Experts predict more child TB cases in outbreak

EXPERTS handling the biggest TB outbreak on recent record have predicted further cases of the disease among children at two Cork crèches.

However, they are confident of containing the outbreak within the two facilities through close monitoring of staff for early symptoms. If they can prevent more adults from becoming infectious, they will stop the spread because child cases are not contagious.

Last night, Dr Philip Monk, a consultant in communicable diseases with Britain’s Health Protection Agency, said even though the TB in question was an airborne strain, there was no question of the crèche buildings being infectious.

“Just like cigarette smoke, it doesn’t stay in the building forever. It is gone in around half an hour,” he said.

It means, however, in the case of one of the crèches, the disease spread from the toddler room — where an infected adult worked — to children in other parts of the crèche. However, because the disease was most intense in the toddler room at both crèches, screening for TB was extended to parents of children who were in the room regularly.

Dr Monk was part of a seven-strong panel of experts in disease surveillance, respiratory illness, and public health medicine who gathered at a hotel in Cork last night to address the concerns of parents whose children attend Panda Paws Preschool and Childcare facility in Co Cork and Nurture Childcare in Douglas, Cork city.

At the two crèches, 19 people have been diagnosed with the disease since March 15, including 17 child cases. Another 18 children and a similar number of adults have latent TB and are on a nine-month course of antibiotics. The remainder — more than 230 — are on a two-month preventative course.

The original TB case was a childcare worker who worked at both crèches. A second adult was diagnosed with the disease at Nurture Childcare last month.

Dr Margaret O’Sullivan, consultant in public health medicine for the Health Service Executive (HSE) Cork, said children were being excluded from activities because of misconceptions about TB.

“There has been a lot of ostracisation of children. At parties they are left to one side — it’s extremely distressing for everyone. Even children who are on (preventative) antibiotics in between screening have been affected. People have a lot of notions about TB and it’s hard to convince them otherwise,” she said.

Dr O’Sullivan said they had passed on parents’ concerns to occupational health officials that childcare workers should be screened before starting work.

“We’ve passed on parents’ concerns to crèche inspection teams in the HSE South and we’ve asked them to relay it nationally,” she said.

Paediatric consultant, Dr Muireann Ni Chroinin, said relapses in children treated for TB were not expected. She said complications were extremely rare.

Regarding the efficacy of BCG, the vaccine used to inoculate against TB, Dr Darina O’Flanagan of the Health Protection Surveillance Centre said medical opinion was divided.

Dr Patrick Wall, professor of public health at Univers-ity College Dublin, said: “Would it have stopped some of these (Cork) cases? Of course it would — but not all of them. There is no vaccine which protects you against everything.”