Vaccine lifts hope of ending disease epidemic

By MARTIN JOHNSTON health reporter

Hundreds of tiny bottles containing new hope of beating New Zealand's worst infectious disease have landed in Auckland.

They are the first batch of a vaccine developed to combat the New Zealand strain of meningococcal disease that has swept the country, especially poorer parts of Auckland and Northland, for more than a decade.

Since 1991, it has infected at least 4200 people and killed 190.

Last year, the worst yet, one sufferer died of it every fortnight.

The epidemic is expected to last another decade.

On Sunday, 351 vials of the new vaccine arrived by air from Norway, where early batches are being made.

Each vial contains 0.5ml of the vaccine, which is expected to be injected into adult volunteers from next week for a clinical trial.

The trial is being jointly run by the Ministry of Health and the University of Auckland. Further trials are planned in the hope the vaccine will prove to be New Zealand's answer to the disease.

The epidemic has cost the country $630 million, of which direct costs to the health sector have been estimated at $300 million.

The Government has committed more than $100 million to the vaccine project, an experiment in which New Zealanders will be international guinea pigs.

Paediatric infectious diseases expert Professor Diana Lennon, of Auckland University, said it would be the first time the New Zealand strain of the vaccine would be used in humans, but it was a modification of a vaccine that had been used safely in hundreds of thousands of Norwegians.

Meningococcal disease, a bacterial infection, can cause meningitis (inflammation of the lining of the brain and spinal cord) and blood poisoning.

A fifth of cases are left with some degree of disability or brain damage, such as deafness, loss of limbs, or grafts to repair damaged skin.

The bug lurks in the throats of up to a fifth of the population, usually without causing them harm.

It can be spread by activities such as sharing drink bottles and kissing and is associated with poverty and overcrowded housing.

One in every 100 Maori and Pacific Island children under the age of 5 can expect to catch the disease.

The ministry says that symptoms include fever, nausea, vomiting and headache, rash, neck stiffness, young children refusing drinks or feeds, sleepiness and joint pain.

The disease is difficult to detect, but is readily treated with antibiotics if diagnosed early.

The trial due to start next week involves 75 people aged 18 to 50 who have been recruited through Auckland hospitals and public health agencies.

They will each receive three injections of vaccine spaced six weeks apart.

They will also have blood tests to check whether it prompts an antibody response to the disease and be asked to report any side-effects.

Professor Lennon said that, if the trial indicated the vaccine was successful and safe, further trials were planned.

But the later trials had not yet been granted regulatory and ethics approval.

A second trial is intended to test the vaccine on several hundred children aged between 8 and 12 and may start in October.

A third is planned for a similar number of young children and toddlers.

Professor Lennon said it was crucial to know whether the vaccine worked on infants because children under 5 with poorly developed immune systems were the main victims of the disease.

It is expected that if the trials lead to the licensing of the vaccine, a pilot vaccination programme will start before next winter, preceding a mass vaccination campaign targeting everyone under 20 from 2004.

Health Minister Annette King has said she considers it a big challenge to prove the vaccine's effectiveness.

"But this vaccine holds the greatest hope of bringing this epidemic under control," she said.

"In the meantime, the people of New Zealand need to remain vigilant and learn the early symptoms of meningococcal disease in order to seek early treatment."

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nzherald.co.nz/health