Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Senator for raising this important matter and for the opportunity to outline the thinking of the Department and the HSE in this regard. Meningitis is defined as inflammation of the meninges, which is the lining around the brain tissue, and this can be caused by bacteria, viruses or, rarely, fungi. When testing for meningitis, a sample of cerebrospinal fluid must be taken, which is then examined for white cells that fight infection and subjected to certain culture and molecular tests. The aim of these tests is to identify the specific organism causing the inflammation. There are two reference laboratories in Dublin where testing is carried out - the Irish Meningitis and Sepsis Reference Laboratory at Temple Street carries out bacterial testing and the National Virus Reference Laboratory provides the viral testing service.

There is a move currently in laboratories to test for a greater number of organisms at the same time. These broader tests provide a number of benefits. They have quick turnaround times that can provide results in approximately two hours and they can be performed in the local hospital laboratory without the need to send samples to the reference laboratories in Dublin. The Irish Meningitis and Sepsis Reference Laboratory supports the introduction of tests for meningitis in each hospital that provides an acute emergency service. There has also been significant progress in research into the use of biomarkers for diagnosing sepsis at the time of presentation. An advantage of these biomarkers is that they are not specific to a particular organism and, therefore, have the potential to detect sepsis due to any invasive bacterial infection.

The Senator referred to one particular commercial testing system, namely, the LAMP HiberGene system. This system can be used to test for two particular organisms in cerebrospinal fluid, namely, meningococcus, and group B streptococcus.As the Senator said, this system has a quicker turnaround that the broader systems I have mentioned. However, it only tests for a very restricted range of bacteria that can cause meningitis and will not identify other causes of meningitis such as pneumococcus and E. coli. The system also does not detect viral causes of meningitis or other viruses that may cause encephalitis, that is, inflammation of the brain. Consequently the other tests must still be carried out to ensure that the correct diagnosis is made. Otherwise, there is a danger that the wrong treatment would be applied with potentially catastrophic consequences.

Finally, I would like to talk about the introduction of immunisation against meningitis into the childhood immunisation programmes in recent years. Every child receives the meningococcal B vaccine at two, four and 12 months of age; the meningococcal C vaccine at six and 13 months; and a booster dose in the first year of secondary school. These vaccines have had a real impact, leading to significant decreases in these forms of meningitis.