Dáil Éireann díospóireacht -
Wednesday, 5 Apr 2000

Vol. 517 No. 4

Written Answers. - Bacterial Meningitis.

Dick Spring

Ceist:

87 Mr. Spring asked the Minister for Health and Children the number of cases of meningococcal meningitis recorded in each of the past five years; the comparative figures for prevalence between Ireland and EU norms; his views on these figures; and if he will make a statement on the matter. [10005/00]

Minister for Health and Children (Mr. Martin)

The number of cases of bacterial meningitis, including meningococcal septicaemia, notified to my Department in each of the past five years is as follows: 1995, 382; 1996, 410; 1997, 508; 1998, 491; 1999, 614 (provisional)

The age-standardised incidence of laboratory-confirmed bacterial meningitis is Ireland is the highest in Europe, at 7.1 cases per 100,000 population in 1997-8. The European average is 1.5 cases per 100,000. By way of comparison, the age-standardised incidence per 100,000 in other EU countries, where available, is as follows:Austria, 1.2; Belgium, 2.3; England & Wales, 3.2 (estimated); France, 0.6; Germany, 0.5; Greece, 1.0; Netherlands, 3.3; Northern Ireland, 3.1; Scotland, 5.5; Spain, 1.4.

My Department has funded the establishment of the Meningococcal Reference Laboratory at the Children's Hospital, Temple Street. The diagnostic service provided by this laboratory, using PCR techniques, has had a significant impact on case ascertainment and confirmation of the diagnosis of invasive meningococcal disease. As a significant proportion of meningitis cases in Ireland are now laboratory-confirmed using PCR, which is not the case in all countries, the incidence figures for other countries may understate their position.

Given the high incidence of meningitis in Ireland, a range of measures has been adopted in order to ensure that the best systems are in place for the surveillance, diagnosis, treatment and prevention of this disease. The working group on bacterial meningitis, which was established in 1996 under the chairmanship of my Department's Deputy Chief Medical Officer and which published reports in 1997 and 1999, includes among its members a range of medical experts who are closely involved in dealing with meningococcal disease in Ireland. The group has prepared and issued detailed advice on the surveillance, diagnosis, treatment and prevention of meningitis and it continues to monitor developments, including the outcome of research, at national and international level, so as to ensure that its advice is in line with best practice.

In recent years surveillance systems in relation to meningitis have been significantly improved. Health boards are required to notify details of cases to my Department within 24 hours of them occurring and these arrangements are operating effectively. The development of the National Disease Surveillance Centre, which was established in 1998, will enable a much improved level of surveillance of infectious disease in Ireland and the centre will assist in the continued development of strategies to control communicable diseases, including meningitis. The centre has already developed a meningococcal disease database, which will enable the pattern of this disease to be analysed in detail.

Planning is under way for the introduction of a vaccine to protect against Group C meningitis, which represents approximately 40% of meningitis cases in Ireland. This will be a major development in relation to the prevention of meningitis, involving the incorporation of the vaccine into the primary childhood immunisation programme and also a phased catch-up programme for older children and young people up to 22 years of age. At my Department's request, a national group has been established by the health board chief executive officers to co-ordinate the process and project teams have been set up at health board level to develop detailed plans for the introduction and delivery of the vaccine.

Before being introduced into use, the vaccine must be licensed in Ireland. The statutory licensing agency is the Irish Medicines Board and it must satisfy itself as to the safety and effectiveness of the vaccine before a licence can be granted.

It is hoped that a Group C vaccine will be licensed in Ireland during the summer of this year. The Government has provided £25 million in the current year for the Group C meningitis vaccination programme, which will begin after the vaccine has been licensed.