Missing medicine endangers health of baby

Photo: Elmo Riig / Sakala

A boy born in June, in Põlva, was facing fatal complications as mother contracted chickenpox, Estonia lacking store of immunoglobulin – antibodies used to fight it.

Luckily, the baby boy’s parents were able to secure immediate help from Finland via personal contacts. Otherwise, the infant, in the worst case, may have developed brain and meninges inflammation. «This was a very rare case,» said Põlva Hospital chief doctor Margit Rikka. «The mother fell ill the day after giving birth. The child needed immunoglobulin, which was unavailable in Estonia,» said she.

According to the doctor, it is agreed in Estonia that, as a rule, regional hospitals ought to carry supplies of such rare medicaments, like Tartu University Hospital. Even Ministry of Social Affairs was engaged in the search. «In the end, the parents, through personal contacts, obtained immunoglobulin from Finland. The child received the treatment and is currently being monitored by physicians,» said Ms Rikka.

Chickenpox is a common children’s disease. Even so, newborns may develop complications due to weakness of the immune system, the mother also not having had time to develop antibodies against the disease. «Therefore, the child was administered immunoglobulin, both mother and child also treated against viruses,» explained Ms Rikka.

Immunoglobulin is necessary with chickenpox, hepatitis B, and tetanus. With botulism and diphtheria, antitoxin is needed.

According to Eveli Bauer, chief specialist of medicaments department at Ministry of Social Affairs, such instances rarely occur. However, as immediate intervention is needed and the preparation difficult to obtain, it has to be kept available.

A corresponding public procurement procedure was announced in the last quarter of 2012, which failed as no offers were made. No corresponding products are registered in Estonia. A new procurement, however, is being prepared.

«Both prior to and after the failed procurement procedure, the medicaments department of Ministry of Social Affairs has been in negotiations with all major local wholesalers, representatives of vaccines producers etc. Alas – to no results,» admitted Ms Bauer.

«Only one seller has so far shown an interest, but they ran into trouble with the medicament documentation and have yet to find a solution,» added the specialist, who was unable to specify the problem – the information being confidential.

Ms Bauer explained that both immunoglobulin and antitoxin are highly specific products. «These are difficult to produce and storage time is short. Also, the needed amounts are very small,» said Ms Bauer.

For a quick solution in the given case, the Ministry of Social Affairs addressed Latvia and Lithuania for help, these also lacking immunoglobulin. «The availability of immunoglobulin is not only problematic in Estonia, but in the entire European Union. There is an awareness of the problem, the solution is being sought,» added Ms Bauer.

Social ministry is dealing with the issue and, as confirmed by Ms Bauer, the goal is to secure a store of immunoglobulin as fast as possible. In the given instance, the family’s expenses will be compensated by the ministry. To the ministry’s knowledge, the case is the only one in the past six months.

Last year, a decision was taken by immunoprophylactics expert committee that the task of guaranteeing a storage of immunoglobulin will, starting January 2012, be laid on Ministry of Social Affairs. Earlier, it was up to hospitals to decide what kind of storage they would maintain, a separate Health Insurance Fund financing mechanism being created to that end.

The Ministry of Social Affairs is tasked with obtaining five differing kinds of immunoglobulin and antitoxin, including chickenpox immunoglobulin, to be stored at two regional hospitals.

Vaccination

Ministry of Social Affairs advises anti-chickenpox vaccination of:

•    children under the age of 13 not having had chickenpox and with no contraindications to live vaccines; as well as those inclined to develop severe cases of chickenpox (those with leucosis or children before planned organ transplants);

•    young people starting at 13 years of age;

•    women planning to get pregnant, having not been sick with chickenpox;

•    staff at children’s departments and haematology/oncology departments.