asked the Minister for Health the steps his Department have taken to investigate the incidence in this country, if any, of the new type of sexually transmitted disease known as acquired immune deficiency syndrome (AIDS); and the general incidence of sexually transmitted diseases in this country.
Ceisteanna—Questions. Oral Answers. - Acquired Immune Deficiency Syndrome.
22.
My Department have asked each director of community care and medical officer of health to investigate whether any cases of AIDS have occurred in his community care area. The Department have asked each director to indicate, in respect of any case, the mortality rate, sex, age, sexual history, nationality and whether the patient has travelled abroad and, if so, to what countries. The directors were also asked to ascertain if the patient had sexual contact in any of the countries he or she may have visited or whether a blood transfusion had been received while in those countries. To date, two cases of AIDS have been reported in this country. One of the persons died.
My Department will continue to liaise on a routine basis with the directors of community care and medical officers of health to ensure that up-to-date information about AIDS is available so that appropriate measures may be taken to protect the public health.
Under the Infectious Diseases Regulations, 1981, medical practitioners are obliged to notify cases or suspected cases of sexually-transmitted diseases seen by them. Unfortunately, the number of cases of sexually-transmitted diseases notified to my Department does not represent the true incidence of these diseases. In an effort to improve the notification and reporting of infectious diseases in general, including sexually-transmitted diseases, my Department recently reviewed the appropriate procedures. Following this review, a circular issued to the health boards laying down revised guidelines designed to facilitate the collection and dissemination of comprehensive information regarding infectious diseases, including sexually-transmitted diseases.
In addition to the recent review of the notification and reporting of infectious diseases in general, my Department have initiated a review of the Department's control measures relating to sexually-transmitted dieseases. This review is designed to evaluate as far as is practicable the problem relevant to sexually-transmitted diseases in this country and to develop a framework for their prevention and control.
Have the Department been notified by the World Health Organisation of the increasing incidence of AIDS, particularly in the US where the number of cases is doubling every six months? This is a disease that carries a very high mortality rate. Has any report been furnished to the Department by the WHO on the incidence of mortality in relation to the disease? Are specific steps being taken by the directors of community care to ensure that the disease is diagnosed, that is, if it exists in this country?
Regarding notification from the WHO, I do not have any information. The focus of the disease is still in New York and California but many cases have been seen in other parts of America, Europe and South Africa. Both cases diagnosed in Ireland were treated and a person died in 1980. That basically is the information I have.
The Minister of State said that in relation to sexually-transmitted diseases in general there appeared to be a degree of under-notification of these, in view of the Infectious Diseases Regulations, 1981, whereby doctors are obliged to notify known cases of sexually-transmitted diseases but apparently they are not doing so. In 1978 in the Department of Clinical and Micro-biology and Community Care in Trinity College a study was done——
A question, please.
The Minister of State said that there was under-notification, but in 1978 in Trinity College a survey was done of the incidence of sexually-transmitted diseases and the notification of them and there they came up with the conclusion that only 18 per cent of cases of sexually-transmitted diseases in this country were being notified. Are any specific steps being taken in the interim, other than the general ones in relation to possible future regulations, to ensure that we will know the true incidence of sexually-transmitted diseases in this country and whether it is high or low in comparison with other countries?
It is generally accepted that it is low, but a major reason for non-reporting of sexually-transmitted diseases in Ireland is that people attend private doctors and because of the confidentiality and intimate nature of the problem doctors do not seem to pass on the information; also, obviously, we have a particular attitude about it. As the Deputy is aware, there was an increase in the fee from £25 to £150 in 1981 which we thought might be a little sugar on the pill to help them to report infectious diseases such as this, but it has not done so. The Deputy himself is a medical man and I suppose he treats patients for many diseases and as far as he is concerned it is purely a relationship between doctor and patient. He would be able to answer that better than I would.
We will not invite the Deputy to answer questions.
Is the Minister of State suggesting——
This is the final supplementary. We debated this last week.
Is the Minister of State suggesting that there is a special doctorpatient relationship in this country more than in any other country?
We cannot have an argument. Ceist Uimhir 23.