The Health Act 1947 and the Infectious Diseases Regulations 1981, as amended, provide the legislative basis for the control of infectious diseases, including tuberculosis, TB, in Ireland. My Department's strategy in relation to the prevention and treatment of TB is guided by the recommendations of the Report of the Working Party on Tuberculosis, 1996, which covers a wide range of issues including epidemiology, surveillance, screening, preventative therapy, clinical management and laboratory diagnosis. Responsibility for the implementation of the recommendations rests with the Health Service Executive. As recommended in the report, a permanent committee — the National Tuberculosis Committee — was established to advise on a detailed strategy for the control and management of TB. The committee meets when necessary to review all relevant issues.
The incidence of TB in Ireland has declined dramatically since its peak at the beginning of the 20th century. The Health Protection Surveillance Centre monitors rates of TB in Ireland on an ongoing basis and identifies any increases in rates or clusters of the disease.
According to data provided by the HPSC and the Department of Public Health in the HSE eastern region, TB notifications both nationally and in the eastern region between 1991 and 2003 are as shown in the following table.
Year
|
National TB Notifications
|
TB notifications in HSE — Eastern Region
|
1991
|
640
|
183
|
1992
|
604
|
202
|
1993
|
598
|
144
|
1994
|
524
|
159
|
1995
|
458
|
150
|
1996
|
434
|
113
|
1997
|
416
|
129
|
1998
|
424
|
154
|
1999
|
469
|
180
|
2000
|
395
|
143
|
2001
|
381
|
171
|
2002
|
408
|
162
|
2003
|
421*
|
167
|
*Figures for 2003 are provisional
The number of cases in each community care area in the eastern region fluctuates each year. In 2003, the highest rates in the eastern region were seen in the north and south inner city areas of Dublin and west Dublin.
TB services in the eastern region are conducted in accordance with the Report of the Working Party on Tuberculosis, 1996. These guidelines are currently being reviewed. The service has a number of components: hospital-based services, public health services, which include contact tracing, and workplace-school-institutional screening.