cellulitis around his eye and in his cheek. His mother, Ora Potaka, said he was "really miserable, and crying for ages so it must have been painful."

She thought his red, swollen cheek was connected to teething but after seeing a GP Isaac was referred to hospital.

He was released after several days on intravenous antibiotics.

"I didn't know anything about cellulitis before. I'd just never heard of it," Ms Potaka said.

"But it was pretty nasty and I'm definitely going to tell all my friends what signs to watch out for."

The research study's conclusions should be out by September next year.