Typhoid

Health

scare in New Zealand

By Martin Tiffany

On the surface, the several cases of typhoid reported in Auckland, New Zealand last year do not appear too much to worry about. But scratch the surface and a bigger problem emerges.

Fresh fish from Western Samoa seems to have been the likely cause of the dis ease in at least two cases. The problem, therefore, is food and people entering New Zealand without undergoing thor ough screening and, in the process, bringing diseases in as well.

Central Auckland’s Medical Officer of Health, Dr Lester Calder, says, cases of the potentially fatal disease can be linked to a typhoid epidemic in Western Samoa in 1993.

He said it was hard to say for certain where a person contracted typhoid and it often took a bit of detective work to trace it to a possible source.

“ Typhoid is uncommon here. It is usu ally contracted when people travel overseas. But when people have not travelled, we have to inquire what they have eaten,” said Dr Calder.

He said two of the cases seemed to have been caused by fish from Western Samoa, and there was a possibility a third case could stem from the same cause.

According to figures from the Communicable Diseases Centre in Wellington, 23 cases of typhoid were reported last year. None was fatal.

Although this may seem nothing to get excited about, it was enough for Dr Calder to broadcast, on Auckland’s Pacific Island Station, warnings of the dangers of bringing in the disease through fresh fish.

New Zealand’s Ministry of Agriculture and Fisheries allows dead fish from Western Samoa and other Pacific coun tries into the country.

Dr Calder said he had asked the New Zealand Ministry of Health to put up warning signs in airports and distribute pamphlets to the various island nations but had not received an enthusiastic response. “They seem worried about it being a political thing,” he said.

Dr Calder also wants to take up with MAF the case of regulations on seafood coming into New Zealand being so lax.

He said people needed to know about the infection, the symptoms - stomach pain, fever - and the fact that because it is a gastrointestinal disease, it can kill you.

“People have to take it seriously.”

Typhoid is a bacterial infection of the intestines caused by contaminated food or water. Often patients who have

recovered become carriers.

Dr Calder is also concerned about the time and money spent when a person is found to have typhoid. There are lengthy tests that have to be carried out on the infected person and relatives, and a course of expensive antibiotics have to

be prescribed.

Dr Farhat Mahmood, South Auckland’s Medical Officer of Health, is also con cerned about the risks of typhoid. He, like Dr Calder, was glad when PIM con tacted him to highlight the problem.

“I am glad you called, I have been try ing to get this problem into the paper,” were Dr Mahmood’s first words. He said everyone bringing fish into New Zealand was taking a risk as there was no way of knowing if the fish was cont aminated.

He was unhappy there were no restrictions on bringing fish to New Zealand and believed the only way to tackle the problem was to educate the people.

South Auckland is the area most at risk because of the high concentration of Pacific Islanders - especially Western Samoans. Most of the fish brought from the Pacific is given as gifts by visitors or returning residents.

Typhoid is not the only disease caus ing concern in New Zealand’s Pacific island population - especially in South Auckland. Tuberculosis rates among Pacific Islanders are high, compared to Europeans and other races.

According to Dr Calder, TB among Pacific Islanders in Auckland is 30 times that of Europeans in Auckland. He blamed overseas travel by Pacific Islanders and Asians for the number of TB cases in New Zealand remaining sta tic.

After World War 11, the rate had declined steadily until the early 1980 s when it levelled off and remained so for the past 10 to 12 years.

Dr Calder sees the end of the welfare state, with its increase in poverty, anoth er factor affecting the number of TB cases.

The TB problem is more difficult to eradicate. Health checks are compulso ry only for Pacific Islanders seeking res idency, but people from Niue, Tokelau and the Cook Islands enjoy New Zealand citizenship and come and go as

they please.

The New Zealand government is reviewing its health screening proce dure for immigrants following concerns raised. But this has already been criti cised as being a breach of human rights.

The battle against diseases being brought into New Zealand is a difficult one to win. ■