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Press Releases - 2008

HPSC urges high-risk categories to get vaccinated against flu as cases double over past week


The Health Protection Surveillance Centre today (Thursday) urged people in high-risk categories to get vaccinated against influenza, as the number of reported cases of influenza-like illness (ILI) in Ireland has doubled in the past week.

ILI rates have risen from 20.3 per 100,000 in the first week of December to 41.3 per 100,000 in the second week.

"As influenza is now circulating in the community, it is important that people in high-risk categories get vaccinated against influenza," says HPSC specialist in public health medicine, Dr Joan O'Donnell.

"High-risk groups are:

"Health Professionals should use antiviral drugs for the treatment or prevention of influenza in high-risk groups.

"The symptoms of influenza usually develop over a matter of a few hours and include a high temperature, sore muscles, dry cough, headache and sore throat. This is different from the common cold, which tends to come on more gradually and usually includes a runny nose and a normal temperature. Anyone in one of the high-risk categories should contact their GP if they develop influenza symptoms.

"Covering your nose and mouth with a tissue when you cough and sneeze, disposing of the tissue as soon as possible and cleaning your hands as soon as you can are important measures in helping prevent the spread of germs and reducing the risk of transmission," added Dr O'Donnell.

ILI rates give an indication of the overall level of influenza activity in Ireland and are reported by selected GPs as part of a surveillance system jointly run by the Irish College of General Practitioners, the National Virus Reference Laboratory and the Health Protection Surveillance Centre.

The weekly influenza surveillance reports and further information on influenza and flu vaccine are available at here.

Teenagers and young adults must get MMR jab as mumps exceeds 1000 cases in 2008 - HPSC


The Health Protection Surveillance Centre today (Tuesday) warned teenagers and young adults to make sure that they have had two doses of MMR vaccine following over 1000 cases of the disease in 2008.

1166 cases have been reported so far compared with 132 for the same period last year and MMR vaccination is the only way to tackle this increase, says HPSC specialist in public health medicine, Dr Suzanne Cotter.

"The huge rise in cases - nearly 60% of whom are between 15 and 24 years old - highlights once again the importance of getting vaccinated with two doses of MMR, which are needed to minimize the risk of infection. This is especially important for all teenagers and young adults, particularly students in schools and colleges following at least seven outbreaks in third level colleges this year.

"Anyone who has not had two doses of MMR needs to talk to their GP or student health service about getting protected. People who are not sure about their vaccination status should get another dose to be on the safe side. The vaccine is free although an administration fee may apply for non-medical card holders.

"Mumps is a contagious acute viral illness that causes fever, headache and painful swollen glands. Complications are usually mild but it can cause meningitis, deafness and inflammation of the testicles, ovaries or pancreas. Students need to be aware that the best way to avoid it is to get vaccinated. Anyone who has mumps should stay off for five days after the onset of swollen glands," added Dr Cotter. 

Further information on mumps is available at: http://www.hpsc.ie/hpsc/A-Z/VaccinePreventable/Mumps/

Health professionals urged to lookout for botulism after four suspected cases in drug users


The Health Protection Surveillance Centre today (Friday) urged clinicians and other health professionals to be on the lookout for botulism in injecting drug users following four suspected cases of the disease.

HPSC and the HSE East Public Health Department have been informed of four presumptive cases of wound botulism - all affecting injecting drug users - which are under investigation in the HSE Eastern Region, according to HPSC specialist in public health medicine, Dr Suzanne Cotter.

"This is a rare condition and we are waiting for further test results to confirm these cases. Wound botulism is caused by a toxin that is commonly found as spores in soil. The illness can be caused if a wound is contaminated by soil or gravel. In recent years this type of botulism has been most commonly reported among chronic drug users. It occurs mainly in skin abscesses from injecting heroin but can also be caused by snorting cocaine.

"Symptoms usually develop about 12-36 hours after exposure to the toxin and typically begin with blurred vision, difficulty swallowing, difficulty speaking and occasionally breathing problems. Diarrhoea and vomiting can also occur and the disease can progress to paralysis. Anyone who experiences these symptoms should seek medical attention immediately. Most people with botulism will recover with treatment, but it can take months. The disease is fatal in 5-10% of cases. 

"Botulism has previously been reported in drug users but few cases are seen in Ireland. The last cases of botulism in drug users occurred in 2002 when three injecting drug users developed botulism," added Dr Cotter.

First case of winter influenza identified


The National Virus Reference Laboratory (NVRL) has identified the first case of influenza A virus this winter. The case was detected by a network of 54 sentinel general practices who report weekly on the number of patients with influenza-like illness. 

The network was established by the Health Protection Surveillance Centre, in partnership with the Irish College of General Practitioners and the NVRL in 2000. 

Commenting on the case, HPSC Specialist in Public Health Medicine, Dr Joan O'Donnell said that the first two confirmed cases of influenza this season have been detected even though overall influenza activity is low. In total, 150 laboratory confirmed cases of influenza were detected through the sentinel network during the 2007/2008 season, peaking in January 2008. 

"As we enter the influenza season it is recommended that people in high-risk groups get vaccinated against influenza. These include:

"The symptoms of influenza infection usually develop over a matter of a few hours and include a high temperature, sore muscles, dry cough, headache and sore throat. This is different from the common cold, which tends to come on more gradually and usually includes a runny nose and a normal temperature. Anyone in the high risk categories who develops influenza symptoms should contact their GP."

The weekly influenza surveillance reports along with further information on influenza and flu vaccine are available at www.hpsc.ie

MRSA rates down but other infections show increased drug resistance - HPSC


New figures released today (Thursday) by the Health Protection Surveillance Centre (HPSC) show that MRSA infections for the first six months of 2008 have fallen by 3.5% compared with 2007 and 7% when compared with 2006.

Commenting on the figures, HPSC consultant microbiologist Dr Robert Cunney said that he was pleased to see a reduction in both the proportion and number of MRSA bloodstream infections but urged caution in interpreting the findings as it is not yet clear whether or not this downward trend will continue. 

"Worryingly, a number of other infections are showing an increased resistance to drugs. These include Streptococcus pneumoniae - the most common cause of pneumonia outside of hospitals and an important cause of meningitis in young children - E. coli which causes kidney infections and is an important cause of wound-related and bloodstream infections in hospital, and vancomycin-resistant enterococcus (VRE).

"A number of new initiatives should help to address the issue of antibiotic resistance in Ireland including:

"However, even with these interventions, it is clear that a lot more still needs to be done to bring the rate of infections caused by antibiotic-resistant bacteria, including MRSA, down to the levels seen in other European countries. Investment in infection prevention and control structures, and in interventions to limit inappropriate antibiotic use, can bring major cost savings to the health service but, more importantly, will also save lives."

Full details and data on antimicrobial resistance and antibiotic consumption in Ireland can be found at:
http://www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrobialResistance/EuropeanAntimicrobialResistanceSurveillanceSystemEARSS/
http://www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrobialResistance/EuropeanSurveillanceofAntimicrobialConsumptionESAC/

Note for editors:

MRSA
Although the downward trend may be significant, it is not yet known if it is due to improved implementation of infection prevention and control interventions, or due to strains of MRSA becoming less likely to cause infection, or some other explanation that is not yet apparent.

Improved infection prevention and control interventions are unlikely to fully explain the overall reduction in MRSA bloodstream infections because:

Streptococcus pneumoniae
Levels of penicillin resistance in Ireland has been rising steadily since 2004 and 18% of reported pneumococcal bloodstream infections were caused by antibiotic resistant isolates in the first half of 2008. This is most likely due to the rising level of antibiotic use outside of hospitals in Ireland. 

E. coli
Levels of resistance to the fluoroquinolone group of antibiotics (commonly used to treat kidney infections and pneumonia) has increased from 12.6% in 2004 to 22.5% for the first half of 2008, while the proportion of multiple-drug resistant E. coli strains has increased from 5.6% in 2004 to 12.5% for the first half of 2008. Much of this increase is probably due to high levels of antibiotic use in hospitals.

VRE
Ireland has the second highest reported rate of VRE in Europe, at 33%. Antibiotic use in hospitals, and inadequate infection prevention and control resources, are the most likely explanations for this.

Householders must properly maintain private water supplies following increase in contamination - HPSC


The Health Protection Surveillance Centre today (Friday) strongly advised householders who use water from private wells to ensure that their wells are properly maintained following an increase in Verotoxigenic E.coli (VTEC) cases.

139 VTEC cases have been reported so far this year compared to around 70-90 cases for the same period in previous years, according to HPSC director, Dr Darina O'Flanagan.

"There is evidence that the increase in VTEC cases may be linked with record rainfall this summer and use of private well water. After periods of heavy rainfall well users may need to consider boiling water intended for consumption or taking other appropriate measures. This is particularly important if vulnerable people such as children, the elderly or immunocompromised persons are drinking the water, especially if the water colour changes or it smells or tastes differently.

"VTEC can cause severe bloody diarrhoea and abdominal cramps. Usually there is little or no fever, and patients recover within 5 to 10 days. However, some people, particularly children under 5 years of age and the elderly, are at risk of a complication called haemolytic uraemic syndrome (HUS), in which the red blood cells are destroyed and the kidneys fail. This happens in up to 10% of child cases. HUS is the principal cause of acute kidney failure in children, and the majority of cases of HUS are caused by E. coli O157:H7.

"Private wells supply water to around 10% of Irish homes and we know that at least 30% of all VTEC cases are associated with water supplied in this way. While not all cases in private well households will have been caused by water consumption we are aware of a number of cases where the water has been shown to be contaminated with E.coli O157 or other E.coli organisms.

"This summer's heavy rainfall has caused very high water table levels, excessive run off and flooding which increases the chances of drinking water being contaminated. Householders can get further advice on private wells from both the HSE Environmental Health Service and local authorities who provide regular local advice on the quality and safety of drinking water," she added.

Students need to get MMR jab following rise in mumps cases - HPSC


The Health Protection Surveillance Centre today (Wednesday) warned all students to make sure that they have had two doses of the MMR vaccine following an increase in the number of mumps cases reported in recent weeks.

Mumps has been on the increase since the beginning of 2008, particularly in the under 25 year age group. Students starting or returning to college shortly are particularly vulnerable following at least seven outbreaks in third level colleges this year, says HPSC specialist in public health medicine, Dr. Joan O'Donnell.

"New students who haven't been vaccinated or who haven't had mumps need to talk to their GP or student health service about getting protected. So far this year 459 cases have been reported, 22 of whom were admitted to hospital. Almost 60% of cases have been in 10 to 24 year olds.

"This follows 142 cases in 2007, well down on 1079 in 2005 which came after a nationwide outbreak that year. It appears that most of these cases caught mumps in third level colleges or secondary schools.

"MMR protects against measles, mumps and rubella and two doses are needed to protect against infection. Anyone who is not sure about their vaccination status needs to get another dose to be on the safe side. The vaccine is free although an administration fee may apply for non-medical card holders.

"Mumps is a contagious acute viral illness that causes fever, headache and painful swollen glands. Complications are usually mild but it can cause meningitis, deafness and inflammation of the testicles, ovaries or pancreas. Students need to be aware that the best way to avoid it is to get vaccinated. Anyone who has mumps should stay off for nine days after the onset of swollen glands," added Dr O'Donnell.

New Clostridium difficile guidelines will make a real difference says HPSC


The Health Protection Surveillance Centre today (Thursday) published national expert guidelines for the surveillance, diagnosis and management of Clostridium difficile to help healthcare professionals combat the disease.

These recommendations will make a real difference in healthcare facilities around the country and their publication follows requests from infection control teams for national guidelines, says HPSC consultant microbiologist, Dr Fidelma Fitzpatrick, who chaired the committee which was responsible for providing the advice.

"Today's publication comes after the recent decision to make Clostridium difficile a notifiable disease from 4th May 2008. Ireland is one of the first countries to take this step and it means that cases must be reported, providing more information about Clostridium difficile and its prevalence.

"Clostridium difficile can be a serious and potentially fatal infection and is the single biggest cause of diarrhoea in patients who have had antibiotic therapy. While most infections take place in hospitals and nursing homes it can also occur in the community. Most of those affected are elderly patients with underlying illnesses.

"Although some people can be healthy carriers, it mostly spreads from one person to another through direct contact. Diarrhoea caused by Clostridium difficile can contaminate the general environment around patients' beds, toilet areas, sluices, commodes, bed pan washers and the like. Spores can survive for a long time and can be a source of hand-to-mouth infection, especially for other patients who have also been given antibiotics.

"The three most important factors in preventing and controlling Clostridium difficile are:

Students need to get MMR jab following mumps outbreaks in third level colleges - HPSC


The Health Protection Surveillance Centre today (Tuesday) warned students to make sure they have had two doses of the MMR vaccine following at least seven mumps outbreaks in third level colleges this year.

Mumps has been on the increase since the beginning of 2008, and students under 25, particularly new students, who haven't been vaccinated or who haven't had mumps need to talk to their GP or student health service about getting protected, says HPSC specialist in public health medicine, Dr Suzanne Cotter.

"153 mumps cases - mostly in the 15-24 age group - were reported to HPSC in the first 16 weeks of 2008, four of which were admitted to hospital. This follows 150 cases in 2007, well down on 1079 in 2005 which came after a nationwide outbreak that year. It appears that most of these cases caught mumps in third level colleges or secondary schools.

"MMR protects against measles, mumps and rubella and two doses are needed to protect against infection. Anyone who is not sure about their vaccination status needs to get another dose to be on the safe side. The vaccine is free, although an administration fee may apply for non medical card holders.

"Mumps is a contagious acute viral illness that causes fever, headache and painful swollen glands. Complications are usually mild but it can cause meningitis, deafness, and inflammation of the testicles, ovaries or pancreas. Students need to be aware that the best way to avoid it is to get vaccinated," added Dr Cotter.

Football fans warned about measles vaccination following major disease outbreaks in Euro 2008 host countries


The Health Protection Surveillance Centre has today (Wednesday) warned football fans planning to travel to this summer's Euro 2008 tournament to make sure that they have been vaccinated against measles, following major outbreaks of the disease in Austria and Switzerland, who are jointly hosting the competition.

While Ireland did not qualify for the tournament some fans may still travel and should be aware that measles is an extremely contagious and potentially fatal disease, says HPSC specialist in public health medicine, Dr Suzanne Cotter.

"These European outbreaks are a reminder of the importance of vaccination, especially for children, as it is the only safe and effective way to prevent measles from spreading. High levels of MMR vaccination are needed to protect against infection and to protect very young children - under 12 months of age - who are too young to be vaccinated. 

"While measles usually occur in children under four years old, people of any age if not already protected through natural infection or vaccination, can catch the disease. Severe disease and complications are most likely in young children under five years and adults over 20 years. It is important to realise that almost half of the deaths associated with measles occur in previously healthy children and young adults.

“The European outbreaks are a timely reminder to get vaccinated. MMR uptake for Irish children at 24 months of age in Ireland currently stands at 88% - which although the highest level ever recorded here - is still short of the 95% needed to prevent the virus from circulating and causing outbreaks. MMR is usually given in childhood – the first dose at 12 -15 months and the second at 4 - 5 years of age. Both the MMR vaccine and the administration fee is free for all children. Most adults, particularly those born before 1978, are likely to have already had measles infection. However, any individual in this age group who has never had measles infection or the measles vaccine should speak with their GP about getting it prior to travel. For adults administration fees may apply,” she said.

Visitors to malaria hotspots must take necessary medication warns HPSC


The Health Protection Surveillance Centre (HPSC) today (Thursday) warned that people travelling to areas where malaria is common must take necessary medication, following a record number of cases of the disease in Ireland.

There has been a progressive increase in the numbers of malaria cases in Ireland over the last few years, and the latest figures show that 96 cases were notified in Ireland in 2006, more than double what was recorded the previous year, says HPSC specialist in public health medicine, Dr Paul McKeown.

"Malaria is a serious tropical disease caused by parasites that are spread by biting mosquitoes. All cases of malaria in Ireland are imported. The disease is contracted in countries where malaria is endemic or found naturally. 75% of cases in 2006 contracted the disease in Africa but fortunately there were no deaths due to malaria. Worryingly however, more than a quarter of cases were in children. 

"Most people infected were visiting family members in countries where malaria is common. However, a number of cases were also seen in holidaymakers, business travellers and people arriving in Ireland for the first time. It is particularly worrying that over 95% of those who acquired malaria either did not take the necessary protective antibiotics or did not finish the course.

"People who live in areas where malaria is common often have some immunity to the disease but this quickly wears off when they move to a non-malarious country like Ireland. Unfortunately, parents returning to malarious countries to visit relatives often don't realise that their Irish born children will have no immunity at all to the disease. There is a worrying rise in the numbers of such childhood cases following travel, particularly to West Africa.

"The best defence against malaria is to avoid getting bitten by infected mosquitoes by staying away from areas where mosquitoes gather and by protecting your skin using clothing, anti-mosquito sprays and mosquito nets. However, all travellers to areas where malaria is common should check with their GP about the need to take precautions. It is crucial to take the preventive prescribed antibiotics. This is especially important for children. It is also vital to take the antibiotics exactly as prescribed by your doctor as they may need to be taken for a number of weeks after returning from the trip," he said.

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Further information on protection from biting mosquitoes and malaria can be found at http://www.hpsc.ie/hpsc/A-Z/Vectorborne/Malaria/

A map showing global malaria distribution can be found at http://www.traveldoctor.co.uk/bigmap.htm

HPSC urges high-risk groups to get vaccinated against flu as cases treble over past week


The Health Protection Surveillance Centre today (Thursday) urged people in high-risk categories to get vaccinated against influenza, as the number of reported cases of influenza-like illness (ILI) reported in Ireland has trebled in the past week.

ILI rates have risen from 16.3 per 100,000 in the last week of 2007 to 52.4 per 100,000 in the first week of 2008.

"As influenza is now circulating in the community, it is important that people in high-risk categories get vaccinated against influenza," says HPSC specialist in public health medicine, Dr Joan O'Donnell.

"High-risk groups are:

"Health professionals should use antiviral drugs for the treatment of influenza in high-risk groups.

"The symptoms of influenza infection usually develop over a matter of a few hours and include a high temperature, sore muscles, dry cough, headache and sore throat. This is different from the common cold, which tends to come on more gradually and usually includes a runny nose and a normal temperature. Anyone in one of the high-risk categories should contact their GP if they develop influenza symptoms," she said.

ILI rates give an indication of the overall level of influenza activity in Ireland and are reported by selected general practitioners as part of a surveillance system jointly run by the Irish College of General Practitioners, the National Virus Reference Laboratory and the Health Protection Surveillance Centre.

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The weekly influenza surveillance reports and further information on influenza and flu vaccine are available here

HPSC advises employers to prepare for vomiting bug


The Health Protection Surveillance Centre today (Tuesday) issued advice for employers on how to deal with norovirus (aka winter vomiting bug), following an increase in the incidence of the illness.

HPSC Specialist in Public Health Medicine, Dr Paul McKeown said that because norovirus is highly contagious it can be very disruptive to organisations and can easily infect staff, customers and clients.

"It will never be possible to prevent this illness completely, but a few simple measures can greatly minimise its disruptive effects to business. Employers can prepare for the possibility of sickness in the workplace by having simple cleaning equipment available and staff assigned to clean and decontaminate soiled areas. Anyone who has norovirus should stay off work until their vomiting and diarrhoea has stopped and for 48 hours afterwards so that they do not infect others on their return.

It is one of the commonest forms of gastroenteritis - infecting as many as 5% of the population each year - and the main symptoms include vomiting and diarrhoea. However patients can develop headaches, muscle aches, fever, and abdominal pain. The onset is sudden and the illness is generally mild, although it can be more severe in older people. It rarely lasts more than a couple of days and most people make a full and rapid recovery," he said.

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The guidelines are available here.


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