I propose to take Questions Nos. 8, 23, 42 and 151 together.
The increased level of notifications of bacterial meningitis and related conditions in recent years is in part attributable to the greatly increased awareness among health professionals and the general public, as well as improved techniques for diagnosis of the condition. Nonetheless, while there continues to be much research in relation to meningitis, it is not fully understood why Ireland experiences such a different pattern of disease from other countries in Europe and elsewhere. It should be noted that, despite the increased incidence of meningitis, there has not been a corresponding increase in mortality from this condition.
The Working Group on Bacterial Meningitis, which was established in 1996 under the chairmanship of my Department's deputy chief medical officer, published its first report in 1997, making a wide range of recommendations on such issues as the surveillance, diagnosis, treatment and prevention of meningitis. In the course of reviewing that report this year, the group found that these recommendations had been extensively implemented by the different interests involved. The group has recently published an updated report and this includes detailed template guidelines on the management of meningitis in the hospital setting. These guidelines are intended to be adapted as considered necessary to meet local circumstances in individual hospitals. The working group is a standing committee and will continue to review the situation and make further recommendations as it considers necessary on the management and prevention of this serious and distressing condition.
On public education, the health boards, in conjunction with voluntary bodies, have conducted extensive educational campaigns on meningococcal disease. There continues to be close liaison between the health boards and the voluntary bodies concerned, principally the Meningitis Research Foundation. The health promotion unit has produced an updated information leaflet and in 1998 a video entitled Meningitis: Prompt Action Saves Lives was produced by the Office for Health Gain in conjunction with the Meningitis Research Foundation. The Irish College of General Practitioners also designates education officers in each health board area who are in a position to assist in the event of an outbreak of meningococcal infection.
A new conjugate vaccine to protect against group C meningococcal disease, which represents about 40 per cent of the disease in Ireland, is shortly expected to become available and planning is under way for its introduction into the primary childhood immunisation programme and for it to be given to older children and young people in a catch-up programme. It is also important that, even after the group C vaccine is introduced, vigilance is maintained, as there will still be a significant risk of people contracting group B disease, which represents about 60 per cent of the cases occurring in Ireland at present. I would like to take this opportunity to emphasise that it is vital that people are familiar with the symptoms of the disease and of the need to seek immediate medical help from a general practitioner or hospital casualty department where they have cause for concern.