I wish to share my time with my party's spokesperson on child care, Deputy Flood.
Adjournment Debate. - Incidence of Meningitis.
I am sure that is satisfactory.
Up until last Saturday I viewed the concern about the incidence of meningitis as a politician and as my party's spokesperson on health but it was brought into sharp focus when my 15 year-old child arrived home from boarding school having suffered from a severe and violent headache with severe joint pain and a high fever— three of the symptoms one would associate with meningitis — for a period of seven hours.
Unlike most parents, I telephoned my GP who gave me strong advice as to what I should do. Thankfully, it was a viral flu which is prevalent throughout the country at present. The vast majority of parents are not contacting their GP, rather they are presenting their children at the casualty unit of their local hospital. The problem in Dublin has received widespread publicity although it is being experienced in the casualty unit of every hospital in the country. Those who need immediate attention have to wait in the queue with everyone else who presents themselves at a hospital. I appreciate the concern about the symptoms of meningitis but everyone has to wait longer, even when some cases are more urgent than others.
All of us realise at this stage that the issue of meningitis is emotive and frightening.Parents who present a child with some or all of the symptoms are concerned that they receive attention immediately and it should be available. The timing is critical as is the question of what should be done to deal with the problem. There are more cases than one would expect at this time of the year. We have to ensure quickly that the medical profession recognises what it is dealing with, be it bacterial, of which there are many varieties, or viral meningitis.We also have to ensure that parents and the public in general are made aware of and recognise the symptoms and take the appropriate action. Prompt action is needed by both the medical profession and parents.
Many children are kept at home with a high temperature, a scratchy throat, fever, vomiting, aching joints and so on which are some of the symptoms associated with meningitis. We need to alert parents to the fact that children would also be sensitive to bright light and have a definite rash. Parents who are concerned should contact their general practitioner and present the child at the local hospital, but the warning signs have to be recognised. Above all, we need to reassure parents.
In this regard I wish to make two proposals to the Minister of State, Deputy O'Shea, for presentation to the Minister.During the months of December, January and February, the crucial and dangerous months, the Health Promotion Unit of the Department of Health should conduct a publicity campaign in the national and local media to indicate to parents that this is a time of danger, to explain the symptoms in great detail and to outline the action they need to take. This should be done as a matter of urgency.
We do not have a national communicable diseases surveillance unit or centre.They have a good model in the United Kingdom. Although it may not be possible to do this in the immediate future a policy decision should be taken by the Minister to establish such a centre, possibly within the Department of Health. It would not involve huge costs or elaborate buildings but the centre ought to be able to avail of medical and nursing skills.
The time available to the Deputy is exhausted.
May Deputy Flood have a few minutes?
I will allow him to intervene for a moment. Members should appreciate that when they seek to share time they need to utilise it fairly.
I thank you, a Cheann Comhairle, for facilitating me. I have a particular interest in this matter. Without being contentious or argumentative on this, I wish to say that perhaps on other occasions the Minister for Health and his Department failed to respond adequately. We should have immediately conducted a nationwide advertising campaign in the printed media, on radio and television to get the message across and explain the symptoms. We should not have depended on the media to publish the information. In the future we should be prepared for such an outbreak in order to save lives.
I thank Deputy Geoghegan-Quinn for providing this opportunity to place on record the current situation about meningococcal meningitis.
I repeat the assurance my colleague the Minister of State, Deputy Currie, gave to the Seanad on Thursday last, that the incidence of the disease, which has been reported to the Department of Health by the health boards, is more or less the same as in previous years and as such does not constitute an epidemic or an unusual nationwide outbreak. The Eastern Health Board, in whose area most of the cases occurred recently, has also confirmed that there is no epidemic of the disease but that there is a higher incidence than usual in the north Dublin area. In addition, Temple Street Children's Hospital has confirmed that the meningitis infections which were confirmed in children admitted there recently were not of a single strain. This reinforces the view that cases are not connected and that the disease has not reached epidemic proportions.
The information from the monitoring of the disease shows that its incidence is running at approximately the same level as in previous years. A total of 225 cases were reported in 1992; a total of 203 cases in 1993 and 239 cases in 1994. For the period between 4 November 1994 and 11 February 1995, a total of 105 cases have been notified to the Department, compared with 84 cases during the same period last year.
The Department, and the health boards, are very vigilant about the surveillance of meningococcal meningitis and operate a comprehensive system for monitoring its incidence. Under guidelines issued by the Department to the health boards, measures are in place to monitor the disease at local level, at national level and at the level of individual cases.
It is not mandatory; we do not have a national centre.
In addition, statistics on deaths from meningococcal meningitis are sent to the Department of Health, by the Central Statistics Office. This represents a very prompt and comprehensive reporting system on the incidence of meningitis and it is a reflection of the seriousness with which the Department treats this disease.
It is haphazard.
Following media reports of an epidemic of the disease in parts of Dublin, the Eastern Health Board issued a press statement on Saturday, 4 February confirming there was no major epidemic of meningitis in the area. In this regard, the board stated that any reference to "an epidemic" was purely technical, in that there was an unusually high number of cases within a specified area and a specified period of time. The cases occurred in different parts of north Dublin, which has a population of 400,000.
My colleague, Deputy Currie, indicated to the Seanad on Thursday last that the incidence of meningococcal meningitis reported to the Department in recent months has not risen above its normal level. However, the occurrence of five deaths from the disease during a relatively short period in January of this year is unusual and a cause for concern. I sympathise with the bereaved families and I am sure Members of this House join me in this.
In view of these deaths, my colleague, the Minister for Health, Deputy Noonan, took special measures to alert health professionals and parents about possible cases of the disease, as early diagnosis and treatment are essential for a complete recovery. On 17 January 1995, the deputy chief medical officer of the Department wrote to each director of community care requesting them to ensure that information concerning the disease is as widely available as possible to parents; that doctors should be extra vigilant in their assessment of patients, bearing the possibility of meningitis in mind, and that preventive measures be implemented as quickly as possible.
The directors of community care were also asked that the leaflet prepared by the Department's health promotion unit on meningitis should be promoted appropriately in each community care area, for example, through schools, health centres and local health board offices.
In addition, directors of community care were reminded of the necessity for early and comprehensive notification of cases of meningococcal meningitis to the Department so that any unusual incidence of the disease nationally could be quickly identified and appropriate action taken.
The Minister for Health also issued a press statement on 17 January 1995, which was carried on television, radio and the newspapers, advising parents and teachers they they should be aware of the symptoms of meningitis and to bring children to their general practitioners if worried. Doctors were advised they should be extra vigilant in relation to cases or suspected cases, as early diagnosis and treatment is vital for a successful outcome in individual cases.
A further letter was issued to the health boards by the Department on 31 January 1995, requesting the health boards to disseminate the health promotion unit's leaflet on meningitis, towards informing the public and professionals such as doctors, nurses and teachers who come into regular contact with children, of the symptoms of the disease, the treatment of cases or suspected cases of the disease and the prevention of infection in contacts of cases or suspected cases.
The Minister also stressed the need for early detection and intervention on a television news bulletin that day. In addition, the print media, radio and television provided excellent support and co-operation to the Department in publicising information about the condition and the steps to be taken by parents, teachers and guardians of children.
A free telephone helpline has been in operation in the Eastern Health Board since 3 February 1995, in order to give information, advice and reassurance to worried members of the public. The helpline, which initially operated from 9 a.m. to 9 p.m., is now operating from 9 a.m. to 5.30 p.m., Monday to Friday, and an answering machine service is in operation outside of these hours. The level of concern among parents about the disease was demonstrated by the fact that 2,500 persons made calls to the Eastern Health Board on the first day of the helpline and this is now averaging ten to 12 calls a day.
The necessary measures were therefore taken by the Minister, the Department and the health boards to inform the public about the current incidence of the disease and, in particular, about the need for vigilance for early symptoms and the importance of early treatment in ensuring a complete recovery.
Finally, I reiterate that the current incidence of meningococcal meningitis is not unusual but this is not to say we should be complacent. Parents, teachers and others dealing with children should familiarise themselves with the symptoms of this very serious disease and if they are worried they should consult their general practitioner as soon as possible.
Will the Minister of State bring the two proposals I made to the attention of the Minister?
I will indeed.