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Press Releases - 2000

Meningitis C Vaccine


The National Disease Surveillance Centre (NDSC) wishes to point out that a recent media report claiming a child entered a coma as a result of receiving the Meningitis C vaccine is incorrect. There were also a number of other misleading inaccuracies in the article.

The Irish Medicines Board (IMB) has confirmed the child did not enter a coma but in fact experienced a faint lasting approximately 10 minutes. The child was not hospitalized and made a complete recovery. The IMB have also stated that they are completely unaware of the reported "case of inflammation in the lining of the brain" as referred to in the article.

In addition, the claim made in the article that the Meningitis C vaccine is suspected to have caused Meningitis C infection in three children is incorrect. Two of the children developed Meningitis B which is a different strain of meningococcal infection which the Meningitis C vaccine does not protect against.

In the third case, infection with Meningitis C occurred in a previously vaccinated person as the vaccine was not fully effective in providing protection in this incidence. However, that person has recovered. The Meningitis C vaccine is not a live vaccine and therefore cannot cause the disease itself.

To date, 350,000 doses of the Meningitis C vaccine have been distributed in Ireland and side effects have been reported in 143 children. There are some side effects associated with the vaccine, which are generally not serious. These occur in all age groups and include nausea, vomiting, headache and a feeling of general malaise or aches and pains. We wish to reiterate that such side effects and reactions were expected and the balance of risk and benefit is overwhelmingly favourable.

Given that one in ten people who suffer Meningitis C die from the infection, this demonstrates that the vaccines have already saved many lives. The meningitis C vaccination provides a clear benefit in terms of lives saved and disabilities prevented. As a result the National Disease Surveillance Centre strongly recommends that those due to be vaccinated should receive the meningitis C vaccine.

To date over 15 million doses of the Meningitis C vaccines have been distributed in the UK. Last winter there was approximately a 75% reduction in the number of confirmed cases of meningitis C disease in the 15-17 and under 1 year olds (the first group to be vaccinated) compared to the pervious winter.

Ireland has one of the highest rates of Meningococcal Group C infection in the developed world and the infection claimed 11 lives out of the 165 confirmed cases reported in Ireland between July 1999 and June 2000. There has also been a 43% increase in the incidence of meningitis Group C infection in the last year and therefore it is of great concern to health professionals in Ireland.

The National Meningitis C Immunisation Programme was launched in Ireland on the 4th October 2000 by Mr Mícheál Martin, T.D. and Minister for Health and Children. The immunisation programme will involve approximately 1.3 million people. Every person in Ireland aged 22 or under will be offered immunisation as part of this phased programme.

NDSC Provides Reassurance to Parents on the Safety of Meningitis C Vaccine


The National Disease Surveillance Centre (NDSC) refutes recent media reports doubting the safety of the recently launched vaccine against meningococcal C infection.  

The NDSC can confirm that none of the UK deaths reported to be associated with the meningitis vaccine can be attributed to the Meningitis C vaccine. These reports of deaths are based on misinterpretation of data from the Committee on Safety of Medicine (CSM) Yellow Card System in the UK.

The CSM has carefully reviewed all data on the safety of Meningitis C vaccines and has concluded that there is no suggestion that this vaccine has led to any deaths. The Meningitis C vaccination provides clear benefit in terms of lives saved and disabilities prevented. The balance of risk and benefit is overwhelmingly favourable. As a result the National Disease Surveillance Centre strongly recommends that those due to be vaccinated should receive the Meningitis C vaccine.

The National Meningitis C Immunisation Programme was launched in Ireland on the 4th October 2000 by Mr Micheal Martin, T.D. and Minister for Health and Children. The immunisation programme will involve approximately 1.3 million people. Every person in Ireland aged 22 or under will be offered immunisation as part of this phased programme. The first phase will commence immediately amongst the groups of the population most vulnerable to the infection, babies and children aged 0-4 years and adolescents aged 15-18 years.  

To date over 15 million doses of the Meningitis C vaccines have been distributed in the UK.  Last winter there was approximately a 75% reduction in the number of confirmed cases of Meningitis C disease in the 15-17 and under 1 year olds (the first group to be vaccinated) compared to the previous winter. Given that one in ten people who suffer Meningitis C die from the infection, this demonstrates that the vaccines have already saved many lives.

1,221 Reported Cases of Measles So Far This Year - 997 of These Cases in Eastern Regional Health Authority


NDSC Warns of Measles Epidemic Because Irish Children are Not Being Vaccinated.

Protect Your Children Against This Virulent Life-Threatening Infection

The NDSC again strongly urges all parents and carers to have their children vaccinated against measles. The MMR vaccine, which is free, can prevent measles in over 90% of cases. This vaccine is given by your GP/ Family Doctor to all children aged 15 months (with the exception of children in Dublin who are given the vaccine at 12 months in the whole of the ERHA region because of the increased number of cases there) and a second dose is now given at primary school at age 5-6 years. With the second dose, over 99% of immunized children are protected from measles infection.

"So far (up to 30th June 2000) the National Disease Surveillance Centre has received notification of 1,221 cases of measles in comparison to only 148 cases in total in 1999. 997 of these cases have been in the Eastern Regional Health Authority (formerly known as the Eastern Health Board). Present vaccination uptake levels against measles are as low as 70% to 75% in some parts of the country when they should be at least 95%. This is leaving Irish Children vulnerable to epidemics" commented Dr Darina O'Flanagan, Director of the NDSC.

Measles is an acute infection which usually occurs in children age 1-4 years of age who have not yet been vaccinated against it but it can also occur at any age. Measles is caught through direct contact with an infected person or through the air by coughing and sneezing. It is highly infectious before the rash appears.

Complications associated with measles include severe cough and breathing difficulties (croup), ear infections, viral and bacterial lung infection (pneumonia) and eye infections. Other more serious problems involve the nervous system and inflammation of the brain. Severe disease and complications are most likely in young children under 5 years and adults over 20 years. While complications are more common in those who are malnourished or those whose immune system is not working properly, it is important to realise that almost half of the deaths associated with measles occur in previously healthy children and young adults.

Note:

The Royal College of Physicians has recently changed the age of the second dose of MMR to 5-6 years. Previously children received the second dose at 11-12 years. The change in the timing of the second dose is intended to provide protection for the 5-10% of children who do not respond to the first dose.

MMR Uptake by Health Board at 2 years of age
   
Health Board MMR % Uptake
Eastern 76%
Midland 68%
Mid-Western 73%
North Eastern 77%
North Western 80%
South Eastern 86%
Southern 75%
Western 78%


Notification of Measles by Health Board ~ 2000
  Jan Feb Mar Apr May June To Date
EHB (Now ERHA) 18 74 198 308 251 148 997
MHB 0 0 0 8 13 6 27
MWHB 2 1 1 1 3 5 13
NEHB 0 2 10 9 3 9 33
NWHB 0 0 3 2 2 3 10
SEHB 0 0 2 5 18 42 67
SHB 0 0 22 24 7 6 59
WHB 1 2 3 3 3 3 15
               
ROI 21 79 239 360 300 222 1,221


   

Notification of Measles in Republic of Ireland (1982 - 2000)
   
Year Number
82 1897
83 6180
84 5725
85 9903
86 451
87 201
88 936
89 1248
90 556
91 135
92 179
93 4328
94 1233
95 235
96 228
97 185
98 204
99 148
2000* 1,221
* 1/1/2000- 30/06/2000

930 Reported Cases of Measles So Far This Year


NDSC Warns of Measles Epidemic: Protect Irish Children Against This Virulent Life-Threatening Infection

In welcoming the launch of the Department of Health and Children Public Education Vaccination Campaign, which will initially concentrate on measles, the NDSC again strongly urges all parents and carers to have their children vaccinated against measles. The MMR vaccine, which is free, can prevent measles in over 90% of cases. This vaccine is given by the GP to children aged 15 months and a second dose is now given at primary school at age 5-6 years. With the second dose over 99% of immunized children are protected from measles infection.

"So far (up to 10th June 2000) the Department of Health and Children has received notification of 930 cases of measles in comparison to only 148 cases in total in 1999 - 769 cases have been in the Eastern Health Board. Present vaccination uptake level against measles are as low as 70% to 75% in some parts of the country when they should be at least 95%. This is leaving Irish Children vulnerable to epidemics such as that which is occurring in the Eastern Health Board" commented Dr Darina O'Flanagan, Director of the NDSC.

Measles is an acute infection which usually occurs in children age 1-4 years of age who have not yet been vaccinated against it but it can also occur at any age. Measles is caught through direct contact with an infected person or through the air by coughing and sneezing. It is highly infectious before the rash appears.

Complications associated with measles include severe cough and breathing difficulties (croup), ear infections, viral and bacterial lung infection (pneumonia) and eye infections. Other more serious problems involve the nervous system and inflammation of the brain. Severe disease and complications are most likely in young children under 5 years and adults over 20 years. While complications are more common in those who are malnourished or those whose immune system is not working properly, it is important to realise that almost half of the deaths associated with measles occur in previously healthy children and young adults.

Editors Notes:
The Royal College of Physicians has recently changed the age of the second dose of MMR to 5-6 years. Previously children received the second dose at 11-12 years. The change in the timing of the second dose is intended to provide protection for the 5-10% of children who do not respond to the first dose.

 

MMR Uptake by Health Board

Health Board

 MMR % Uptake
Eastern 76%
Midland 68%
Mid-Western 73%
North Eastern 77%
North Western 80%
South Eastern 86%
Southern  75%
Western 78%


 

Notification of Measles by Health Board ~ 2000
Jan Feb Mar Apr May June To Date
EHB 18 74 198 308 163 8 769
MHB 0 0 0 8 13 3 24
MWHB 2 1 1 1 3 1 9
NEHB 0 2 10 6 1 0 19
NWHB 0 0 3 2 2 1 8
SEHB 0 0 2 5 18 13 38
SHB 0 0 22 24 3 0 49
WHB 1 2 3 3 3 2 14
ROI 21 79 239 357 206 28 930

 

 

Notification of Measles in Republic of Ireland (1982 - 2000)
Year Number
82 1897
83 6180
84 5725
85 9903
86 451
87 201
88 936
89 1248
90 556
91 135
92 179
93 4328
94 1233
95 235
96 228
97 185
98 204
99 148
2000* 930
* 1/1/2000- 10/06/2000

NDSC Completes Two Major Review Documents On the Process of Notification of Notifiable Diseases and the Control of Anti-microbial Resistance and Invites Comments from Interested Healthcare Professionals


Two Sub-groups of the Scientific Advisory Committee of the National Disease Surveillance Centre have just produced two major review documents on Notifiable Diseases and on Antimicrobial Resistance. These documents have been sent out to relevant representative bodies for review and NDSC is now seeking comment from the wider community.

The first document is entitled a ''Review of the Current List of Infectious Disease and of the Process of Notification". This document reviews the current list of notifiable diseases under the infectious disease regulations. It makes recommendations regarding proposed additions and deletions to this list and makes proposals regarding the process of notification in respect of each disease.

This review was led by Dr Lelia Thornton, Specialist in Public Health Medicine at the Eastern Regional Health Authority (ERHA), in conjunction with representatives from the paediatric, public health, environmental health, general practice, infection control nursing, and medical laboratory science communities.

The second document is entitled "A Strategy for Control of Antimicrobial Resistance in Ireland (SARI)". The need to develop a national strategy for the control of the development and the spread of antimicrobial resistance in Ireland is recognised. The report recommends that the Department of Health and Children (DOHC) considers the control of antimicrobial resistance in humans a priority and that it makes resources available to ensure that the recommendations are implemented. The document also recommends that all efforts to address the problem of antimicrobial resistance in humans should be considered in parallel with existing and future efforts addressing the problem in animals.

In conclusion SARI recommends the development of a three-tier strategy, with local, regional and national tiers. Such a framework will ensure that existing services are developed and strengthened and local ownership of the problem whilst tackling it within a national setting.

The development of this document was led by Dr Olive Murphy, Consultant Microbiologist at the Bon Secours Hospital, Cork in conjunction with a multidisciplinary committee comprising representatives from the veterinary, pathology, nursing, dental, paediatric, agriculture and pharmaeconomic community. The committee also comprises a GP and public health representative and representatives from the Food Safety Authority, Consumers Association and pharmaceutical industry.

Members of the community are invited to review these two documents on the NDSC website and to submit comments by Tuesday June 6th 2000 by e-mail to info@ndsc.ie or alternatively to the NDSC by fax at (01) 661 7347

Following the consultation process the document will be finalised, taking into consideration the views obtained and will be sent to the Department of Health and Children for consideration. 

National Disease Surveillance Centre Warns Parents to Ignore Unfounded Vaccine Scare and Get the MMR Vaccine for their Children. Irish Children Should Not Die of Vaccine Preventable Illness


The National Disease Surveillance Centre (NDSC) is alarmed at the recent media reports and subsequent public interest in a theory, which suggest that the measles-mumps-rubella (MMR) vaccine in general may be linked to autism. The NDSC holds the belief that the current scientific evidence, which states that since 1988 more than 250 million doses of the MMR vaccine have been given to children with no sudden change in the incidence of autism, does not support this theory.

A recently published study in The Lancet by Dr Brent Taylor(1) provides the best population-based evidence regarding MMR vaccination and autism. The authors identified all 498 known cases of autism related disorders living in certain parts of London and who were born in 1979 or later and correlated the cases to an independent vaccination registry. The results showed:

The media reports on the alleged link between the MMR vaccine and the development of autism relate to studies conducted by Dr Andrew Wakefield, Senior Lecturer in Paediatric Gastroenterology of the Royal Free Hospital in the UK in conjunction with Professor John O’Leary, Director of Pathology of the Coombe Women’s Hospital in 1998(2).

“The second Wakefield study has not yet been published. It is for this reason that we should not be rushing to conclusions about its’ validity. When it is published it will be examined in light of the many other studies on autism and MMR. The findings must then be set in context. Other researchers will then try and replicate the study to see if the findings hold true” said Dr Darina O’Flanagan, Director of the National Disease Surveillance Centre.

“It would be a disaster if children were to die of vaccine-preventable disease over this unfounded vaccine scare. We join in one voice with the Department of Health, the Irish Medicines Board and the Royal College of Physicians to refute the allegations made about the link between the MMR vaccine and the development of autism. Children have a right to expect to be fully immunized and parents and health authorities have a responsibility to see that that right become a reality” added Dr O’Flanagan.

References
1 + 2 http://www.cdc.gov/nip/vacsafe/concerns/autism/autism-mmr.htm (Last accessed May 31 2000)

Disease Surveillance Centre Says Every Hospital in Ireland Needs an Active Aggressive Infection Control Policy to Combat Hospital Acquired Infections and Deaths


Hospital acquired infection results in increased complications and mortality rates, extra beds days, and additional costs for hospitals and health boards. Every hospital in Ireland needs an active aggressive infection control policy to combat these infections according to the National Disease Surveillance Centre (NDSC).

The NDSC has issued this statement in the wake of the UK National Audit Office report entitled The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England. The report says that every year 100,000 infections are acquired in English hospitals costing the NHS £1 billion according to a study of 219 acute hospital trusts. The report also revealed that 5,000 patients die from hospital acquired infections every year and these infections are implicated in the deaths of another 15,000.

"We have a comparable problem here in Irish hospitals. Infection can spread from patient to patient or from hospital personnel to patient and usually occur in the respiratory, urinary and digestive tracts and in open wounds. Infections are often acquired by 'at risk' patients in intensive care units, surgical wards and by patients who are already immunosuppressed (such as patients on renal dialysis or on chemotherapy). When a patient acquires a hospital infection, they have to stay an extra four days in hospital on average. In addition to the distress caused to the patients and the increased mortality risk, this represents a significant cost to the health services." said Dr Edmond Smyth, Chairman of the NDSC Scientific Advisory Committee and Consultant Microbiologist, Beaumont Hospital

"It is important to emphasise that not all of these infections can be prevented but current evidence shows that a well-organised infection control programs can reduce the number by one-third. Every hospital needs access to such a service, which normally comprises an Infection Control Doctor, Infection Control Nurse and secretarial support. The number of personnel in such a team reflects the size and type of hospital. Currently such services are not operational in all Irish hospitals because of resourcing and staffing issues. Other issues such as patient staff ratios, the lack of facilities for isolating patients and hand-washing also need to be addressed. In addition to improving the overall quality of patient care, the implementation of such a service is cost effective." said Dr Olive Murphy, Consultant Microbiologist, Bon Secours Hospital Cork.

The Scientific Advisory Committee (SAC) of the NDSC has undertaken to develop principles in relation to infection control in hospitals. The SAC is a multidisciplinary committee comprising representatives from the veterinary, pathology, nursing dental, pediatric, agriculture and pharmaeconomic professions. The committee also comprises a GP and public health representative and representatives from the Food Safety Authority, Consumers Association and pharmaceutical industry.

The National Disease Surveillance Centre (NDSC) is Ireland's leading specialist centre for communicable disease surveillance. The Centre was set up in 1997 in Dublin conjointly by Ireland's eight Health Boards and with the approval of the Minister for Health and Children. The aim of the NSDC is to improve the health of the Irish population by the collation, interpretation and provision of the best possible information on diseases including environment and safety hazards. This is achieved through surveillance and independent advice, epidemiological investigation, research and training.

National Disease Surveillance Centre Warns of Outbreak of Measles in the Eastern Health Board and Strongly Advises Parents To Get Their Children Vaccinated


The National Disease Surveillance Centre (NDSC) has been advised of an outbreak of measles in Dublin. Since January 2000 over 40 cases of measles have been notified to the Eastern Health Board. Over 17 children have been hospitalised, with 3 children needing intensive care.

Measles is an acute infection which usually occurs in children aged 1-4 years of age who have not yet been vaccinated against it but it can also occur at any age. Measles is caught through direct contact with an infected person or through the air by coughing and sneezing. It is highly infectious before the rash appears.

Complications associated with measles include severe cough and breathing difficulties (croup), ear infections, viral and bacterials lung infections (pneumonia) and eye infections. Other more serious problems involve the nervous system and inflammation of the brain. Severe disease and complications are most likely in infants under twelve months, those who have weakened immune systems and those who are malnourished.

The National Disease Surveillance strongly urges all parents and carers to have their children vaccinated against measles. The MMR vaccine which is free, can prevent measles in over 90% of cases. This vaccine is given by the GP to children at 12-15 months of age and a second dose is given in primary school at age 11-12 years.

The current reported uptake of the MMR vaccine in Ireland is well below that required to prevent outbreaks of measles and spread throughout the community.

All children need to be protected against measles. Without protection, there is a very real chance that more children may become infected and suffer serious consequences.


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