Dec 8, 2016

Trinity Professor Warns Against Complacency Toward Tuberculosis, as Cases Increase in Ireland

The Irish tuberculosis expert co-authored the first update to international guidelines for treatment of the disease, in 17 years.

Aoife O’DonoghueSenior Staff Writer

A Trinity professor and Irish tuberculosis expert has stressed the dangers of becoming complacent towards tuberculosis as Ireland continues to see an increasing number of multidrug resistant tuberculosis cases, particularly among marginalised members of society.

Prof Joseph Keane, who is part of a small group of scientists influencing international health policy on the global tuberculosis epidemic, warns that we should not “become complacent about the spread of tuberculosis both globally and here at home in Ireland”.

Keane’s warning comes as the Centre for Disease Control (CDC) – a group in the US who monitor and control diseases – has come out with new, updated international guidelines relating to tuberculosis diagnosis. This the first update in 17 years, and Keane co-authored the best practise global guidelines as the only Irish author to be involved.


In a press statement, Keane explained that these new guidelines took eight years to develop, and will “help in detecting tuberculosis, [Multi-Drug-Resistant] tuberculosis and latent tuberculosis infection – which will support disease elimination”.

Tuberculosis is an infectious disease that spreads through the air and can be challenging to diagnose and treat. Many people can have latent tuberculosis, meaning they are carrying the bacteria, but the disease is dormant. Tuberculosis infects one third of the global population and kills 1.5 million people every year.

Tuberculosis most often affects the lungs, but can affect other parts of the body such as the kidney, spine and brain. Those at higher risk of developing the disease include people with HIV and others with weakened immune systems, those with diabetes, smokers and others who are taking immune-suppressing medications called Tumor Necrosis Factor (TNF) blockers.

The disease guidelines were published today in the Clinical Infectious Diseases journal, a leading journal in the field of infectious disease with a broad international readership. It was published by the Infectious Diseases Society of America in conjunction with the American Thoracic Society, and Centre for Disease Control and Prevention.

The guidelines recommend that doctors should employ newer tests in patients at risk for latent or active tuberculosis infection. They also recommend that doctors shouldn’t overlook active tuberculosis disease as a diagnosis, even in those countries where it is not as high risk.

The guidelines further recommends that healthcare providers consider testing for latent tuberculosis in patients who live with a person who has tuberculosis disease, those who have immigrated from countries where tuberculosis is common, as well as those in high-risk settings, such as prisons, hostels, and homeless shelters.

Dr Anne Marie McLaughlin, Consultant Respiratory Physician at St James’s Hospital, Dublin, commenting in a press release explained that, in Ireland, there are 329 cases of tuberculosis a year and that “the complexity of these cases and the increase in the number of multi-drug resistant cases is pushing the limits of our services”.

McLaughlin further explained that often the patients they see are “marginalised members of society, with addiction issues”, and she added that this presents a “big challenge to get these persons to take the antibiotics they need, because they need to be on tuberculosis medication for six to 48 months”.

In the press release, Dr Finbarr O’Connell, also a Consultant Respiratory Physician at St James’s Hospital, expanded on this, explaining that “in 2004, funding for a national tuberculosis unit was promised, to be located at St. James’s Hospital. Our public health efforts to fight tuberculosis would be helped if this facility was delivered now”, as it would advance “our care of this epidemic that has not gone away”.

In February a team of researchers from Trinity and St James’s Hospital made a breakthrough in the treatment of tuberculosis. They discovered, for the first time, how exactly our immune system responds to the disease, opening up the possibility of more effective vaccines and personalised therapies.

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