Health

Friday 25 July 2014

Is TB injection still necessary for newborns?

A review is under way to assess if all newborns still need to be vaccinated against tuberculosis (TB) in light of a fall in cases of the disease.

The BCG vaccine is between 70 and 80pc effective against the most severe forms of TB, such as TB meningitis in children.

However, it is less effective in preventing respiratory disease, which is the more common form in adults.

The havoc that TB inflicted in Ireland during the 1940s when 4,000 people were dying annually is still fresh in the memory of many who lost loved ones.

The arrival of antibiotics to treat the disease, better living conditions and the BCG vaccine all combined over time to control the scourge.

According to the Department of Heath the World Health Organisation (WHO) describes nations with an incidence of less than 10 cases of tuberculosis per 100,000 population as "a low incidence" country.

In 2010 and 2011, the annual TB notification rates in Ireland were 9.2 per 100,000. There were 420 people diagnosed with TB in 2010 and 424 in 2011.

This is the lowest rate recorded since surveillance of TB began in the 1950s and Ireland is now categorised as a "low incidence" country.

The number of patients diagnosed with TB up to November 9 this year is 339, which is a decrease of 49 cases compared to the same period in 2011 (388 cases).

The people who are most likely to catch TB are the very young, the elderly and those with an immune system weakened either by illness or by certain medications.

Health Minister James Reilly said: "I am happy to confirm that the overall rate of tuberculosis continues to decline and this decrease has prompted a review in the HSE of the continuing requirement for BCG which is currently in progress."

In keeping with other parts of the world, TB rates are higher in inner city areas. The rates in parts of inner city Dublin and North Dublin, range between 17 per 100,000 to 30 per 100,000 in some areas.

The HSE local health office covering these areas say there is a decline in TB rates and point out that in 2010 the rate was 22.9 per 100,000 population (31 cases).

This compared to a rate of 14 per 100,000 (19 cases) in 2011.

The disease in Ireland is mostly found in marginalised groups such as the homeless, prisoners, drug addicts and immigrants from countries where there is a high incidence of the disease.

Homeless people are at increased risk of TB, are less likely to keep taking antibiotics and have worse treatment outcomes, including death rates,than the general public.

The Department of Health said that in many industrialised countries, TB rates among the homeless can be up to 20 times higher than the general population.

Future funding and services are now being mainly targeted as those groups who are most vulnerable to contracting TB.

TB is spread if someone inhales any droplets of saliva from the coughs or sneezes of an infected person.

Most people who are diagnosed need to be prescribed a long-term course of antibiotics, which usually lasts for at least six months.

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