All at-risk groups must be screened, warns expert

A NATIONAL TB screening programme covering all at-risk groups should be introduced immediately, a respiratory expert has urged.

President of the Irish Thoracic Society, Dr Terry O’Connor, who described the current outbreak of TB among schoolchildren in Cork as “worrying”, warned that the BCG (Bacillus Calmette-Guerin) vaccination did not ensure that a person would never contract TB.

Dr O’Connor, a respiratory physician in the Mercy University Hospital, Cork, said communities would remain vulnerable to the contagious disease because of the absence of a comprehensive screening programme.

While the BCG vaccination should continue to be part of the effort to reduce the incidence of the disease, having a good screening programme was more important, he pointed out.

“There is a national programme in place, but it is not targeting all at-risk groups,” he said.

The Health Service Executive’s head of health protection, Dr Kevin Kelleher, said the health authority was examining available resources to see how the national programme could be expanded.

Dr O’Connor said patients with chronic medical illnesses, such as chronic kidney failure, could often be carriers of TB and their condition increased the risk of the disease becoming active and infectious.

He also believed that people coming from countries where there was a high incidence of TB should be offered screening as a matter of routine.

Dr O’Connor said most forms or the disease were easily treatable once diagnosed and usually involved taking antibiotics over a six to nine-month period.

While the BCG vaccination reduced the incidence of childhood tuberculosis meningitis and miliary tuberculosis, it was not entirely clear that it prevented the disease, he said.

“Establishing a vigorous programme to screen for and treat latent TB will be the most effective way of reducing the incidence of TB in Ireland, will reap long-term public health and cost gains, and should be introduced without delay,” he said.

He pointed out that patients with latent TB, a dormant form of the disease, had a 10% risk of developing active TB over their lifetime.

Dr O’Connor said a good national screening programme would involve public health officials pro-actively identifying cases of latent TB among high-risk groups.