Spike in rheumatic fever coincides with launch of unprecedented research funding

4/06/2020

Spike in rheumatic fever coincides with launch of unprecedented research funding

Cure Kids, New Zealand’s largest charitable funder of child health research, says its new $10million funding commitment to address the effects of social deprivation on child health illnesses is critical, and that the need for it has been reinforced by a recent increase in rheumatic fever across New Zealand.

In recent weeks, Wellington’s Regional Public Health services reported a spike in typical case numbers, with a 25% annual increase nationally (from 58 to 72 children) and nine hospitalisations in Wellington in 2020, compared to an average of one to two cases.

Cure Kids CEO Frances Benge says the charity’s increased funding for this condition is timely, with research needed to help understand risk factors, design preventative interventions, develop a diagnostic test and effective treatments for rheumatic fever, and create a vaccine for Group A Streptococcus.

“This year, Cure Kids launched a contestable funding round to help answer these questions, committing the first $3 million over the next three years. We received 17 proposals, 11 of which have made it into the final stage. In August, an Assessing Committee, including leading scientific advisors, Māori and Pacific health advisors, and international subject matter experts, will meet to decide the final successful applications.”

She says the heightened focus on new research is due to New Zealand having one of the highest rates of rheumatic fever in the developed world, despite this being a preventable illness. The condition disproportionately affects Māori and Pacific communities, and requires a significant research investment in order to eliminate it from our country.

Dr Nikki Moreland, Senior Lecturer in Immunology and Biomedical Scientist at the University of Auckland, is currently funded by Cure Kids. Her work focuses on identifying biomarkers for rheumatic fever.

“There is no single, specific test for the diagnosis of rheumatic fever, so a quick diagnosis is not always possible. Identifying unique biomarker(s) present in rheumatic fever is an important first step to developing an accurate diagnostic test; something is needed to speed up diagnosis,” says Dr Moreland.

Professor Michael Baker has pioneered research on risk factors for rheumatic fever in New Zealand, co-funded by Cure Kids, showing how the risk of rheumatic fever is strongly associated with household crowding.

“Rheumatic Fever is a preventable disease that has been eliminated in most high-income countries,” says Professor Baker.

“The lock-down largely quarantined the entire New Zealand population at home for six weeks.  This intervention is highly effective at stopping transmission of epidemic diseases like Covid-19 and influenza.  Unfortunately, it may have the opposite effect for diseases caused by bacteria that are widely carried in the population like Group A Streptococcus.  Large families living in crowded houses may therefore have been exposed to increased transmission of these bacteria to children and young people who are vulnerable to developing acute rheumatic fever causing the current spike of cases.”

This public health issue encompasses three conditions – Group A Streptococcus (strep throat), rheumatic fever, and at its worst state, rheumatic heart disease – meaning it straddles both communicable and non-communicable diseases (NCDs).

Public and private donations are sought throughout the year and culminate in Cure Kids’ annual Red Nose Day appeal, which has been moved forward to 31 July 2020 due to COVID-19-related funding constraints.