A small number of cases of the extremely drug resistant TB, about which the World Health Organisation has been expressing grave concern, have been seen in the Republic, it was confirmed last night.
The WHO yesterday called for measures to be strengthened and implemented to prevent the global spread of these virulent TB strains, which it said were virtually untreatable using currently available anti-TB drugs.
Dr Joseph Keane, a respiratory consultant at Dublin's St James's Hospital, said a small number of cases of XDR-TB, or Extensive Drug Resistant TB (also referred to as Extreme Drug Resistance) had been seen here. He said he had treated some of them.
"When these arise they are so unusual they are a cause for concern. The numbers are very small but the amount of work I need to invest in them is very large. They require extraordinary treatment over a period of years as opposed to the usual six to nine months," he said.
The cases had been emerging over the last couple of years. Some were imported by people moving to the country from abroad and some had arisen in Irish people as a result of their poor compliance with the treatment regime they had been put on, he said.
Dr Keane said cases of XDR-TB were resistant not only to the two main first-line drugs used to treat TB but also to three of the second-line drugs which doctors could normally fall back on.
Cases of XDR-TB, he added, are treated with "whatever remaining drugs are available to you but these drugs have significant side effects". These side effects can include deafness, anaemia and nerve damage.
Dr Keane explained that the condition was not a death sentence in a well nourished, HIV negative person who could avail of good health services. The situation was very different in Africa, he observed.
"I'm actually dealing with a small number of cases at the moment. We can say the cases are doing very well, are not infectious and they are responding well to treatment. We have every reason to believe they will make a good recovery," he said.
He said the public and hospital TB service in the State needs to be strengthened, not diminished, and ringfenced funding needs to be delivered to strengthen the national TB reference laboratory at St James's Hospital.
A spokesman for the Health Protection Surveillance Centre also confirmed there had been a small number of cases of XDR-TB in the State. It is monitoring the situation.
Today and tomorrow the WHO will join other TB experts at a two-day meeting in South Africa to assess the response required to address TB drug resistance, particularly in Africa.
Recent findings from a survey conducted by the WHO and the Centre for Disease Control in the US on data from 2000-2004 found that XDR-TB has been identified in all regions of the world but is most frequent in the countries of the former Soviet Union such as Latvia, and in Asia.
"XDR-TB poses a grave public health threat, especially in populations with high rates of HIV and where there are few healthcare resources," the WHO said.