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Dáil Éireann debate -
Tuesday, 11 Apr 2000

Vol. 517 No. 6

Written Answers. - Meningitis Incidence.

Bernard Allen

Question:

221 Mr. Allen asked the Minister for Health and Children if he will make as statement on the serious situation where ten deaths have occurred from meningitis in the first two months of this year compared to a total number of just eight deaths in 1999. [10428/00]

Bernard Allen

Question:

227 Mr. Allen asked the Minister for Health and Children if he has initiated any studies into the incidence of bacterial meningitis which has increased almost five-fold since 1990 with over 600 cases reported in 1999. [10435/00]

I propose to take Questions Nos. 221 and 227 together.

Eighteen deaths from bacterial meningitis, including meningococcal septicaemia, were notified to my Department by the health boards in 1999. In 2000, 12 such deaths have been reported to date.

The number of cases of bacterial meningitis notified to my Department in 1990 was 131. The provisional number of cases notified in 1999 is 614. 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 to 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 and which published reports in 1997 and 1999, includes among its members a range of medical experts who are closely involved in dealing with meningococcal disease in Ireland. The group has prepared and issued detailed advice on the surveillance, diagnosis, treatment and prevention of meningitis and it continues to monitor developments, including the outcome of research, at national and international level, so as to ensure that its advice is in line with best practice.
A new conjugate vaccine to protect against group C meningococcal disease, which represents about 40% of the disease in Ireland, is expected to become available later this year 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 will also be 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% of the cases occurring in Ireland at present.
In recent years surveillance systems in relation to meningitis have been significantly improved. Health boards are required to notify details of cases to my Department within 24 hours of them occurring and these arrangements are operating effectively. My Department has also funded the establishment of the meningococcal reference laboratory at the Children's Hospital, Temple Street and the diagnostic service provided by this laboratory has had a significant impact on case ascertainment and confirmation of the diagnosis of invasive meningococcal disease. As part of the preparations for the introduction of the new vaccine the meningococcal reference laboratory is undertaking a study to establish the sub-strains of group C meningococcal disease currently circulating in Ireland. This will enable an analysis to be carried out after the vaccine has been introduced, to establish its effect on the sub-strains of the disease in circulation.
The development of the national disease surveillance centre, which was established in 1998, will enable a much improved level of surveillance of infectious disease in Ireland and the centre will assist in the continued development of strategies to control communicable diseases, including meningitis. The centre has already developed a meningococcal disease database, which will enable the pattern of this disease to be analysed in detail.
I am aware that in recent years a considerable amount of research has been undertaken in Ireland on a range of issues in relation to this disease, including whether particular sub-groups within the population may be at particular risk of contracting meningococcal infection, the question of genetic susceptibility to infection, the early management of the acute condition and on the follow up of surviving children.
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