I thank the Ceann Comhairle for allowing me to raise this issue. I call on the Minister for Health and Children and the Minister of State to introduce a universal hepatitis B vaccination programme for all infants as a matter of urgency. It is a disgrace that Ireland has not implemented the World Heath Organisation's recommendations to introduce such a programme. There is a policy of selective vaccination but most countries recognise that this policy has little effect in containing the spread of the infection.
There are a few alarming facts about hepatitis B. The World Health Organisation estimates that it is responsible for more than 1,000,000 deaths per year and the best informed estimates say that the disease is one hundred times more contagious than HIV. Between 5 per cent and 10 per cent of adults infected with hepatitis B will become carriers of the infection without knowing it. Such a carrier, without showing symptoms of the disease, can pass it on to many more vulnerable individuals.
Carriers will carry the disease in the blood for many years without feeling any adverse effects, yet infecting those with whom they come into contact. They can also develop serious liver disease in later life from which they may die.
Ireland is considered a low risk country as we have a relatively low incidence of the disease. However, we have become complacent. There were 663 new cases between 1988 and 1993. The cause of transmission in 34 per cent of cases was unknown; 8 per cent were caused by drug addiction or the sharing of needles; 15 per cent via sexually transmitted diseases and 5 per cent from mothers to new born babies. Irish people travelling on holiday or to work abroad are generally not covered by any vaccination programme yet they are entering high risk areas such as southern and eastern Mediterranean countries. The selective vaccination programme means that health care workers receive 85 per cent of the vaccine but account for only 5 per cent of the infections.
Health professionals in the US believe the true incidence of hepatitis B infections is dramatically underestimated because the disease is under reported, especially among ethnic groups. It is also the case that many infants can have the disease in early stages but not show serious symptoms. In Ireland, health professionals believe that we also underestimate the true incidence of the virus and the carrier pool as we only screen high risk groups, thus missing infections and carriers in low risk groups. Individuals in high risk groups can often be missed as they are likely to be aware of the risks and not present themselves for testing.
Research in America has shown that infants infected with the disease are at a disproportionate risk of developing major complications, including chronic hepatitis with cirrhosis and liver failure. To reduce the risk of contracting the disease there are two choices. First, one can avoid contact with high risk groups or people in close contact with such groups. However, given the salient nature of the disease we cannot be confident of this approach. The second choice is to eliminate the risk by introducing a vaccine into the existing vaccination programme. This option would seem the most cost effective as the alternative is frightening — an already strained health system would have to cope with a huge increase in costs of treatments.
Hepatitis B is a debilitating illness and removes victims from the workplace for a considerable period. We could face a situation far more serious than the hepatitis C crisis as hepatitis B is more contagious. In addition to the huge strain on the health care systems, the Minister could face a litigation problem as treatment costs are enormous. We are currently ignoring the recommendations of the World Health Organisation. The disease is potentially fatal. Although this disease is classified as low risk in Ireland, this implies some risk. The hepatitis B vaccine could be introduced at negligible cost into the existing vaccination system.
Any person can be infected by the virus but no one has to be infected. The Minister should give serious consideration to the immediate introduction of a universal hepatitis vaccination programme for all infants.
