A number of children have developed meningitis caused by the bacterium haemophilus influenzae, despite having been vaccinated against the disease, it has emerged.
A recommendation, made last July, to offer a booster vaccine against the infection has yet to be implemented.
Medical sources have confirmed that at least three children under the age of four have been hospitalised with haemophilus meningitis this year. It has also emerged that a number of children have suffered neurological damage from the disease in the last number of years, with one child at Our Lady's Hospital for Sick Children, Crumlin, left with serious neurological complications following invasive haemophilus infection.
Children are vaccinated against haemophilus influenzae type b (Hib) at two, four and six months as part of the national childhood vaccination programme. However, medical experts are now concerned that immunity from these vaccinations does not continue for the main risk period of infection, which lasts until five years of age.
Despite the rising incidence of late Hib infection, a recommendation to offer a booster vaccine made by the National Immunisation Advisory Committee (NIAC) to the Department of Health in July has yet to be implemented. Paediatricians and infection control experts have expressed concern a booster programme has not started in advance of the winter period when haemophilus infection is at its peak.
Dr Kevin Connolly, a consultant paediatrician at Portiuncula Hospital, Ballinasloe, and a member of the advisory committee, said: "I am disappointed that the implementation of a booster programme was not advanced quicker. The NIAC scheduled extra meetings specifically to discuss whether a booster was necessary. We made a decision in July in the hope that a booster dose would be introduced before the winter period. I am very disappointed that nothing definite has been decided thus far".
Dr Karina Butler, a consultant in infectious diseases at Our Lady's Hospital for Sick Children, confirmed last night that she had seen "a small number of cases of invasive Hib disease. The numbers are small but the trend is up and is similar to that seen in the UK. It is now recognised that Hib vaccine given in the first year of life is not strong enough to last through the risk period".
She added: "We need a booster vaccine to protect children up to five years of age. Among the types of infection we have seen is meningitis and some children have developed septic arthritis in their joints as a result of Hib infection".
A source in the Health Service Executive said it is actively planning a booster Hib programme. He estimated it could be December before additional vaccinations would begin. Asked about the budgetary implications of the programme, the source said both the cost of the vaccine and a fee for family doctors would have to be included. He said that, for logistical reasons, it would be the end of the year before a programme could begin. It is estimated the cost of the "catch-up" programme for the 200,000 children involved is about €8 million.
Haemophilus influenza type B is known to cause invasive blood-borne infection such as meningitis, septic arthritis (joint infection) and epiglottisis (a potentially fatal infection of a part of the voice box). A vaccine against the bacterium was introduced in 1992, resulting in a decline in Hib disease. But in 2003, 14 Hib cases were reported, the highest number since 1994.