02 March 2006

Tuberculosis outbreak warning

Irish Independent

Infectious disease clusters linked to inner-city pubs could herald epidemic, says expert

Eilish O'Regan
Health Correspondent

CLUSTERS of TB here could be a signal of an epidemic outbreak, an infectious disease expert warned yesterday.

Dr Margaret Hannan, head microbiologist at the Mater Hospital in Dublin said 300 cases of TB which were investigated recently involved mostly young Irish males from north inner-city Dublin.

She said many of these drank in local pubs in the north of the city and control measures are needed to ensure the disease does not spread.

Dr Hannan said the findings are a sign of a lack of TB control and they were not being picked up by the health system.

The problem has been exacerbated in the last year by the closure the TB unit in Peamount Hospital in Dublin, she told the 'Irish Medical Times'.

Since then patients with the disease who need to be hospitalised are cared for in acute general hospitals. She said 26 cases of the infection were traced to one bar and another cluster of cases were linked to one family.

"These were young men in employment who were living in urban parts of Dublin.

We found that those infected with TB were all living in certain areas and drinking in certain pubs

"One of the things we found was that they were all living in certain areas and all drinking in certain pubs.

"That is indicative of poor TB control in the country and that could be the beginning of an epidemic outbreak," she added.

The expert criticised the poor infrastructure in Ireland for the management, control and prevention of TB.

There were 437 cases of TB in 2004 while the previous year there were 407 cases, research into the disease showed.

Dr Hannan explained: "The research looked at all of north Dublin, and found people who had evidence of recently picking up the infection were young Irish-born males and not the usual suspects who are drug addicts, heavy-drug users, immigrants and the poor."

She warned if TB becomes a problem, it takes about 10 to 15 years to get a handle on it and to treat it because it is very difficult to diagnose and it is very difficult to treat.

The closure of the Peamount unit has taken away a service that was essential and it was not just providing medical care.

"It was a social support for people who cannot afford housing and who cannot afford to take care of themselves.

"There is now a big gap in the service. These people are not sick enough to be in one of our acute hospital beds, but you want them looked after, you want them warm and dry and fed every day while they are getting over their TB," added Dr Hannan.

Patients who have TB need to be monitored to ensure that they take a correct course of antibiotics otherwise resistance to the drugs will increase.

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