I welcome the Minister of State on his first visit to the Seanad. He has been in three other Houses of Parliament but this is his first visit to this House. As guidance, I suggest a ten minute time limit, but if Senators wish to speak for longer there will not be a problem.
Meningitis Outbreak: Statements.
Is that agreed? Agreed. I also welcome the Minister of State and wish him well in his new position.
Thank you, Sir, and I thank Senator Manning for reminding people of my long and distinguished career. It is not quite true to say that I have never been in the Seanad Chamber as I was here for committee meetings, but this is my first occasion to formally address the Seanad.
My colleague, the Minister for Health, Deputy Noonan (Limerick East), who could not be here for this debate today, asked me to acknowledge the importance of this opportunity to speak to this House about meningitis. I also wish to thank Senator McGennis for providing this opportunity to place on the record of the Seanad the current situation about meningococcal meningitis in this country.
At the outset, I wish to reassure the Seanad that the incidence of the disease, which has been reported to my Department 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 recent cases occurred, has also confirmed that there is no epidemic of the disease but there is a higher incidence than usual in the north Dublin area. In addition, Temple Street Children's Hospital confirmed at the weekend 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; 203 cases in 1993 and 239 cases in 1994. For the period between 4 November 1994 and 27 January 1995, a total of 87 cases have been notified to the Department compared with 74 cases during the same period last year. Since 27 January 1995, a further nine cases have been reported but no new cases have been reported to my Department since.
My Department and the health boards operate a very comprehensive system for monitoring the incidence of meningococcal meningitis. Under guidelines issued by my Department to the health boards, the following measures are in place to monitor the disease at local and national level and at the level of individual cases.
First, an immediate preliminary notification of a cases is made to the local director of community care by the relevant doctor or hospital based doctor, initially by telephone and then confirmed in writing. This enables the director of community care to take any necessary action at local level. Secondly, the director of community care makes an immediate notification of the disease to my Department. This enables the Department to maintain an up-to-date picture of the situation nationwide and to assess if the incidence of the disease is unusually high. Thirdly, as soon as possible following the preliminary notification a report on individual cases is furnished to my Department. This enables the Department to assess if cases are related and if contacts have been treated. Finally, every week cases of the disease occurring in their areas are notified by the directors of community care to my Department. This also enables the Department to monitor the incidence of the disease nationwide on a week to week basis.
In addition, statistics on deaths from meningococcal meningitis are sent to my Department by the Central Statistics Office. As I have said, this represents a very prompt and comprehensive reporting system on the incidence of meningitis and it is a reflection of the seriousness with which my Department treats this disease.
Following media reports last week of an epidemic of the disease in parts of Dublin, the Eastern Health Board issued a press statement last Saturday, 4 February, confirming that there is no major epidemic of meningitis in the area at present. In this regard the board stated that any reference to "an epidemic" is purely technical in that there was an unusually high number of cases within a specified area and a specified period of time — that is, in north Dublin.
While the incidence of meningococcal meningitis reported to my Department in recent months has not risen above its normal level, the occurrence of five deaths from the disease during a relatively short period in January of this year is unusual and is a cause for concern. I would like to sympathise most sincerely with the bereaved families and I am sure that the Members of this House join with me in this.
In view of those deaths, my colleague, the Minister for Health, took 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 my 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 my 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 my 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 that they should be aware of the symptoms of meningitis and to bring children to their general practitioners if they were worried. The Minister advised that doctors 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 my Department on 31 January requesting them 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 with cases or suspected cases. The Minister also stressed the need for early detection and intervention on a television news bulletin that day.
A free telephone helpline has been in operation in the Eastern Health Board since 3 January in order to give information, advice and reassurance to worried members of the public. The helpline, which operates from 9 a.m. to 9 p.m., will continue for as long as the board considers necessary. 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. This is now averaging 300 calls a day.
I am satisfied that the necessary measures have been taken by my colleague, by the Department and by 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.
I wish to refer briefly to reports that a vaccine for meningitis has been developed in Cuba and could be used here to prevent most cases of the disease. These reports have been thoroughly checked by my Department and in particular with the World Health Organisation. The position is that this vaccine is still in the early trial stage and has not been tested yet to the point where it could be used on a population wide basis. The WHO is not prepared to recommend its use at this point and we would need much more data as to its efficacy and safety before considering its use here. I will, of course, be watching developments in this regard with a view to introducing a vaccination programme as soon as an acceptable vaccine is available.
Finally, I wish to reiterate that the current incidence of meningococcal meningitis is not unusual, but this is not to say that 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.
I welcome the Minister to the House on his first visit. I congratulate him on his appointment and wish him well.
I extend my sympathy to the families who have suffered the loss of a loved one from this tragedy recently. To some extent, we can thank the media for highlighting this outbreak. The Minister and the health board do not like to call it an epidemic but the media kept this matter upfront. Senator McGennis will elaborate further on this issue in so far as it has affected her area of north County Dublin more than any other area. I am glad the Leader of the House responded to the call for this debate.
From discussions I have found that the area of greatest concern for parents has been the sense of the unknown and the sense of fear. It reminds me of the time when I was much younger and there was a similar sense of fear about polio. At that time, parents were most perturbed if they heard of a case, regardless of how far away it was from them. On this occasion, I find that this same sense of fear and the unknown is very much on parents' minds. To a great extent, it reflects on successive Ministers for Health — not just the current Minister and Minister of State because they are a short time in office — that there is a lack of concrete information. It may not be possible at all times to provide such information but there is a lack of sound information on meningitis.
If one was to listen to reports on the symptoms of meningitis, one would be struck by their similarity with many other upsets in children. This is what confused and frightened parents most. If a child did not feel well in the morning, because of a stomach upset, parents were immediately struck with fear that it could be a symptom of meningitis. We should provide as much information as possible about meningitis to the public. The telephone helpline alone is not sufficient: it is more a crisis intervention. Good health education for parents is necessary.
The matter of a vaccine should be further considered. I understand conclusive evidence in this regard is still not available. The development of a vaccine for immunisation by the World Health Organisation or others involved in medical science would allay fears. It would not necessarily mean that the Department of Health would have to start general immunisation of children but it would mean that there was a vaccine available as a safeguard and a backup in emergencies. While nobody can directly blame the Minister for Health, there seemed to have been a gradual rather than a quick response to the outbreak. If it were not for the media and the House highlighting the problem, the telephone helpline might not have been set up and we might not have received the response that eventually came. I am not criticising the Minister but for the future, I call on the him, through his Department and officials, to make general sound information on meningitis part of a health education programme for Irish parents. If this is done, people will appreciate it. I am sure the Department will keep a close watch on the situation regarding a vaccine for use in Ireland for outbreaks and as a response in emergencies.
I welcome the Minister to the House. I also thank Senator McGennis for raising this issue, one with which I have been familiar for some time. As a member of the Eastern Health Board I am aware of the concern of board members and the public about the increase in the incidence of meningitis in part of the board's area at the end of last year.
Figures of cases notified during each month of last year were circulated to the board at its January meeting and it was noted that about ten cases were notified during each of the last three months of the year. We were reassured that a similar incidence rate had occurred at the beginning of the year and, indeed, during two of the summer months.
At its meeting last Thursday, members were informed that 20 cases had been notified during January with four deaths, one of them a teenage girl. Most of the cases have come from the north city and the south Fingal areas. Concern was expressed over the increase and over some reports in the media which magnified the problem using expressions like "killer bug" etc.
I understand that only one or two further cases have been reported since last week's meeting and hopefully the incidence of the disease is on the wane. However, health board staff are keeping the situation under close surveillance and, in order to counter the concern and anxiety of parents, the board has set up a free telephone advice service which has been in operation continuously since last Friday and is still in operation.
I noted from a television programme recently that the accident emergency department at Temple Street Hospital was overcrowded by anxious parents. My own child suffered from meningitis when he was three years of age. It was not the meningococcal strain but the viral strain which can be treated. Nevertheless, I can understand the anxiety of parents.
It would appear that some parents. who had gone to their general practitioners and had been reassured by them that their children had not got meningitis, still insisted on going to Temple Street Hospital. The worry is that children who are affected and need urgent attention might be deprived of that attention if that was allowed to continue. So I ask parents who have been reassured by their GPs to accept that reassurance.
The health board members are aware of the leaflet produced by the Department of Health which has been widely distributed through the health centres within the board's area and has been sent by post to anxious parents and to people who phone the health board headquarters. General practitioners have been circulated to be alert to the condition in children and teenagers and advised to administer penicillin if they suspect the disease before sending the patient to hospital.
At the board's meeting we were informed that the drug rifampicin has been available to all the board's hospitals. This is a preventative antibiotic. It is given, I understand, to household or school contacts of cases as a preventative measure.
There is nothing new in the upsurge of meningitis in Dublin. It has happened before and I understand that Cork city had a similar upsurge three years ago. It had all the features of the present one with the usual emotional response from the public and the media. That is understandable because of the nature of the disease itself.
I understand this meningitis has been on the increase in most of the European countries in recent years and that epidemics of it occur regularly in Third World countries. It would seem, therefore, that we may have further local visitations of this disease especially during the winter months, so it behoves us to have a plan to deal with this problem. It would appear to be absolutely essential that there should be close co-operation between hospitals, GPs, health boards and staff and that the public should be kept informed of the situation on a day to day basis wherever the disease is prevalent.
I was pleased to read in today's The Irish Times that members of a British based organisation named “Meningitis Research”, whose aim is to promote a search into the cause of meningitis, will be visiting Dublin next month. This group has come to Dublin at the invitation of parents whose children have died as a result of meningitis. A spokesman for the parents' group, Mr. Brian Cavanagh, welcomed the recent efforts of the health boards, doctors and the media in raising awareness and responding swiftly to parents' concerns.
The group is hoping that when the current crisis recedes every effort will be made to find the vaccine to eradicate this problem. I understand there is no vaccine available at present but there is hope to develop one in the future; I was pleased to hear from the Minister's speech that some inroads have been made into this area in Cuba and I hope that drug can be developed and tested to relieve parents of the terrible anxiety they suffer when their children have meningitis.
In conclusion, I ask the Minister to allow this group to visit the Department to reassure them of our commitment to help anxious parents to overcome this problem.
I thank the Leader of the House for arranging statements on this subject and I join in the congratulations to Minister Currie who is a constituency colleague of mine. I know he will do a superb job in his new position.
I requested that the Minister come in and make a statement on the increased number of cases of meningitis. I did not refer to it as an epidemic because I was acutely aware of the fact that I did not want to say or do anything which might increase the fears of people with children who are unwell. I accept the part of the Minister's report where he states that there is not an epidemic but there certainly is an increased number of cases, particular on the northside of Dublin.
I attended a funeral less than three weeks ago of a 17 year old girl in Rush. She was a lovely, intelligent, attractive and energetic young girl. I know her mother well; she is a friend of mine. It was a very moving funeral anyway. It was in response to that that I felt we had to be seen to at least comment on what was happening. When you see large rows of schoolgirls standing outside a church mourning one of their colleagues, it is important that people in positions of power at least express our sympathies, show that we are doing something to try to contain the cause and ensure that information is made available.
I convey my sympathy to the families of those who have lost children. The funerals of a two year old child the previous week and this 17 year old girl show that this disease does not discriminate. When dealing with certain illnesses, we often pay special attention to very young children. As a mother of three children, I know the first two years are an absolute nightmare. One is watching for temperatures and every time a child gets a temperature, he is rushed to Temple Street Hospital because the parents are worried that it is something more than just a cold, a 'flu, or a temperature itself. This disease does not restrict itself to very young children. As we have seen, teenage children and babies have been affected and have died.
The Minister has given a very lengthy reply. I welcome aspects of it and I am not attempting to apportion blame to anybody. It would be a shame if we were to try to do that. As politicians from all sides of the House, we simply need to reassure the public that we are all concerned about this and that we will all attempt to do what we can within our areas of responsibility.
I am quite satisfied with the Minister's explanation of the monitoring and reporting systems but the reply does not state — or maybe it is just not clear — that the Department of Health or the health boards have discovered why there is this increase in this cluster of cases in the northside of Dublin. I wonder if that information is available. In the report, Temple Street Hospital said there is no common link between these cases, which rules out an epidemic but why is this? Have we any idea why we have this increase in this specific geographic area?
I also thank Senator Doyle, who is a member of the health board, because he has given additional information here today. The fact that there were 20 more cases of meningitis in January — luckily enough they were not fatal cases — is a cause for concern and I am certainly concerned about it. The help line and the various initiatives which the Minister took may have been helpful. I differ with my colleague, Senator Finneran, in that I believe that whatever politicians do helps to a certain extent; but programmes like Marian Finnucane's programme, when she had a mother on for most of the duration of the programme explaining exactly what happened with her child, probably are much more effective. I know it is not planned and it is not a Government intervention, but when somebody puts the human face on something like this on the public airwaves it is very effective.
During the last three weeks each of my three children has come down with this 'flu bug and you do find yourself standing over their beds at one or two o'clock in the morning checking temperatures and things like that, so we owe a debt of gratitude to people like the woman who went on the programme and warned parents and advised them how this disease can become fatal within a very short time. In one case the child would have died within 45 minutes if antibiotics had not been administered.
The last point I would like to make to the Minister concerns the fact that the information leaflets and other information are distributed through health boards. As I said, I would not have much cause to visit a health board because my children are now grown and I wonder whether we are succeeding in targeting all of the people that should know about this? We will get mothers of very young children through the health boards, district nurses and so on, but mothers of teenagers, generally speaking, have finished with that kind of involvement with health boards. Therefore, there is probably a need to continue putting the message out in whatever way possible to try to ensure that the target market, if you like, which is all parents of children up to maybe 20 years of age, are aware that this thing can be fatal and that it can become extremely dangerous within a period of maybe half an hour if adequate medical aid is not given.
I thank the Leader again and the Minister for coming into the House today and I urge him to ensure that whatever can be done to even save one life is done.
I welcome the Minister to the House today as a fellow Ulsterman and wish him well in his portfolio in the new Government. I congratulate Senator McGennis for having this very emotional matter of meningitis discussed here today in this Chamber.
The pain suffered by a family which has lost a young child to a sudden or fatal illness can never be fully realised. Every sympathy must go out to the families who have suffered since the outbreak of meningitis has occurred in this country.
I read an article recently that meningitis has reached epidemic proportions in one area in Dublin. The words that were used in that paper to describe the meningitis were a little too strong. I do not believe that there was an epidemic and papers should be very concerned about the reaction of the public to words like "epidemic." Concern grows over the levels of the potentially dangerous virus countrywide. Four people died from bacterial meningitis in Dublin last month compared to five deaths from the condition for the whole of last year in the capital. The upsurge in the incidents of bacterial meningitis in the Eastern Health Board area is worrying. What is required now is a sense of alertness rather than alarm. There is no doubt that doctors are currently on the alert for meningitis, as they would be annually around this time of year when most cases seem to occur. There has been no major evidence to show that there has been neglect on the part of the Department of Health or the health boards in dealing with meningitis. It is a time for the community to be concerned and to make sure that everything is being done to curtail the dangers of it.
While there has been no increase in meningococcal infection in the north west region, where I come from, during recent months the illness occurring in the Western and Eastern Health Board areas is causing concern to parents. In the past three months one Donegal child was diagnosed with meningitis at the end of December and there were no cases in Sligo.
We know that it occurs more commonly during the winter and spring months. It is caused by a bacteria which is carried in the nose and throat of about 10-15 per cent of the population at any time. Most people who carry the bacteria do not get ill; however, when illness does occur the person may become very ill very quickly. While most people who carry the virus do not get ill, a very small number will. Children and young adults are at greater risk of developing infection, but I read recently that one 54 year old person died of the disease also.
Meningococcal infection may cause meningitis, which is an inflammation of the lining of the brain and is the more usual presentation; or it may cause septicaemia, where the infection occurs in the blood and is not confined to the brain. Septicaemia is a much more serious form of this infection.
A child affected by this disease will be unwell with a temperature, off form and off their food. With meningitis they may have a headache and may dislike bright lights — this is one of the dominant features of the disease. These symptoms will not occur with septicaemia. The child may develop joint pains and, more importantly, may develop a rash of red or purple spots which looks like bruises or bleeding underneath the skin. There may also be a change in the child's level of consciousness in that he or she may be difficult to wake properly.
If parents are concerned about their child they should contact their family doctor immediately and this is the message that should go out from this debate here today. If the child is very ill and the doctor is not immediately available they should take the child — on the advice, I am sure, of everyone here — to the nearest hospital casualty department.
Young adults are also more susceptible to meningococcal infection. Many are away from home working or in third level colleges. More than 7,000 students in Galway have been issued with warning letters in relation to the virus by the Western Health Board. There have been four meningitis cases among students there, three in UCG, one in Galway regional technical college, and a 20 year old Cavan student has died from the virus. So these are a group of people — I am talking about the student type — who are vulnerable and all care must be taken to see that they are well warned about the dangers. When someone in this situation gets ill their friends or landlady might keep an eye on them or seek medical help if their illness gets worse. When they are away from home they do not seem to take the care that would be given to them at home in looking after themselves.
What is required now is for the community to be on the alert rather than to be alarmed, and in saying this it is not an attempt to diminish the pain and grief suffered by those parents who have lost a child. They have suffered terrible pain and we all offer our sympathies to them; but we must also support them, as we should the rest of the community, in making sure that all information is available to help the community to tackle this deadly disease.
I, too, welcome the Minister to the House, congratulate him on his appointment and wish him all the best in his new portfolio. I also thank Senator McGennis for bringing this item to the agenda and I thank the Leader of the House for allowing us time to make statements on it.
I find this issue very difficult to deal with. It is very frightening. When I saw it on the agenda I wondered what I was going to say, because as a mother and the wife of a general practitioner I have come into contact with people who have been exposed to meningitis. Like Senator McGennis this year I did not experience the funeral of a child, but last year a young schoolgirl in Portlaoise died of meningitis and at the funeral I expressed the same sort of grief and concern that Senator McGennis spoke about this morning. The difficulty with meningitis is that nothing can be done about it. That is what is very frightening. I compliment all the Members here who have spoken about it in a very responsible way because this is a topic that nobody should be alarmist about.
I was thinking yesterday about what I would say and I went down to my husband's surgery and in the waiting room I came across a leaflet distributed by the health promotion unit of the Department of Health. I read it and I was impressed by the contents; it told one everything one needed to know about meningitis. I do not know if it was distributed last week — I asked my husband where he got it and he thinks he got it from the health board; it was sent to him to distribute to the patients. If it had been issued immediately early in January, when there were a lot of media reports about meningitis, it would have been helpful. I do not know if it was, but I became aware of it this week. It contains all the information anybody would need to know about meningitis.
I welcome what the Minister has said today and I welcome the measures in place to monitor the disease. This is the first time I realised that all of these measures were in place and I am reassured by them. Anybody reading the leaflet would also feel reassured that the health boards are making information available.
People are worried about the disease being contagious. The leaflet states that it is not a highly infectious disease and it is important to realise this. It strikes so quickly and people die so quickly that it is very frightening and hysteria about it can grow quickly. I listened to the woman on Marian Finucane's show and I listened to the parents of the 21 month old child who died last Sunday week who were on the Gay Byrne show. In their case the difficulty was that their child did not seem to have any of the symptoms that people were being asked to look for. It is a difficulty for parents that in a short time this becomes a fatal disease.
It is important that what the Minister has said today would allay the fears of a lot of people. However, such a statement could have been issued in the middle of January when people were concerned about it. I appreciate the difficulties for the Minister, as one does not wish to be alarmist and it is a most sensitive subject; it is a difficult issue to deal with. If we are open and tell people what we know it can help to allay parents' fears. I only became aware of the information leaflet yesterday but I was impressed by it. If it had been publicised immediately and perhaps an advertisement taken in the paper, it would have been helpful.
I appreciate the difficulties for the Minister and the Department. I would be a little critical of the media in calling this an epidemic. To most people an epidemic means a widespread incidence of the disease. From the figures the Minister has given us today as to the number of cases reported annually, the Department obviously believed there was an increased incidence in a certain area of north County Dublin but that overall it was not an epidemic. Perhaps "an epidemic" is a technical term used in the Department but that should be explained. The media should be responsible, as it must be extremely distressing for a parent to experience the death of a child from meningitis. Many parents would wonder if they should have gone to the doctor earlier or what they should have done or if they are to blame. The issue needs to be treated sensitively.
I welcome what the Minister has said. I have read about the vaccine being talked about that is being developed in Cuba, but I appreciate that until the World Health Organisation has thoroughly checked it out it cannot be introduced. It is reassuring to tell people that we have a vaccine against one of the forms but as yet no vaccine is available against meningococcal meningitis.
The leaflet states that antibiotics would be given to members of a family. It states that: "The bacteria are spread between people by coughing, sneezing and kissing. They cannot survive long outside the body and cannot be picked up from water supplies, swimming pools, buildings or factories." Making this information public is helpful as people may be scared about the disease.
I thank Senator McGennis for this opportunity to have statements on this matter. It is good that the Minister's speech is on public record. The public should be made aware through this leaflet around this time every year when there is, I understand, an increased incidence. Given the media hype about the matter, taking an advertisement in the papers or publishing this leaflet at the time would have been a good idea. I thank the Minister for being here. The debate was responsible and reasonable.
I welcome the Minister of State to the House. I heard him say this is not his first visit as he had been in the Chamber for committee meetings. I am sure he shares our affection and admiration for the beautiful plasterwork.
A meeting such as this in the Seanad is extremely useful and I hope it will be covered by the media. I am sorry to see that there does not seem to be anybody present, but they may well be listening on the monitors and perhaps the Minister has issued his statement to the press. It is important that panic should be averted in this matter. It is extremely serious and I am well aware of it. A friend of mine has a grandson of about 14 years of age who contracted a viral form of meningitis and it was a cause of grave concern. It is a most unpleasant disease.
It is important that the public be given clear, accurate and non-hysterical information in the manner that this debate, to which I have been listening, has done. Temple Street Children's Hospital is just around the corner from where I live and on the news the other day I saw a rather harassed physician there making the point that because people did not have access to information and were not quite sure what the symptoms were, a large number of rightly concerned and responsible parents had turned up and were swamping the hospital with a series of symptoms that were not necessarily specific to meningitis. They were going straight into the emergency section and clogging it up; and because every case had to be treated as if it were a case of meningococcal meningitis it was possible that medical resources could be diverted away from the real cases of infection into a generalised view.
I am glad this debate took place and I congratulate Senator McGennis and Senator Henry on having instigated it. I hope it will be widely reported in order to reduce the apprehension of parents and, principally and particularly, to reduce the pressure on our hard working medical personnel, especially in the children's hospitals.
That was the only point I wished to make and I have been uncharacteristically brief.
The Minister has indicated that he would like to make a concluding comment. I welcome him to the House.
Thank you, a Chathaoirligh. I thank all the Senators who welcomed me to the House and congratulate me. I have listened with interest to the contributions of Senator Finneran, Senator Doyle, Senator McGennis, Senator Maloney, Senator Honan and Senator Norris. I am impressed by the amount of preparation put into the contributions and the research done. Some people might learn from that, but I do not want to make too much of that point.
You are not looking for a programme manager?
One needs to be careful with advisers at present. I thank those who contributed to the debate and I have noted the concerns of the House in relation to this serious public health matter. I am glad of the opportunity to reiterate the need for the early diagnosis and treatment of cases and suspected cases. I join with Senator Norris in the hope that some publicity will be given to our deliberations today because it is important to reassure people and to satisfy them of our concern about this outbreak.
Senator Finneran mentioned the important role which the media has played. As my colleague the Minister for Health stated on the "The Pat Kenny Show" last Friday, 3 February, RTE in particular has done a great job in reporting recent cases and in bringing the symptoms and the early warning signs of the disease to the public's attention. A number of Senators mentioned how useful this service has been. It is necessary for parents, in particular, to know the symptoms. We must, however, strike a balance between our concern and our wish to explain the symptoms to the public and going over the top. Mothers and fathers can be easily scared if a child is not well; this is natural. We should be concerned, but we should not overdo it.
Senator Finneran mentioned the difficulties in identifying cases due to the relationship of the symptoms to other conditions. I agree with him that information on the disease is a central and critical aspect of the containment of it. As I said earlier, the health promotion unit has disseminated an information leaflet through the health boards, schools and other outlets. That has been very valuable.
I do not agree with Senator Finneran — perhaps this was the only area of disagreement in the proceedings — that the response of the Department was slow. The Department and the health boards monitor the disease continuously and are aware if a major problem develops. I believe their response was right. He suggested that this has been a problem under successive Ministers. I do not know whether that is the case as I can only refer to one Minister.
Senator Doyle referred to the situation in the Eastern Health Board area as reported to the board last Thursday, 2 February. The report indicated that eight cases were reported in January 1994, while 20 cases were reported in January 1995. Of these 20 cases, 14 were from the greater Dublin area, mostly from north Dublin. Professor O'Donnell, the board's chief medical officer, mentioned on "Morning Ireland" on Friday, 3 February, that the cases in Dublin need to be put into perspective. Most of the cases occurred in an area with a population of approximately 400,000. As I mentioned, those admitted to Temple Street Children's Hospital did not suffer from the same strain of the disease.
Senator Finneran and Senator Doyle referred to the need for a vaccine against the disease. Unfortunately, there is no proven, effective vaccine. Senator Doyle also referred to the visit to Dublin of the meningitis research group from the UK, who I would be happy to meet. I also read the press report to which Senator Doyle referred and I noted a telephone number in County Antrim, which I am sure will be available.
Senator McGennis expressed the fears and concerns of parents about the possibility of their children contracting the disease. Pending a safe, effective vaccine against this form of meningitis, information is of critical importance. I have taken note of the concerns expressed by Senator McGennis and others in relation to the key role of information. My Department will review the method of distributing information about the disease to ensure that it reaches as wide an audience as possible.
Senator McGennis asked about the possible cause of the disease in north Dublin. By its nature this disease is sporadic and occurs occasionally in clusters in localised areas, particularly in areas of high population density, such as north Dublin or Cork city two years ago. There is no obvious link between these cases. Different strains of the bacterium are involved so the reasons for this particular cluster are difficult to identify.
Senator Maloney spoke about the possibility of the spread of meningitis among groups such as students. He asked that that be taken into account by my Department in its review of the circulation of information about the disease and I am happy to assure him in this regard.
Senator Honan's remarks about the need for balance and a proper perspective to be taken in relation to bacterial meningitis are welcome and reflect the tenor of the debate. I am happy to take on board suggestions made by Senator Norris and I thank Senators who contributed to the debate. As I said, their contributions were constructive and responsible and they complement the efforts of the Minister, the Department and the health boards to deal with the disease. This debate will lessen anxiety and will contribute to our knowledge about the disease.
While this debate was taking place, in an act of great political courage and integrity, the Minister of State at the Department of Finance, Deputy Hogan, announced his resignation in the other House. I applaud him for his integrity and I would like to say that he has paid a high price for what was a genuine mistake. I am sure Members on all sides would hope that Deputy Hogan will soon find his way back into the front ranks of Government again.
When is it proposed to sit again?
At 2.30 p.m. on Wednesday, 15 February 1995.