TB outbreak: Call for improved screening

RESPIRATORY healthcare professionals have called for improved TB screening after it emerged that public health officials are investigating an outbreak of the disease in a Cork school.

Today more than 220 pupils and staff attending Ballintemple National School, Crab Lane, in the suburbs of Cork city, will begin a screening process following diagnosis of the disease in three children who attend the school.

Last Friday the Health Service Executive (HSE) confirmed to the Irish Examiner that the first child case of TB had been notified to its public health department on July 29. A second child case was notified on August 10, at which point public health doctors identified an outbreak.

A third child case was notified on August 17. The source of the disease has not been identified.

The incubation period from infection to the development of a positive tuberculin skin test can be up to 12 weeks. School holidays began at the end of June.

Parents of children attending the school have been given details of when to attend screening at St Finbarr’s Hospital chest clinic and health officials are hoping the screening will help identify the source.

Meanwhile the Irish Thoracic Society (ICS) said the latest TB outbreak highlighted the need for improvements central to addressing “the continued challenge of the disease to public health in Ireland”.

ICS president Dr Terry O’Connor, a respiratory physician at Cork’s Mercy University Hospital, said this included establishing a vigorous national screening programme for high-risk groups and treating them for latent TB before active infection develops; greater education of healthcare professionals and members of the public to recognise symptoms of TB and routine testing for TB in patients with persistent phlegm coughs.

The ICS has also called for the funding of microbiology laboratories to test for TB on a routine basis and the enhancement of TB diagnostic facilities. Dr O’Connor said the current cluster of cases demonstrated that “TB has not gone away”.

“Ireland has seen a rise in case numbers in recent years and the contagious nature of the disease means that communities are vulnerable if the proper safeguards are not in place,” he said.

The ICS said patients with TB should complete treatment to avoid recurrence and spread of the disease.

“High rates of treatment failure are a serious issue in the management of TB and can be avoided through Directly Observed Therapy, where patients are assigned a healthcare professional to monitor their treatment and ensure compliance with medication. Ireland falls short of World Health Organisation recommendations with regard to the routine practice of DOT,” Dr O’Connor said.