Eamon Gilmore (Dún Laoghaire, Labour)
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I thank the Ceann Comhairle for permitting me to raise this issue. It is the second time I raised the sad case of a 24 year old constituent who contracted CJD. I raised it on 5 May 2005 when the young man was still in hospital. Jason Moran of Shankill, County Dublin has since died. At his recent inquest, the Dublin County Coroner called for a State investigation into Jason's death and the possibility that there may be a CJD cluster in the local area.

It has emerged that three cases of variant CJD were closely linked geographically, namely, the case of Jason Moran from Shankill, a second case in Bray and a third case with close family ties in Ballybrack. The total distance between the places where all three cases occurred is approximately five miles.

As I stated in May, Jason Moran contracted variant CJD in Ireland. He had not been out of the country prior to the time in which he could have picked up the disease and it follows that he must have contracted CJD from a meat product purchased and consumed in Ireland. That two other cases have such close geographic links to Jason raises obvious questions as to whether there are CJD clusters.

The State authorities have a duty to investigate how Jason Moran contracted variant CJD in the first instance and whether there are any links to the other cases. I understand that the HSE has been asked to carry out some inquiries. I would like to know more about their nature and whether it is intended to publish the outcome. I do not wish to raise an alarm about the cases concerned but, given the Jason Moran case and two others, the possibilities must be fully examined and the results made public.

Separately, the Government should introduce a compensation scheme for the families of variant CJD victims. Such a scheme was introduced in the United Kingdom following the publication of the Southwood report in 1989. The Government should do the same. The most immediate requirement is for the State to accede to the request of the county coroner, hold an investigation into these cases and publish the results.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am also taking this Adjournment debate on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. I thank the Deputy for raising this matter as it provides the Tánaiste an opportunity to outline to this House the position in regard to this issue.

Late in 2004 the Tánaiste learned with regret of the occurrence of a case of variant CJD in a young man in Dublin. This young man subsequently died in 2005 and the recent inquest into his death confirmed that he died of variant CJD. The Tánaiste and I again wish to extend our deepest sympathies to his family.

Following the inquest on 10 January last, the Dublin County Coroner wrote to the Tánaiste and to the Minister for Agriculture and Food requesting an investigation into the apparent geographical connection of this case with two others. The chief medical officer of my Department has requested the HSE to examine these cases to investigate any possible link between them. In addition, the CJD advisory group, which operates under the aegis of my Department, will discuss this issue at its next meeting to be held on 7 February. However, on the information currently available to the HSE, it can see no basis for the suggestion that there may be a cluster of such cases but it is making further inquiries in this regard and will keep my Department informed of any developments.

At this stage it can be said that the probability is that this case of variant CJD was contracted before the current very strict controls on the sale of meat in Ireland were brought into force in 1996. Given that the incubation period for variant CJD is considered to be up to 15 years, it is virtually impossible to identify a specific source of infection. The long incubation period would also make it difficult to establish a common exposure time between individual cases.

The CJD advisory group provides scientific, professional and technical advice on all aspects of CJD and recommends appropriate policy responses in light of the evolving information and evidence on this topic. The group comprises experts in public health, communicable disease surveillance, neurology, transfusion medicine and food safety. The group will continue to monitor all developments nationally and internationally and, along with my Department's chief medical officer, will advise on any relevant developments. The Tánaiste has been briefed by the chairman of the CJD advisory group on any possible broader public health implications that may have arisen from this case.

There are no public health issues in this case in regard to the blood supply or any surgical procedures. New variant CJD, vCJD, is a rare degenerative fatal brain disorder in humans. It is believed the vast majority of persons who have developed vCJD became infected through the consumption of cattle products contaminated with the agent of BSE.

The Food Safety Authority of Ireland and the Department of Agriculture and Food are responsible for BSE controls in Ireland. The FSAI stress that BSE controls in place in Ireland since 1996 are very strict and there are layers of robust control measures to ensure maximum consumer protection from BSE.

The incidence of BSE in Ireland continues to decline in the Irish cattle population, demonstrating that the controls introduced in 1996 and 1997 are working. There are fewer cases of BSE, and the vast majority of current cases are in animals born before the introduction of these enhanced controls.

One of the key factors for establishing the FSAI in 1996 was the BSE crisis. The FSAI bases its decisions on the best scientific data and knowledge, and develops inspection and audit controls to ensure maximum consumer protection for meat and meat products. A rigorous policy of safeguards is firmly established throughout the food chain.

In Ireland, there is a sequence of controls for BSE along the food chain. The feeding of meat and bone meal is prohibited to all farm animals and there are stringent controls at rendering plants and feed mills. The main consumer protection measure has been the removal of specified risk materials, SRM, from the human food chain. SRM are the parts of an animal most likely to contain BSE infectivity if that animal is incubating the disease.

All cattle are examined by veterinary inspectors before slaughter at the abattoir and rapid BSE testing is carried out on all animals over 30 months of age. Veterinary inspectors, under service contract to the FSAI, ensure slaughtered cattle have had SRM removed. At boning plants, the carcasses are inspected again. In butcher shops, environmental health officers under contract to the FSAI inspect carcasses at this level. In addition, all butchers operating in Ireland are aware that it is illegal to sell meat products containing SRM.

The FSAI and the Department of Agriculture and Food have been at the forefront in the EU with the most aggressive controls to protect both animals and humans from the BSE agent. The FSAI, the Department of Agriculture and Food and the other agencies involved in policing the food chain are working to ensure full compliance and maximum consumer protection.

The Tánaiste has also been assured that the measures in place to protect public health, particularly on the protection of the blood supply, are in accordance with best international practice. A number of technical sterilising measures are taken on blood supplies and a number of donor deferral measures, especially in respect of people who lived in the UK, form the cornerstone of this activity.

Following discussions with the chairman of the CJD advisory group and the medical director of the Irish Blood Transfusion Service, IBTS, the conclusion is that the circumstances presented by the occurrence of this case do not require that any other measures need to be taken. The IBTS undertook a review of its policies following the case of transfusion infection in the UK in 2004 and will continue with those policies.

The CJD advisory group has also endorsed the most up-to-date infection control guidance in respect of the management of CJD in the hospital setting and the Department has ensured the circulation of the guidance through the hospital system. The disease continues to be notifiable and the national CJD surveillance unit in Beaumont Hospital continues its activity in monitoring the occurrence of CJD in Ireland.

The results of the HSE investigation into possible links between three variant CJD cases is awaited and it will be referred to the CJD advisory group for consideration.