John Whelan (Labour)
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I thank the Minister for coming to the House to address this issue, about which I will make every effort to avoid scaremongering or being sensationalist. Although it had been my understanding that tuberculosis, TB, was a disease that largely had been eradicated from the community, it has been brought to my attention that it is re-emerging and that its incidence in the community is again on the rise. This is a matter about which I am alarmed. While I am making an effort to be careful in the wording of my question, the word "consumption" strikes fear into people's hearts. My maternal grandmother unfortunately died of TB at the age of 37. It was a scourge in the 1950s and Dr. Noel Browne is rightly credited with intervening to largely rid the country of this terrible disease.

The Minister should outline what public health measures are in place to monitor what I understand to be the growing incidence of TB in the community. I refer in particular to schools or other public institutions in which the disease could be contagious and passed on. I am deliberately avoiding the citing of specific examples, although cases have been brought to my attention because I do not wish to cause undue distress or anxiety within the community. However, I refer to specific and real occurrences and not simply to a hypothetical threat. I wish to ascertain the HSE's policies in respect of monitoring, testing and keeping the public informed. It is only fair to make children in schools or people working in other public institutions aware to facilitate check-ups or analysis. I understand people can have latent cells without being aware, thereby possibly passing on the disease to others. Parents and the community at large are entitled to know the present status of TB in the community and to be aware of the HSE's policy with regard to monitoring and control.

Ruairi Quinn (Dublin South East, Labour)
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I thank the Senator for raising this matter as it provides me with an opportunity to outline to this House the importance of the issue raised. As of 1 January 2011, the national TB surveillance system moved to the computerised infectious disease reporting system, CIDR. This has improved timelines for reporting outbreaks. Provisional data for 2010 showed an 11% decline in TB cases, with 427 cases provisionally notified, compared with 472 cases in 2009 and 468 reported for 2008. Up to the end of February 2012, a total of 64 cases were reported. This constitutes a fall from 84 cases during the same period last year. Rates of TB incidence vary in different areas, with higher rates in the east and south and lower rates in the north east and north west. Seven TB outbreaks were reported to the Health Protection Surveillance Centre, HPSC, during 2010, with 41 active TB cases, 60 cases of latent TB infection and 20 hospitalisations. No deaths were reported from these outbreaks.

Guidelines on the prevention and control of tuberculosis in Ireland were published in April 2010 by the HPSC. The recommendations in these guidelines are based on a review of international literature, expert opinion and an extensive consultation process. They provide advice on the diagnosis and treatment of active TB and latent TB infection, outbreak management and contact tracing procedures and screening for TB in special situations such as, for example, health care settings, new entrants to Ireland, prison and homeless settings.

The HSE service plan for 2012 gives a commitment for health protection to focus on the control of TB. Deliverable outputs in this area for 2012 are to implement TB guidance and develop and implement a TB action plan which reflects the World Health Organization, WHO, targets for the elimination of TB by 2050. There are specific measures in place to control TB, the first of which is diagnosis and treatment. Acute hospitals have facilities for diagnosis, isolation and treatment of patients with TB. Problematic cases may be referred to the specialised TB unit in St. James's Hospital, which also has a TB reference laboratory. Second, this matter concerns contact screening. HSE public health departments investigate all TB notifications to determine possible sources of infection. Persons in contact with those infected are screened and those who are found to have active TB infection or latent TB infection are treated. The third component of the programme relates to vaccination. BCG vaccine is offered to all children, generally at birth. Although the vaccine provides limited protection against TB, it does protect against serious childhood forms such as TB meningitis.

The fourth measure relates to occupational screening. In this context, some occupations, for example, those relating to health care, require screening for TB before persons are allowed to start work.

The fifth measure relates to screening for immigrants. New entrants to Ireland, particularly those who come from countries in which there is a high incidence of TB, are offered screening.

The sixth measure relates to improving awareness of TB in general. In this context, front-line health care workers are regularly reminded to be vigilant of the symptoms and signs of TB infection. In addition, information leaflets explaining various aspects of TB, for example, vaccination, TB tests, treatments, etc., are also available. Furthermore, HSE regional TB committees meet regularly to examine the position vis-À-vis TB in their areas, devise strategies and co-ordinate control activities among health care professionals.

The Department of Health and the HSE remain committed to combating TB in Ireland. I share the Senator's concerns about the sense of doom which surrounded the debate on consumption, so much so that in the past many were afraid to mention it if there was TB in the family. I hope this disease will eventually disappear for good.

John Whelan (Labour)
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I thank the Minister for his thorough and comprehensive response. I am heartened and reassured by the information he has provided on the measures that have been put in place by the Department of Health and the HSE. What has been instituted appears to be wholly comprehensive. I will relay the Minister's reply to the parents and other members of the community who brought their concerns on this matter to my attention. I am sure the information the Minister has provided will readily allay their concerns.

Marie Moloney (Labour)
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May I make a comment?

Terry Leyden (Fianna Fail)
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No, that would not be in order at this time. I thank the Minister for coming to the House to take the various matters raised on the Adjournment.