Dáil Éireann debate -
Thursday, 29 May 2003

Vol. 567 No. 7

Written Answers. - Infectious Diseases.

Jimmy Deenihan

Question:

199 Mr. Deenihan asked the Minister for Health and Children the number of cases of measles, bacterial meningitis, septicaemia, e-coli 0157 and salmonella which have been notified to each health board area since the public health doctors' strike began on 14 April 2003; and if he will make a statement on the matter. [15010/03]

Minister for Health and Children (Mr. Martin)

In accordance with the Infectious Diseases Regulations 1981, as amended, health boards are required to provide to the director of the National Disease Surveillance Centre by the Wednesday of each week a return of the cases of infectious diseases notified during the week ending on the previous Sunday.

Information in respect of the number of cases notified by health boards to the National Disease Surveillance Centre since the commencement of the public health doctors' dispute until Friday, 23 May 2003 regarding bacterial meningitis – including meningococcal septicaemia – Escherchia coli 0157, measles, salmonella and typhoid is as detailed in the table below. These data are incomplete as returns have not been received from all health boards. Health board chief executive officers have recently been reminded of the need to ensure weekly returns continue to be made to the NDSC. I will provide the Deputy with more complete information once it is forwarded.

Health Board	BacterialMeningitis	E. Coli 0157	Measles	Salmonellosis	Typhoid*
ERHA	8	0	33	10	1
MHB	N/R	N/R	N/R	N/R	N/R
MWHB	1	0	11	1	0
NEHB	5	0	3	2	0
NWHB	N/R	N/R	N/R	N/R	N/R
SEHB	**	**	**	**	**
SHB	N/R	N/R	N/R	N/R	N/R
WHB	0	1	2	6	0
Total	14	1	49	19	1

* Case of Salmonella typhi notified, classified separately from Salmonellosis.

N/R = no reports received from these health boards since the public health doctors' strike commenced.

** Batch of paper notifications for weeks 15-20 received on 23/5/03 have yet to be collated.

Based on data received from Galway and Roscommon only.

Jimmy Deenihan

Question:

200 Mr. Deenihan asked the Minister for Health and Children the arrangements which have been put in place in each health board area to ensure that cases of diseases (details supplied) do not develop into outbreaks which would result in serious risk to human health and could be life-threatening; and if he will make a statement on the matter. [15011/03]

Minister for Health and Children (Mr. Martin)

The National Disease Surveillance Centre plays a key role in respect of the prevention and management of infectious diseases in this country. The Irish approach to infectious diseases outbreaks is based on sound internationally accepted principles such as: preventative measures; early identification of cases; effective clinical care including good hospital infection control; appropriate surveillance; and contract tracing and management of contacts.

The procedures for dealing with infectious diseases are based on these principles. Many infectious diseases can be prevented by vaccine use. Immunisation against infectious disease has probably saved more lives than any other public health intervention, apart from the provision of clean water. Improvements in living standards have reduced the mortality from infectious diseases, but immunisation has also played a large role in the reduction of disease incidence.

It would not have been possible to eradicate smallpox without vaccine, and the eradication of polio in the European region is also largely due to immunisation. In recent years, improved economic and social conditions, together with public health action, have virtually eliminated the pandemics of communicable diseases.

I will continue to establish expert committees-groups to advise on the most appropriate action given the particular circumstances of the outbreak concerned. Guidelines and protocols on the management of many different types of outbreaks have been developed based on the principles referred to above. These guidelines also take into account guidance published by the World Health Organisation, the Centres for Disease Control in the USA and a number of other reputable international public health bodies. Most outbreak situations begin with the establishment of an outbreak control team, which manages the outbreak and puts in place whatever control measures are needed.

Health boards have protocols and procedures in place for dealing with cases of infectious diseases such as measles, bacterial meningitis and septicaemia and incidences of food-borne illnesses such as e-coli 0157 and salmonella. Cases must be notified, in the first instance, by the diagnosing clinician to the relevant health board which in turn notifies the National Disease Surveillance Centre. Any further actions required such as implementation of control measures, contact tracing, surveillance and so on are then undertaken by the relevant board and the National Disease Surveillance Centre, as appropriate. Furthermore, in the case of food-borne illness, environmental health officers carry out environmental investigations and implement appropriate environmental control measures.

The current public health doctors' dispute has hampered the health boards' ability to respond to infectious disease cases. My Department, together with the ERHA and each health board, has put contingency plans in place to enable them to provide an emergency response to infectious disease outbreaks during the course of the strike. These plans include: the establishment of a national network of senior co-ordinators at health board level to monitor the contingency plans and report on suspect cases throughout the country; and the establishment of an incident room with a dedicated national call number in my Department, with reports are forwarded twice daily by health boards.

Unfortunately, at present the capacity of the Eastern Regional Health Authority, the health boards and the National Disease Surveillance Centre to respond to any problems in the area of infectious diseases is compromised due to the ongoing industrial action by public health doctors. Every effort is being made to resolve this dispute.