Press Releases - 2009

Householders should properly maintain private water supplies following possible disease threat from heavy rainfall - HPSC

The HSE Health Protection Surveillance Centre today (Wednesday) strongly advised householders to ensure that any private water wells are properly maintained following an increase in Verotoxigenic E. coli (VTEC) cases in November, which may be linked with recent heavy rainfall. 

Twenty six cases of VTEC have been reported in November, compared with between two and 10 cases for the same period in previous years, according to HPSC specialist in public health medicine, Dr Paul McKeown.

“So far in 2009, a total 216 cases have been reported and anyone who drinks water from private wells may need to consider boiling water or taking other appropriate measures after periods of heavy rainfall. 

“This is particularly important for vulnerable people such as children, the elderly or immunocompromised people. Well water can become polluted without any noticeable change in taste or smell. In the longer term, householders should disinfect their private wells regularly and protect them from contaminated surface water. 

“VTEC can cause severe bloody diarrhoea and abdominal cramps. Usually there is little or no fever, and patients recover within five to 10 days. However, some people, particularly children under five 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.

“Around 10% of Irish homes get their water from private wells. However, around 70% of our recent cases report drinking water from private wells. While not all of these cases are caused by water consumption it does raise concerns that the water serving these households may be contaminated.

“The recent 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 disinfecting and protecting private wells from your Local Authority and on microbiological testing of well water from the HSE Environmental Health Service,” he added.

HPSC urges parents to get their children vaccinated against measles as ongoing outbreak leaves child severely ill in hospital

The HSE Health Protection Surveillance Centre today (Monday) urged parents to make sure that their children are vaccinated against measles following a national outbreak of the disease which has left a child severely ill in hospital with pneumonia as a result of measles infection.

The current outbreak which started in August, is continuing, and there are real concerns about spread among non-vaccinated individuals, according to HPSC specialist in public health medicine, Dr Suzanne Cotter.

Eleven cases have been reported to date in November, bringing the total to 75 so far this year. This compares to 50 for the same period in 2008. Eighteen people have been hospitalized with measles this year and no deaths have been reported. One case has required intensive care treatment and ventilation for severe pneumonia.

Most cases (80%) are less than 10 years of age; with 30% aged 1-2 years of age. A majority of cases this year have occurred among children from the Traveler community.

Measles is highly infectious and can cause severe illness and occasionally cause death. An outbreak in 2000 resulted in more than 1600 cases and three deaths. As vaccination with the MMR is the only way to prevent measles infection, all parents must make sure their children have received the recommended two doses of the vaccine. While the first dose is usually given at 12 months of age by GPs and the second in school at 4-5 years of age, the vaccine can be received at any time, said Dr Cotter.

HPSC urges parents to get their children vaccinated following measles outbreak

The HSE Health Protection Surveillance Centre today (Thursday) urged parents to make sure that their children are protected against measles following an outbreak of the disease in three HSE regions.

Measles can be a serious and potentially fatal illness and children who have not been vaccinated are particularly at risk of measles during this time, says HPSC specialist in public health medicine, Dr Suzanne Cotter. 
"The outbreak in the HSE South, HSE Southeast and the HSE West, is predominantly affecting young children and teenagers from the Traveller Community. Since January, 63 cases of measles have been notified nationally, 12 of whom were hospitalised. This compares with a total of 55 for all of 2008.

"The majority of notified cases have been in the 1-4 year age group, but cases have also been reported in children less than one year of age and teenagers. The oldest case reported was 33 years of age. No deaths have occurred and none of the confirmed cases were vaccinated.

"This is the second outbreak affecting travellers in 2009, following a family outbreak earlier this year, which was linked to the ongoing measles outbreak in the UK.

"Measles is a highly infectious disease, 1 in 20 will get pneumonia, 1 in a 1000 will get encephalitis, 1-2 in a 1000 will die. To be protected you either need to have received the MMR vaccine or to have had the disease. There is no other way to prevent measles infection.

"Two doses of MMR are recommended, the first at 12 months of age, which is given by a GP, and the second at 4-5 years of age, which is usually given in schools. It is particularly worrying in this outbreak is that many of the parents of the children affected were not aware that their children were not vaccinated and therefore not protected.

"Parents need to check their child's immunisation records and see if their child received two doses of MMR. If no records are available then the child should be brought to the GP for vaccination. GPs are encouraged to provide all parents with hand held immunisation records so that parents can keep track of vaccines received. MMR given to a child within 72 hours of exposure to measles may prevent measles," she said.


Note for editors:

One dose of MMR is considered to be approximately 95% effective in preventing measles, while two doses are considered to be 99% effective.

The current MMR uptake in children at 24 months is 90%, with regional rates varying from 76%-98%.

Any area or community with low MMR coverage is at particular risk of measles outbreaks in the community.

Although there are no MMR uptake figures for the traveller community, anecdotal reports suggest that children in some families may have lower uptake than children in the settled community. This may be related to increased mobility, uncertainly about vaccines received and lack of readily accessible immunisation records (including hand held records).

The last large measles outbreak occurred in 2000 when over 1600 cases were reported and there were three measles associated deaths.

HPSC publishes HIV and AIDS figures for 2008

New figure released today (Thursday) by the HSE's Health Protection Surveillance Centre show 405 newly diagnosed case of HIV in Ireland during 2008 - a 3.6% increase compared with 2007 - and 28 new cases of AIDS.

The cumulative number of AIDS cases reported up the end of 2008 is 999, with 411 deaths reported among AIDS cases. There were three deaths among AIDS cases reported in 2008. The total number of HIV infections reported up to the end of 2008 is 5,243.

178 of the newly diagnosed HIV cases were heterosexually acquired, 97 new infections were among men who have sex with men (MSM) and 36 were among injecting drug users (IDUs). However, this data must be interpreted with caution as information on risk group is not available for 87 cases, making analysis of trends difficult.

258 of those diagnosed with HIV in 2008 were male, and 146 were female, while gender was unknown for one case.

There were seven new diagnoses of HIV infection in children during 2008. All are likely to have been infected through mother to child transmission (MCT). Of these, two were born in Ireland and the remaining five were older children who were born in Sub-Saharan Africa.

Of the 312 HIV cases where geographic origin is known, 123 were born in Ireland, 121 were born in sub-Saharan Africa, 28 were born in Western Europe and 17 in Central Europe.

HPSC specialist in public health medicine, Dr Aidan O'Hora, said that the number of patients presenting with an AIDS related illness continues to decline.

"This is reflected in the sustained drop in reported AIDS cases since 2003. The number of AIDS related deaths has also declined and these trends are welcome and suggest that individuals are accessing care and treatment early which in turn improves clinical outcomes and life expectancy.

"The antenatal HIV screening programme introduced in Ireland in 1999 continues to be a success. Mother to child transmission of HIV can be dramatically reduced or prevented by appropriate treatment and intervention measures. Of the total of 106 babies born to HIV infected mothers during 2008, only two were diagnosed with HIV infection, and one of these was born to a mother who was not known to be infected during pregnancy, and who later tested positive. 
"The overall HIV data suggest that the numbers are increasing, but are concentrated among a number of risk groups and may fluctuate from year to year. The figures highlight the continuing need for appropriate prevention and treatment services for all risk groups in Ireland, including migrants and ethnic communities.
"The number of people living with HIV is growing and given the increases in sexually transmitted diseases which facilitate the transmission of HIV infection, people should heed the safe sex message. Anyone engaging in sexual activity should practice safe sex. A properly used condom provides effective protection from HIV.

"The epidemiology of HIV in Ireland is complex and due to the voluntary nature of the reporting system, it is likely that the number of case reports is an underestimate," added Dr O'Hora.

The HPSC 2008 HIV and AIDS report is available here.

Young people advised to get vaccinated as HPSC warns of mumps outbreak

The HSE's Health Protection Surveillance Centre today (Tuesday) warned all young people, particularly second and third level students, to make sure that they are protected against mumps following a huge rise in cases since the start of 2009.

Already 848 cases have been reported since January compared to just 62 for the same period in 2008, according to specialist in public health medicine, Dr Suzanne Cotter.

"To be protected you need to have had two doses of MMR vaccine or to have previously had the mumps. There is no other way that you can be protected.

"We have seen an on-going increase in mumps throughout 2008, and now 2009, especially in third level colleges. It appears that relatively few students are taking up the free vaccine provided by the HSE through student services and GPs, despite previous alerts about getting protected against the disease. All students and staff in colleges, universities and schools and who have not had two doses of MMR and who can't remember having mumps, should see the student health service or their own GP for the vaccine. Anyone who is not sure about their vaccination status needs to get another dose to be on the safe side.

"So far this year, at least 14 cases - all male - have been hospitalised as a result of mumps infection, mainly because of orchitis (inflammation of the testes). Many other young people have been severely affected by mumps since the outbreak began, leading to missed work and lectures, with potentially serious consequences for academic performance and interference with exams.

"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.

"Anyone who has mumps should stay off for five days after the onset of swollen glands," added Dr Cotter.

People who become ill after recovering from flu may be at risk of meningococcal and pneumococcal disease - HPSC

The Health Protection Surveillance Centre today (Monday) asked people who have recently recovered from flu and who have become very unwell again with high fever shortly after, to seek medical attention as they may be at slight risk from meningococcal and pneumococcal disease.

HPSC has seen an increase in both diseases and while both are rare, they mostly occur in winter and can be associated with high influenza activity, says HPSC specialist in public health medicine, Dr Suzanne Cotter. 

"Symptoms of meningococcal or pneumococcal meningitis or septicaemia in infants include high fever, floppiness, high pitched crying and sometimes vomiting. Older children and adults suffer from fever, malaise and headache, nausea and vomiting, drowsiness or difficulty rousing and a red rash may also occur. Anyone who develops any of these symptoms should seek immediate medical attention.

"Battling the flu can affect someone’s natural immunity and may make them more vulnerable to infection with these bugs. The very young, the over 65s or those with chronic illness may be particularly at risk.

“A total of 26 cases of meningococcal disease were reported in December 2008 compared with 13 in December 2007. Most were reported in week 53 (end December /January) when 11 cases were notified. Six cases have been provisionally reported for the first week of January.

"Fifty-eight cases of invasive pneumococcal disease were reported at the end of December 2008 compared with 29 cases in the same period last year. Sixteen cases were reported in the last week of December and 26 cases have been provisionally notified in the first week of January.

"Vaccines to protect young children and at risk children and adults against the most common strains of pneumoccocal disease are routinely recommended. All children born since 2nd September 2006 are offered pneumococcal conjugate vaccine as part of the new vaccination programme which started in September 2008.

"Vaccination against Meningococcal Serogroup C has been available since 2000 and is routinely recommended for all children and young adults up to the age of 23 years. Older people and those with no spleens or with poorly functioning spleens are also recommended to get the MenC vaccination.

HPSC urges high-risk categories to get vaccinated as flu continues to circulate

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

ILI rates have risen from 72.8 per 100,000 in the last week of December 2008 to 100.6 per 100,000 in the first week of January 2009. This is the highest rate seen since the 2000/2001 influenza season.

"As influenza continues to circulate in the community, it is important that people in high-risk categories get vaccinated against influenza," says HPSC specialist in public health medicine, Dr Derval Igoe.

"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 who gets flu should stay at home, rest, drink plenty of fluids and use over-the-counter remedies like paracetamol to ease symptoms. People in 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 washing your hands with soap and water as soon as you can are important measures in helping prevent the spread of flu," added Dr Igoe.

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.




Health Protection Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1, Ireland. t: +353 1 8765300 f: +353 1 8561299 e:hpsc@hse.ie
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