Dáil Éireann debate -
Tuesday, 4 Feb 1992

Vol. 415 No. 3

Adjournment Debate. - County Cork Meningitis Outbreak.

Mr. G. O'Sullivan

In view of the serious concern and fear being shown and expressed by parents in Cork city and county, I take this opportunity on the Adjournment to request the Minister for Health to intervene immediately in the present outbreak of meningitis which is affecting children in the Cork area.

Some commentators have indicated there is no crisis but I use the word "crisis" advisedly because it is a crisis for every child who contracts meningitis. A recent report by the Southern Health Board states that 15 cases have been identified in the past month. Nine cases were identified in the Blarney area and this necessitated the closure of schools in the area. Another five cases have been identified in the city and a report no later than this evening states that two children are seriously ill with meningitis in hospital. The report states that while 15 cases have been identified there have been no deaths as yet.

The present situation is completely unacceptable. Do we have to wait until a child dies before urgent action is taken? While some schools have closed in the Blarney area, the health board admit they are finding it difficult to get information across to parents due to the current RTE dispute.

I have no wish to cause unnecessary anxiety for parents but I know that the local radio station and the local press in Cork are being beseiged by anxious parents seeking information and being critical of the Southern Health Board for the way they are handling the present situation.

It is also very serious when one takes into consideration the bed complement in Cork city. Cork Regional Hospital advertised recently in the local press that they would be only taking in emergency cases due to the health cutbacks. The South Infirmary Victoria Hospital and the Mercy Hospital are in the same position with long waiting lists. I shudder to think what the situation would be if meningitis became rampant throughout the city and county. At present it is practically impossible to get an elderly person admitted to hospital. With no let-up in the cutbacks in health since 1987, and with medical and nursing staff stretched to breaking point trying to provide the necessary services, a burden such as a major epidemic would make it impossible for staff to cope with additional admissions.

As the Minister knows, meningitis is a lethal disease that can cause death or brain damage. It is only natural that parents are seriously concerned with the situation. While the 15 cases identified so far may not be a great number at this time, it is also a fact that this is a highly contagious disease which can be passed on very quickly from one child to another. And 15 cases at present are 15 cases too many.

The disease can also cause complications such as temporary blindness, and deafness, which may become permanent. It is also a fact that loss of hearing in small children may result in their becoming deaf mutes.

I believe that the situation in Cork city and county needs immediate ministerial intervention so that appropriate action can be taken by the health board. If that action necessitates the closure of all schools in the area as a preventative measure, so be it.

But what is also urgently needed now, Minister, is that the fears and concerns of the parents are put at rest and assurances given that all measures will be taken to curb this serious outbreak of meningitis.

Minister of State at the Department of Health (Mr. Flood)

I wish to point out that during 1991 there were 38 cases of suspected meningo coccal meningitis in Cork city and the south Cork community care area. They were scattered sporadically and the majority occurred in the first quarter of 1991.

The health board have informed the Department that since 1 January this year there have been 15 suspected cases; five in Cork city, nine in the greater Blarney area and one in Glanmire. The age range is from nine months to 16 years and in three of the 15 cases girls were affected. No deaths have been reported.

My Department are liaising with the Southern Health Board regarding these cases and the Health Board are taking the appropriate action to deal with the situation.

Three schools in Blarney have been closed. The pupils were issued with information leaflets on the condition and its early symptoms as treatment in the initial stage is essential to achieve maximum results. General practitioners in Cork were issued an update on the situation. A press statement was issued by the health board to the national papers on Wednesday, 29 January in which they emphasised the need to itemise the early symptoms.

Close liaison with hospitals, general practitioners and schools is being maintained by the health board, and the public have been advised that they can contact the local director of community care or the medical officer of health for information.

Meningococcal meningitis is one of the three main types of bacterial meningitis. At a national level the Department of Health monitor the incidence of bacterial meningitis in two ways: first, through the weekly reporting of cases by general practitioners to the local director of community care or medical officer of health who, in turn, reports the cases to the Department; second, reports on individual cases of bacterial meningitis are submitted by the local director of community care or medical officer of health to the Department.

These reports in recent years have not indicated any major outbreak, a clustering of cases or particular possible sources of infection. The pattern of infection has been of sporadic cases occuring in various parts of the country. However, in view of the need to be vigilant in reporting cases, the deputy chief medical officer of my Department has written to each director of community care or medical officer of health informing them of this and asking them to liaise with general practitioners to ensure that there is a high awareness of the disease among general practitioners and that appropriate control and management measures are undertaken.

The Department operate a control programme in conjunction with the health boards and with primary care doctors. The appearance of a case of bacterial meningitis indicates to the local health service the presence of infection in the area. The director of community care or the medical officer of health then liaises with local general practitioners to create a more clinical awareness of the presence of the infection. That is important because in the more pernicious types of infection the prognosis will depend on early diagnosis and appropriate antibiotic therapy. Prophylactic therapy is also initiated for the family and immediate contacts of cases.

As I mentioned earlier, the Southern Health Board are taking the appropriate steps in relation to the cases occurring in the Cork area and will continue to do so until the infection has been cleared.