The Southern district has the highest rate of new infections of hepatitis C in the country, recent statistics reveal.
And after being updated on the situation last week, the Southern District Health Board has agreed to work on a plan to tackle the blood-borne virus.
It is hoped the new strategy will quickly lead to a district-wide agreement on what hepatitis C services should be provided across Otago and Southland.
The board made the decision to support the strategy's joint development by health and non-government groups at last week's community and public health advisory committee meeting, following a report from public health physician Dr Keith Reid.
Dr Reid said recent health surveillance data showed last year 45% (13) of the new cases notified in New Zealand were in the Southern district, up from 33% (9) in 2011.
The figures also suggested there was a high rate of treatment for the disease in the South, with 54 people, or 11.3% of all cases being treated in the country, being treated by the Southern DHB in 2011.
But the problem was actually likely to be a lot bigger.
Only about a quarter of carriers were aware they had the disease, and an estimated 1.5% (about 3600 people) of the adult population of Otago and Southland carried the virus.
An anonymised study, involving the testing of blood samples submitted for other purposes, was under way in Dunedin, which would provide information on the extent of the disease in the wider community.
Dr Reid said the district's high levels of diagnosis and treatment reflected an awareness of the condition within the Southern DHB's medical community and a willingness to treat chronic infection.
However, that also meant significant commitment to treatment costs - eradication treatment costs $30,000 per person for the full 48-week course - and questions had been raised about the balance between spending on treatment and spending on preventive work.
He said most southerners diagnosed were most commonly infected through intravenous drug use, or sex with an intravenous drug user. The next most common cause was tattooing in an unregulated setting.
The Ministry of Health managed contracts for preventive and harm reduction activity across the country, including needle-exchange services and hepatitis C resource centres.
However, there was ongoing concern that the ministry funding did not match the need for needle-exchange services across the Southern district, particularly in rural areas, he said.
Several proposals had been made to the ministry for outreach services, but none had been taken up so far.
The Southern DHB provided strategic support and advice to the needle-exchange service, clinical support to the hepatitis C resource centre and services to prisoners.
Public Health South also actively raised awareness of safe sex practice and dealt with local councils about tattooing.
Despite that activity, the infection rate had been high for two years now, indicating additional measures were needed to bring it back down, Dr Reid said.
Hepatitis C
• An infectious virus affecting primarily the liver.
• Spread by blood-to-blood contact.
• Has infected about 50,000 people in New Zealand; 75% of these people are unaware they are living with the virus.
• Can be treated with medication.
• Between 50% and 80% of people treated are cured, depending on the genotype of the disease they have.
• Is a leading cause of liver transplantation.
•Cannot be vaccinated against.
• Symptoms include decreased appetite, fatigue, nausea, muscle or joint pain and weight loss.
Source: Hepatitis Foundation of NZ
