asked the Minister for Health if he is concerned at the increase in the number of cases of AIDS reported; and the measures he has taken to prevent the spread of the disease in this country.
21.
Ceisteanna — Questions. Oral Answers. - AIDS Cases.
8.
asked the Minister for Health the incidence of acquired immune deficiency disease in Ireland; the steps which have been taken to ensure the accurate diagnosis and surveillance of suspected cases of acquired immune deficiency syndrome; and if he is satisfied that our arrangements for epidemiological surveillance of AIDS is in conformity with the highest international standards.
I propose to take Questions Nos. 8 and 21 together. Eight cases of AIDS have been diagnosed in Ireland to date, seven among homesexual or bi-sexual men and one haemophiliac. Five have died, one has gone abroad and two are under care. The groups most at risk of developing the disease are bi-sexual or homosexual men, intravenous drug abusers, people who have received transfusions or blood products from an infected source and sexual partners of AIDS patients or AIDS suspects. There is no evidence to date that casual or social contact with others presents a risk of infection.
Measures taken for the control of the disease in this country include the following:
1. Detailed instructions have been given to health boards about arrangements for reporting and surveillance of cases and suspected cases of AIDS. These instructions are updated periodically to take account of new information about the disease as it becomes available. The surveillance system is working satisfactorily.
2. In accordance with World Health Organisation recommendations, the Blood Transfusion Service Board have been using heat treated blood products only since 1 January 1985. In addition, the board have made arrangements to provide our total requirements for these products from domestic blood. These are important measures for the protection of our haemophiliac population. Persons in the at risk groups are asked not to donate blood. All blood donations are tested for the presence of AIDS virus anti-bodies.
3. Arrangements have been made for routine anti-body testing of intravenous drug-abusers. Other persons who suspect that they may have the disease should make arrangements for AIDS anti-body testing through their general practitioner or at an STD clinic. Confirmatory testing as required is arranged at the virus reference laboratory, UCD, Belfield.
4. In addition to the information already circulated to health boards, a general informatiion booklet on AIDS for all doctors is in course of preparation. An information leaflet for the general public is also being prepared. In the normal way, counselling and education are matters for the family doctor.
I am satisfied that our arrangements for monitoring developments in Ireland and internationally relative to the disease are adequate.
I do not wish to cause alarm but, in view of the rapid spread of this disease in other western countries and the fact that there is no treatment for it, is the Minister satisfied that the measures he has in mind, particularly for the information of the public, are sufficient?
I have endeavoured to give as much detailed information as possible. For example, I have encouraged direct contact between the Deputy Chief Medical Officer of the Department of Health and the media. I have asked him to speak to various groups and to the media in a professional capacity about the various aspects of this disease and he has done so very competently. We are deficient in terms of written information, but that is being remedied. This matter has been the subject of considerable public misconceptions and fears. Nevertheless, eight cases have been diagnosed so far.
There is growing public concern about this condition. I questioned one of the Minister's predecessors in this House about four years ago and he did not know very much about it. At the time the press and the public thought I had gone mad. However, that is beside the point. Is the Minister satisfied that our methods of surveillance comply with the conditions laid down by the international centre for the control of that disease in Atlanta in the United States? Does the Minister have any statistics on the incidence of seriologically positive cases of the HTLV3 virus which exist in this country since a certain percentage of those seriological positive cases may develop the overt disease? Has the Minister any statistics in relation to the AIDS related complex which is now causing considerable concern internationally since it is more likely to be transmitted by a hetrosexual contact?
Our dependence in terms of reporting arrangements has been for the most part the WHO questionnaire which, as the Deputy knows, is very complex. I am reasonably satisfied from the discussions I have had in the Department that the directors of community care have made satisfactory reporting arrangements. I am satisfied that there is a sufficient degree of alertness and that we do not need to be too preoccupied with the Atlanta report. I will write to the Deputy to give him the seriological data and other relevant matters. I made a public statement about the incidence of positive reports, and I do not want to cause undue public alarm about it.
Would the Minister clarify the position regarding blood given by donors for transfusion to others? What type of testing is carried out on such blood to ascertain the presence of AIDS? Does the Minister regard the testing being done as satisfactory? Would he specify if testing is done for seriological analysis and is he aware that it takes three months to ascertain if anti-bodies are developing? He referred to deep freezing of blood. Would he agree that this destroys the essential red cells and therefore is not suitable for transfusion except in limited cases?
It is of critical importance that suspects in any circumstances should not present themselves to the National Blood Transfusion Service and try to avail themselves of the automatic testing which the service now carries out on donors. The other tests can be done separately. I have made substantial additional cash resources available to the transfusion service and major precautions are being taken in this matter. The board have been using heat treatment to blood products since 1 January and I am assured that the deficiencies referred to by the Deputy are being looked at in the process. We are not now importing any blood because there was a substantial risk of infection from certain imported blood. All our blood requirements are now being filled by domestic suppliers. Great precautions have been taken in the last four or five months under new chairmanship: an excellent board member has been appointed chairman of the transfusion service and our service is now a match for any transfusion service in the world, including the UK and Northern Ireland.
Are we using the anti-bodies tests?
All blood donors are tested for the AIDS virus. A number of representations have been made by individuals who wish to give blood to their relatives. That is not acceptable. The precautions now in force are very extensive. We spent money in 1985 in this and the Government have made more money available.
I wish to ask a supplementary on Question No. 21.
The Deputy may ask one brief question and the Minister may give one brief reply.
The Minister said he would supply me with figures. Have the Department got those figures or will it take a long time to provide them? I am speaking of people who are seriologically positive to the virus. In other countries that is probably the best yardstick they can get. In the United States they found one million people who are HTLV3 positive. In the UK the figure is 10,000 and in France, 40,000.
The Deputy has asked the question and he should let the Minister answer.
Can the Minister give us the incidence of seriologically positive cases among those who suffer from haemophelia?
If the Minister has a short answer would be please give it?
I have been waiting to ask a supplementary.
I know that. It is ridiculous.
I will forward the information to the Deputy.
Have the Department got the information?
We have got it.