Dáil Éireann debate -
Tuesday, 30 Jun 1998

Vol. 493 No. 3

Written Answers. - Hepatitis B Infection.

Michael Ring

Question:

261 Mr. Ring asked the Minister for Health and Children the study, if any, his Department has carried out on the level of hepatitis B in Ireland; the number of people infected with hepatitis B; the source of their infection; and the cost of medical treatment for this virus. [15648/98]

Michael Ring

Question:

262 Mr. Ring asked the Minister for Health and Children the plans, if any, which exist to implement an educational programme high-lighting the risks of the hepatitis B virus. [15649/98]

John Gormley

Question:

276 Mr. Gormley asked the Minister for Health and Children the number of cases of hepatitis B reported in the period 1988-98; the cause of transmission where known; and if he will make a statement on the matter. [15837/98]

Nora Owen

Question:

294 Mrs. Owen asked the Minister for Health and Children the number of cases of hepatitis B which have occurred in each of the past two twelve month periods; and if he will make a statement on the matter. [16134/98]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 261, 262, 276 and 294 together.

My Department has not carried out a study into the prevalence of hepatitis B in Ireland. However it is recognised that the availability of more detailed information is this regard will help to inform future policy in relation to the disease. A multi-institutional study into the prevalence of hepatitis B in the population generally is planned, the majority of the funding for which will be provided by the Health Research Board. This study is expected to commence shortly. My Department has also received a proposal from a hospital for a study to examine the prevalence of hepatitis B and C in women of child bearing age. This proposal is currently being considered in my Department.

Hepatitis B is a notifiable disease under the Infectious Disease Regulations, 1981. Each health board is statutorily required to notify my Department on a weekly basis of the number of cases of the disease reported in its area. The number of cases of hepatitis B notified to my Department from 1988 to date is as follows: 1988 — 32; 1989 — 20; 1990 — 11; 1991 — 15; 1992 — 13; 1993 — 11; 1994 — 20; 1995 — 11; 1996 — 10; 1997 — 26; 1998 — 74 (up to 22 May, the latest date for which complete returns are available).

In the 12 month period to 22 May 1998, 95 cases of hepatitis B were notified. The corresponding figure for the preceding twelve-month period was 14. Information on the possible means by which the disease has been contracted in individual cases is not routinely collected by my Department. It is not possible to indicate the cost to the health service of treating cases of hepatitis B.

The number of cases notified to my Department indicates that the incidence of hepatitis B in Ireland is low. While the WHO has recommended the introduction of hepatitis B vaccination, several low-incidence countries, including Ireland, the UK, the Netherlands and the Nordic countries, have instead initiated a selective approach which targets high risk groups. It has been considered that this represents a more effective approach in situations where the incidence of the disease is low and where cases occur in identifiable population groups. There are no plans at present for a general education programme regarding hepatitis B. The health promotion unit has produced an information leaflet on the disease, giving information about how the disease is contracted, the precautions which should be taken by persons at risk and the symptoms and treatment available.

My Department's policy on immunisation against hepatitis B is guided by the advice of the immunisation advisory committee of the Royal College of Physicians of Ireland, whose guidelines recommend immunisation for individuals who are at increased risk of hepatitis B because of their occupation, lifestyle or other factors such as close contact with a case or carrier.

In respect of workers within the health service, my Department wrote to all health boards and voluntary agencies in June 1997 stressing the importance of vaccination for "at risk" health care staff and clients. This was a reiteration of earlier advice. Since 1 January 1997 all new health service employees who will be involved in exposure-prone procedures are routinely screened for hepatitis B. No applicant will be allowed to commence employment unless these procedures are followed. All new employees in the category concerned must provide documentary evidence that they are not infectious carriers of the hepatitis B virus.

The immunisation advisory committee of the Royal College of Physicians of Ireland is currently reviewing its existing guidelines on immunisation, and future vaccination strategy for hepatitis B is among the issues which my Department's chief medical officer has asked the committee to consider in the course of its review.