Doctors warn TB infections set to rise

THE consistent decline in tuberculosis (TB) rates in Ireland over the past 50 years may be somewhat reversed by the increase of immigration into Ireland, leading experts in the area said yesterday.

Four respiratory physicians from hospitals in Dublin and Cork told the Oireachtas Committee on Health that the number of cases of TB had fallen from almost 7,000 a year in the early 1950s to around 400 per annum at present.

However, in a presentation to the committee, the experts said TB incidence may increase in Ireland as a result of rises in Britain and also because many immigrants come from countries with higher levels of TB than this country. Some come from countries, such as the former Soviet bloc, where resistant forms of TB are more common. They prolong the treatment period to periods between 12-18 months.

One of the consultants, Dr Tim McDonnell of St Vincent’s Hospital, said that there was an immediate need to invest resources into treating the disease.

He told the meeting, chaired by Fianna Fáil TD Jimmy Devins, that a national laboratory for identifying TB specimens had been sanctioned for St James’s Hospital in Dublin but no support had been provided. He said that specimens now had to be sent to Britain for analysis.

Also a 15-bed isolation unit had been promised for the same hospital but had yet to become reality. Such a unit was necessary, said Dr Barry O’Donnell of St James’s Hospital, to prevent an epidemic.

Dr McDonnell also told the meeting TB vaccination should be scrapped. He said the BCG injection was not worth the money as it was not a very effective vaccine. He said resources would be better spent elsewhere.

Among the deficits identified by the group was a lack of isolation - there is now only a single bed available in Dublin and there are four in Cork. These isolation beds are used to treat the more resistant forms of TB, which often take over a year to treat.

They also said that there was a need for more specialised TB nurses and pointed out that the spread of respiratory physicians throughout the country was inadequate.

The highest incident rates of TB were recorded in the Cork and Kerry areas (at 13.3 cases per 100,000 population), in Dublin and in the south-east. The overall rate for Ireland compares to the incidence in Britain, Spain and in Belgium.