Written answers

Tuesday, 30 March 2004

Department of Health and Children

Tuberculosis Incidence

9:00 pm

Photo of Dan NevilleDan Neville (Limerick West, Fine Gael)
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Question 412: To ask the Minister for Health and Children the number of drug resistant tuberculosis cases in 2003 and to date in 2004; if he has in place a response in the event of an outbreak of the multi-drug resistant tuberculosis strain identified by the World Health Organisation in several Baltic states and central Asia; and if he will make a statement on the matter. [9550/04]

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Health Act 1947 and the Infectious Diseases Regulations 1981 provide the legislative basis for the control of infectious diseases, including tuberculosis, in Ireland. My Department's strategy on the prevention and treatment of tuberculosis is guided by the recommendations of the report of the working party on tuberculosis, 1996, which covers a wide range of issues including epidemiology, surveillance, screening, preventative therapy, clinical management and laboratory diagnosis. Responsibility for the implementation of the recommendations rests with the departments of public health in the regional health boards. As recommended in the report, a permanent committee — the national tuberculosis committee — was established to advise on a detailed national strategy for the control and management of tuberculosis. The committee meets when necessary to review all relevant issues.

I am aware of the World Health Organisation's recent press release concerning levels of multidrug-resistant tuberculosis in central Asia and eastern Europe, including several of the EU-accession countries, and my Department has kept abreast of developments in this area for a number of years. The National Disease Surveillance Centre monitors rates of tuberculosis in Ireland on an on-going basis, identifies any increases in rates or clusters of the disease here and notifies my Department accordingly. The NDSC will advise my Department of any actions that are deemed necessary to deal with additional cases should the need arise. I am confident that the public health service can deal adequately with such cases.

According to the National Disease Surveillance Centre, the most serious form of drug resistance is multi-drug resistance which is defined as resistance to isoniazid and rifampicin. The following figures have been supplied by the National Disease Surveillance Centre for the years 1999-2002, inclusive. Treatment of tuberculosis lasts on average six to nine months and for this reason final figures for 2003 are not yet available from the NDSC.

Type of Resistance/ Year 1999 2000 2001 2002**
Cases resistant to isoniazid 4 6 9 3
Cases resistant to rifampicin 0 3 2 1
Cases resistant to ethambutol 0 0 2 0
Cases resistant to pyrazinamide - 4 4 0
Cases resistant to streptomycin 0 1 7 1*
Multi-drug resistant cases 2 3 2 0
* resistant to streptomycin and isoniazid
**NB figures for 2002 are provisional

In terms of the total number of cases of tuberculosis notified as compared with the resistant cases notified, the following information is for the years 1999-2002 inclusive:

1999

number of TB cases = 469

number of partially resistant cases = 7 (1.5% of total cases)

number of multi-drug resistant cases = 2 (0.4% of total cases)

2000

number of TB cases = 395

number of partially resistant cases = 5 (1.3%)

number of multi-drug resistant cases = 3 (0.6%)

2001

number of TB cases = 381

number of partially resistant cases = 12 (3%)

number of multi-drug resistant cases = 2 (0.5%)

2002 (provisional)

number of TB cases = 400

number of partially resistant cases = 5 (1.25%)

number of multi-drug resistant cases = 0 (0%).

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