Dáil Éireann Debate, Tuesday - 18 October 2005
162 Mr. Quinn asked the Tánaiste and Minister for Health and Children her proposals to combat a flu epidemic; the timescales involved for the production and distribution of a vaccine; the numbers of vaccinations involved; if she has satisfied herself that an appropriate action plan to expedite the vaccine for the bird flu strain is in place; and if she will make a statement on the matter. [28807/05]
View answer180 Mr. Boyle asked the Tánaiste and Minister for Health and Children the steps she is taking to deal with the possible flu pandemic; if she has satisfied herself that Ireland has sufficient stocks of anti-viral drugs at present; the details of current stocks; and if she will make a statement on the matter. [28957/05]
View answer268 Ms Fox asked the Tánaiste and Minister for Health and Children if she has formulated a strategy to deal with a flu pandemic should one occur; the details of this strategy; and if she will make a statement on the matter. [28991/05]
View answer300 Ms C. Murphy asked the Tánaiste and Minister for Health and Children the measures she has taken in preparation for a potential avian flu outbreak here; the measures she proposes to take in the future regarding such an outbreak; if these measures are in accordance with World Health Organisation recommendations; and if she will make a statement on the matter. [29143/05]
View answer309 Mr. Crowe asked the Tánaiste and Minister for Health and Children the action she has taken since 1 July 2005 to address the threatened avian flu pandemic; if further stocks of medicines to combat the threat have been ordered and when stocks already ordered will come on stream; and if she will make a statement on the matter. [29152/05]
View answer348 Mr. Durkan asked the Tánaiste and Minister for Health and Children the way in which it is intended to distribute the stocks of anti-flu virus drugs available to her in the event of an outbreak of avian flu; and if she will make a statement on the matter. [29519/05]
View answerI propose to take Questions Nos. 162, 180, 268, 300, 309 and 348 together.
I wish to take this opportunity to clarify that avian influenza, "bird flu", is an infectious disease of birds caused by the type A strains of the influenza virus. The Department of Agriculture and Food is responsible for controlling avian influenza in birds and mammals other than humans. That Department has a contingency plan for avian influenza and all questions relating to this should be referred to my colleague, Deputy Coughlan, Minister for Agriculture and Food.
There have been a number of outbreaks in poultry in Asia since late 2003. Countries currently affected are Viet Nam, Thailand, Cambodia, Indonesia, Laos, the People's Republic of China, Kazakhstan, Mongolia and the Russian Federation east of the Ural Mountains. Turkey and Romania have now been added to this list. According to the World Health Organisation, the spread of the A/H5N1 virus to poultry in new areas is of concern as it increases opportunities for further human cases to occur. However, all evidence to date indicates that the H5N1 virus does not spread easily from birds to infect humans. The WHO level of pandemic alert remains unchanged at phase 3: a virus new to humans is causing infections, but does not spread easily from one person to another.
My Department and the Health Service Executive are closely monitoring avian influenza developments with particular reference to the public health implications. Information on avian influenza is available on the health protection surveillance centre website under the health topics section and a factsheet for travellers forms part of this information. There are no special travel restrictions, immunisations or precautions to countries affected by avian influenza, A/H5N1, because of the presence of that virus. Standard precautions for travellers are: to avoid contact with live poultry and wild birds; to avoid visiting live animal markets and poultry farms; to avoid contact with surfaces contaminated with animal faeces; to avoid handling birds found dead; not to eat or handle undercooked or raw poultry, egg or duck dishes; exercise good personal hygiene with frequent hand washing; do not attempt to bring any live poultry products back to Europe.
The health protection surveillance centre posted the following documents on its website, www.hpsc.ie, on 14 October: Interim guidance for protection of persons involved in Avian Influenza outbreak control and eradication activities in Ireland; Interim guidance on public health actions to be taken on notification of Avian Influenza in animals in Ireland; Avian Influenza Case Surveillance Form. A sub-group of the influenza pandemic expert group had been working on this guidance material. It was published on Friday last due to the increased concern following confirmation of H5N1 infection in Turkey.
In addition, interim Irish guidelines on the investigation and management of suspected human cases of avian influenza — influenza A/H5 — have been circulated to all health care professionals and are also posted on the HPSC website. A clinical management algorithm has been circulated to hospitals and clinicians on the appropriate management of travellers returning from countries affected by avian influenza presenting with fever and respiratory symptoms. This will assist in early detection of any influenza A/H5 cases.
Three times in the last century, the influenza A viruses have undergone major genetic changes, resulting in global pandemics and large tolls in terms of both disease and deaths. The most infamous pandemic was "Spanish Flu" which affected large parts of the world population and is thought to have killed at least 40 million people in 1918-1919. More recently, two other influenza A pandemics occurred in 1957, Asian influenza, and 1968, Hong Kong influenza, and caused significant morbidity and mortality globally.
The overall aims of influenza pandemic planning are to reduce mortality and morbidity, and to minimise the resulting disruption to society. However, the consequences of a global pandemic are still likely to be serious. Pandemic planning can only mitigate the effects. My Department and the Health Service Executive are working closely together on pandemic planning. A detailed plan for response to an influenza pandemic was prepared in 2004. This plan is currently being updated to reflect the most up to date advice of the influenza pandemic expert group and the World Health Organisation, WHO. This work has continued over the summer.
Vaccination will be the primary public health intervention in the event of an influenza pandemic. Developments are taking place at international level seeking to expedite the pandemic vaccine production process. A vaccine is in development which could offer some protection against an H5N1 flu strain. International experts consider that a stockpile of H5N1 vaccine could be used as a first line of defence for priority groups while a vaccine against the exact pandemic influenza strain is manufactured. It was decided in August on foot of expert advice that a limited amount of H5N1 vaccine should be purchased. It is intended to purchase 400,000 doses, sufficient for 200,000 people. The Department of Health and Children is actively pursuing this matter. H5N1 vaccines will not be available anywhere before March/April 2006.
Antivirals can shorten the duration of the disease and alleviate symptoms. We already have an emergency supply of over 45,000 treatment packs of antivirals, Tamiflu®, and 10,000 units of paediatric suspension. We are stockpiling a further 1 million treatment packs of Tamiflu®. This quantity is sufficient to treat 25% of the population. A total of 600,000 packs will be delivered by the end of this year. The remaining 400,000 packs will be delivered next year. Plans for the storage and distribution of antivirals are being developed as part of the planning process. The size of the stockpile is in line with international trends, for example, the UK is also building up a stockpile to cover 25% of its population. Its stockpile will be complete by the end of 2006.
I am aware of reports regarding research which is to be published later this week regarding the possibility that the use of Tamiflu® may have contributed to the emergence of partial resistance to the drug in a Vietnamese patient. This interesting study will be considered by the expert group in the course of its ongoing work. However, it was already known that the potential for drug resistance exists and the situation is being monitored. Tamiflu® remains the internationally agreed antiviral of choice in the context of a pandemic.
It should be noted, however, that pandemic planning is a dynamic process. This means that the strategy for use of antivirals must be kept under review. In particular, the expert group will need to review the epidemiological data before final recommendations are decided in the setting of an imminent pandemic. The decision making process will be guided at all times by relevant expert advice from the European Commission and the World Health Organisation.
