A DRAMATIC increase in the level of hepatitis B infections over the past decade has prompted the HSE to add a vaccine for the disease to the childhood immunisation programme from September.
The number of hepatitis B cases in Ireland has risen from a few dozen in 1997 to almost 900 last year. The majority of those infected had contracted the disease in a country where it is epidemic before coming to Ireland.
A national conference on immunisation in Moate, Co Westmeath was told that hepatitis B is "50 to 100 times more infectious than HIV" and that up to a quarter of those who develop a chronic infection will die from liver disease, cirrhosis or hepatocellar cancer. The majority of cases identified in Ireland are chronic.
Dr Lelia Thornton, a consultant specialist in public health with the Health Protection Surveillance Centre (HPSC), said 90 per cent of hepatitis B infections in infants were chronic infections.
Hepatitis B is transferred through bodily fluids and the Republic is one of a relatively small number of European states, others being the UK, Netherlands and most Scandinavian countries, that do not have universal childhood vaccination. The WHO recommended the inclusion of a hepatitis B vaccine in all national immunisation programmes in 1997.
Dr Thornton told The Irish Times that the current policy of "selective vaccination" of adults, based on clusters of the virus, would continue.
She said the incidence of hepatitis B was noticeably higher in some regions particularly the east of the country.
Hepatitis B can also be prenatally transferred but steps are being taken to prevent this. "If the newborn is vaccinated almost immediately it can prevent infection from the mother and we have been in touch with all maternity units about maternity screening and this is now being done," she said.
One reason this year's conference was held in the midlands is because it has some of the highest vaccination rates in the State, and is one of the few consistently meeting the WHO's recommended vaccination uptake target of 95 per cent.
Dr Phil Jennings, director of public health in the HSE Midland, said in 2002 the vaccine uptake rates in the region were among the lowest in the State.
As a first step to rectify this, an audit of the vaccination programme was conducted. This revealed a lack of co-ordination between the different agencies.
"We decided to make this issue a high priority and divided the roles and responsibilities. We also tried to show parents and medical parishioners the complex steps involved in immunising."
From having vaccination rates in the mid-60s just over five years ago the midlands has met the recommended 95 per cent level since 2005.
Aside from improving communications between healthcare staff, Dr Jennings said the midlands region also centralised a number of smaller immunisation databases into one.
"We also have a policy of sending out reminder letters to parents which perhaps is something that other regions may not do as much," she said.
Dr Brenda Corcoran, public health medicine consultant at the National Immunisation Office (NIO), said the second major change to the childhood immunisation programme this year would be the addition of a pneumococcal vaccine.
In this case it is not an increase in the rates of infection that has prompted the change but rather the emergence of a new vaccine.
The benefit of adding this vaccine would be in the "population immunity effect", Dr Corcoran said, as lower rates of this infection in children would reduce its prevalence among the elderly, she said. Pneumococcal bacteria can cause meningitis and pneumonia.
Dr Corcoran said the NIO was still awaiting funding approval for a national immunisation database. This is WHO European Immunisation Week and it runs until the 27th.
For more information on vaccines visit: www.immunisation.ie/
