Dr Kerryn Phelps, Health Editor, with Steve Leibmann, Channel Nine, 'Today'
LEIBMANN: Most people would know that the Australian rock group Silver Chair has been forced to cancel sold out concerts in Sydney, New York and London, because their front man, Daniel Johns is not well enough to tour. His illness is unusual for someone in his twenties. It is Reactive Arthritis, a very painful condition leading to chronic swelling of the joints, and impaired movement, and of course, for a guitar player like Daniel Johns, it can potentially be career threatening. Joining us now, is our Health Editor, Dr Kerryn Phelps. Morning.
PHELPS: Morning, Steve.
LEIBMANN: What is Reactive Arthritis?
PHELPS: Well, as the name suggests, the reaction to something, and it is an arthritis, which is a swelling of joints, and it is a reaction, usually to an underlying infection of some sort, that triggers of this immune response in the body. Now, that underlying infection can be a food poisoning type of problem, like Campylobacter, or Shigella, or salmonella. It can also be a sexually transmitted disease, like Chlamydia. There are a range of other viruses and bacteria that can also trigger Reactive Arthritis, not all of them have been confirmed, but certainly the food poisoning ones, and they Chlamydia, are well described.
LEIBMANN: Is it common, and can anyone get it?
PHELPS: It isn't particularly common, but anyone can get it. There is a particular genetic predisposition, which is a blood test called HOAB 27, which is a blood type, if you like, and there are people who have that particular type of thing in their blood are more likely to get this type of Reactive Arthritis. But, it is not confined to those people, and in fact, the age group most likely to get Reactive Arthritis is 20 to 40, but it can happen at any age, children can get it, elderly people can get it, right across the spectrum.
LEIBMANN: Reading the articles about Daniel Johns, there was a suggestion in some of them, that if you get it, it normally only lasts for a handful of months, but he has had it much longer than that.
PHELPS: Yes. There is a number of different patterns, sometimes it only lasts for a few days and you're back on your feet, back to your normal activities. It can last weeks, it can last months, in some people it can keep coming back at them, or in other people it can be a chronic situation. And, it's not just joint swelling, there are some other signs of Reactive Arthritis; inflammation of the eyes, and in some people lower back pain, some people can get diarrhoea, which could well be related to the food poisoning problem, and the ongoing problem with the bowel there. There can be some scaly patches on the skin, the arthritis is usually in the lower limbs, knees, ankles, feet, but it can also, as in Daniel Johns case, occur in the hands and other parts of the body, and you can get what are called 'sausage toes' which are, swelling around the toes.
LEIBMANN: How do you treat it? Is prevention the way?
PHELPS: First thing is to see if there is some underlying infection, and if you have that it needs to be treated. If it's bacterial, it can be treated with antibiotics. If it's viral, clearly that can't be treated with an antibiotic, because it won't work. Then you need to treat the inflammation, and the symptoms. So, some people will find that anti-inflammatory drugs help, hopefully then it will go away. If it doesn't go away and you're left with a chronic type of arthritis, then you have to look at what are called disease modifying drugs, and there is one called sulphasalazine, there are some chemotherapy type drugs which can dampen the body's immune system which can be useful, some people need cortisone treatment. It's interesting, this disease has been around a long time, it's thought to have been first described by Hypocrites, and there was some suggestion that Christopher Columbous might have suffered from it in some of his sea voyages. So, it is one well described, and well recognised.
LEIBMANN: So, normally Reactive Arthritis, can progress to just Arthritis?
PHELPS: No, generally it doesn't destroy the joints, and once it passes the joints still remain quite normal. So once somebody can actually get their way through this illness, if they can get passed that, and not have a chronic ongoing form of the disease, then their joints will return to normal.
LEIBMANN: Just quickly, so if you get it, treat it, get rid of it, will it come back? Can it come back?
PHELPS: It can come back, and the thing is if you are prone to this type of disease, and you get another trigger infection, say you get another bout of food poisoning, then you can get the Reactive Arthritis again, but it can be terrible disabling, and very distressing, and can be difficult to diagnose, because there is not a Reactive Arthritis blood test that you can do. But, nonetheless, you need to obviously see a doctor make sure that you get the diagnosis right.
LEIBMANN: Okay. See you next week.
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