Top paediatrician warns more babies will suffer this winter as RSV drug still unapproved

[00:00:00]As winter begins, staff at Middlemore's Kids First Hospital are bracing for a surge in admissions. Recently retired pediatrician Adrian Trenholm says many children and babies will end up in here, the hospital's resuscitation room.

[00:00:18]>> An example would be if a child with RSV, a little baby, has stopping breathing episode now and here. They might need to come in here and be resuscitated and they might need respiratory support, IV lines, all those things. But for me, over the years, just coming in here brings that, you know, just run from home, coming in to see what's happening.

[00:00:39]Is it meningitis? Is it pneumonia?

[00:00:42]Is it septicemia? Is it RSV?

[00:00:45]>> Respiratory syncytial virus, or RSV, is a potentially deadly lung infection.

[00:00:51]Trenholm, who's worked as a pediatrician for 46 years before he retired in April, says there is an antibody injection called palivizumab, [music] which would cut child hospitalizations because of the disease. It's approved and funded in many parts of the world, just not in New Zealand yet. Both Medsafe [music] and Pharmac say they are assessing the drug.

[00:01:16]>> So, for 40 years, I've watched every winter, I've been in these rooms, I've seen kiddies struggling to breathe, moms crying, upset, distraught, shouting at me, having to send them to intensive care, no treatment, no treatment for RSV, just got to support them. And then, after 40 years, this stuff is available.

[00:01:38]>> Well, we have but we don't have it yet.

[00:01:40]>> We don't have it. And it might be too expensive, I don't know.

[00:01:42]>> Are we too slow though, do you think, as a country?

[00:01:45]>> Well, I helped do the research.

[00:01:47]>> [music] >> Consultant pediatrician Dame Tuila Percival says the high rate of respiratory illnesses in general among children and babies in New Zealand >> [music] >> is a blight on our country.

[00:02:00]>> As a pediatrician who's worked over 25 years, what troubles you about the state of play right now in Auckland or New Zealand?

[00:02:07]>> I've worked in South Auckland for a long time and I, you know, I have colleagues who come from other places and what we see here is an incredible burden of disease and we see children suffer suffering that shouldn't be suffering like this. So, we see kids with really bad pneumonia, um chronic lung disease, children [music] who are very, very unwell, um much more than you'd see in any other place, um in New Zealand.

[00:02:34]>> It's something that shouldn't really be that bad. Um these are illnesses that are driven by um children who live in low-resource settings.

[00:02:43]Things like rheumatic fever, really. I trained in England, I never saw a case.

[00:02:48]I trained until I'd done 2 years as a doctor. I never saw a case of acute rheumatic fever. It was a strange disease.

[00:02:55]>> Half of the rheumatic fever in the country happens here in South Auckland.

[00:02:59]You know, we're not half the country, but most of the cases presenting [music] to our hospital. Rheumatic fever's unusual in developed countries, apart from Auckland and South Auckland in particular.

[00:03:10]Um in Australia you see it, but in in places where you've got indigenous a lot of indigenous children.

[00:03:16]>> In the past year, more than 1,500 children were admitted to Kids First with respiratory issues including influenza, pneumonia, and RSV. 424 were admitted for skin infections like eczema and cellulitis. There were 90 admissions for rheumatic fever and rheumatic heart disease, and 14 were on the ward for whooping cough. Trin Holm says that's a list of disgrace, but says it's not the fault of parents who often struggle with poor housing and even transport to access health care.

[00:03:55]>> Whooping cough, where did that come from? I thought we'd got rid of that.

[00:03:59]I've seen eight kids die of whooping cough in my time and I just want it gone.

[00:04:04]RSV, I always used to call this the RSV capital of Australasia just here.

[00:04:10]>> Both Trenholm and Percival say there have been many advances since [music] Kids First opened its doors 25 years ago.

[00:04:19]>> Better staffing, better trained staff, more diversity of staff, better skills, um and I think our clinical tools are much better.

[00:04:27]>> There are interconnecting rooms [music] and extra beds so parents can stay with sick children. There are dedicated play rooms and [music] staff who are specially trained to help children with autism. Percival is passionate about her work but says it's the lack of basics that continue to put children at risk and in hospital.

[00:04:51]>> What I'd say is crowded, poor housing, um cold, lack of access to heat can make things worse. So, you're more likely to get respiratory infections, you're more likely to get repeated episodes of pneumonia, more likely to get bronchiectasis. So, it yeah, definitely makes things worse.

[00:05:10]>> Are things improving?

[00:05:12]>> To be honest, I don't think they are particularly.

[00:05:15]So, you know, we're still seeing I'm not seeing a lot of kids that sleep in cars anymore but I see kids who are living in garages, you know, or um you've got four kids and parents living in one room.

[00:05:29]So, that's what I saw 10 years ago, I'm still seeing it now.

[00:05:33]>> So, do you think the issue of child health is being neglected in New Zealand? [music] >> I don't think it's it has the priority that it should have, here.