TB expert: Disease still poses threat to health

Joseph Keane is a professor at Trinity College Dublin

A leading expert on tuberculosis (TB) has said the Government should fortify public health efforts to deal with TB, especially those responsible for the identification of cases, expert referral and dealing with those affected after an outbreak.

Joseph Keane, consultant respiratory physician in St James’s Hospital, and professor in Trinity College Dublin, said the subject should not be ignored even though there are low rates of TB among the general Irish population.

Prof Keane referred to the publication earlier this year in the international Journal of Infection, which looked at drug-resistant TB in Ireland between 2001 and 2014.

The study, which was led by Dr Emma Roycroft, a specialist scientist in St James’s Hospital, said the “prevalence of MDR/XDR-TB in Ireland, while low, still poses a threat to public health” and that “‘cross-border’ European Union strains have been found in Ireland” and putative transmission between an Irish-born patient and a non-Irish born patient was discovered.

There were 42 MDR-TB cases diagnosed in Ireland between 2001 and 2014.

According to the study, “over 75% of MDR-TB cases were confirmed in non-Irish born individuals and seven MIRU-VNTR genotypes were identical to clusters in other European countries indicating cross-border spread of MDR-TB to Ireland”.

It is understood there have been three cases of extensively drug-resistant TB (XDR-TB) in Ireland over the past 40 years, with six-figure treatment costs per patient.

The report concluded: “Our molecular epidemiological analyses identified the spread of MDR-TB to Ireland from other jurisdictions and its potential to evolve to XDR-TB.”

Prof Keane stressed that the issue was not the entry of people from other countries into Ireland, but rather whether our health system was taking sufficient steps to avoid MDR-TB from developing in individuals, thereby limiting its potential spread.

If they are ignored and not managed they have within themselves and without knowing it, the capability of spreading this disease,” he said.

Prof Keane said public health doctors had a key role i and their efforts should not be diverted elsewhere, while he also stressed the need for a dedicated MDR centre.

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