HC Deb 09 February 1999 vol 325 cc119-23 3.31 pm
Ann Clwyd (Cynon Valley)

(by private notice): To ask the Secretary of State for Wales to make a statement on the meningitis outbreak in south Wales.

The Parliamentary Under-Secretary of State for Wales (Mr. Jon Owen Jones)

Over the past two weeks, 11 cases of meningococcal infection have been identified in the Taff Ely area. Seven cases have been identified in schoolchildren attending Coed-y-Lan upper and lower schools and Trerobert primary school at Ynysybwl. Two pre-school children have also been affected and one 15-year-old pupil has died. Immunisation of all staff and pupils at the three schools is being carried out today. Appropriate antibiotics have been given to the above and to direct contacts in the case. The two other cases involve a teacher at Cardinal Newman school in Rhydyfelin, and an older woman from there, both of whom died. The teacher is believed to have had contact with one of the other known cases. Two helplines have been established, one by the health authority, and one by the education health authority. The National Meningitis Trust is also actively involved in providing advice locally.

This is a rare situation and all general practitioners are being asked to be alert to the signs and symptoms of meningococcal disease in the Bro Taf area. Parents and guardians should also be vigilant. It is a dreadful illness, swift and sometimes fatal in effect, but it is very treatable if prompt diagnosis is made. The House will share my sympathies for the relatives of the deceased and for the great anxiety that the people of the Pontypridd area, especially parents, are feeling.

Ann Clwyd

I am grateful to my hon. Friend. I offer my sympathy to the families of those who have died, and to those who are concerned about children who are sick in hospital or attend schools where an outbreak has occurred. My hon. Friend the Member for Pontypridd (Dr. Howells), the Minister for Competition and Consumer Affairs, who is sitting on the Front Bench at the moment, has already been actively concerned in the matter.

I am getting phone calls from worried constituents who fear that their children are at a school where one death has occurred but where they are not receiving any offer of treatment. Why is that? Can the Minister say how contagious health professionals believe meningitis is and say who needs antibiotic protection and who needs immunisation? A public health emergency has been declared in the Bro Taf health authority area. As my hon. Friend said, parents have been asked to be extra vigilant in looking for the symptoms of meningitis. Spotting the symptoms is vital, but even now, not everyone knows what to look for, particularly as there are several strains of meningitis with various symptoms. Can my hon. Friend spell that out? Can he also assure the House that there are sufficient stocks of all medicines that might be needed to contain the outbreak? Can he give details of the public helpline available to people who are concerned and who would like further information?

Are there any social, psychological or biological reasons why the number of cases among teenagers has apparently more than doubled in the past few years? I know that, in 1996, there was an outbreak of meningitis in the Minister's constituency. Given that it appears that Wales has one of the highest levels of meningitis in Europe, can he tell the House whether any research is being done to establish the reasons?

Mr. Jones

Meningitis is a highly complex illness and medical science is far from understanding why there are outbreaks in particular areas at particular times and why they do not occur more often. The bacterium that causes the illness is present in about 10 per cent. of the population at all times, yet it does not normally—in most cases, for most people and at most times—cause an outbreak. What exactly causes an outbreak to occur remains a matter of great conjecture.

The vaccinations that exist are effective against a particular strain of the illness—the strain that is present in the cases reported in Pontypridd. However, the vaccine is not effective for long, nor is the use of antibiotics: those prophylactic measures have to be applied where and when the illness occurs, when it occurs in a non-sporadic fashion. The vast majority of cases, dreadful as they are, are sporadic, in that no others are affected. That is not the case in Pontypridd, where there has been a relatively large number of cases.

The health authority and the education authority have acted promptly to ensure that antibiotics and vaccinations are delivered to those who are most at risk. I am confident that all that could reasonably be asked to be done has been done promptly in the Pontypridd area.

Mr. Nigel Evans (Ribble Valley)

I offer the sympathy of the official Opposition to the families and friends of those who have died of the disease. I pay tribute to the nurses and medical teams who are working in the Bro Taf health authority area, vaccinating pupils, teachers and others at three of the schools in the area affected by the outbreak; and to staff from medical charities associated with meningitis who are working with parents, spreading information about the disease and counselling those in need.

What extra support is the Minister giving the health authority to ensure that it is able to deliver the necessary medical support as quickly as possible to those in need, while ensuring that other medical priorities are not affected? Are there any plans to vaccinate pupils and staff from other schools in the area? What contact has the hon. Gentleman had with the Meningitis Research Foundation and the National Meningitis Trust, both of which are being inundated with requests for help, advice and counselling? I have spoken to both organisations today: one told me that 200 calls had been received over the weekend, and the other said that, this year alone, 10,000 calls had been received—an incredible figure. What extra resources can be given to those organisations, to help them to disseminate information and counsel parents, pupils and others in the short term?

As the hon. Member for Cynon Valley (Ann Clwyd) said, the incidence of meningitis among teenagers has doubled over the past three years. The incidence of meningitis in Wales is three times that in the United States of America: we in Wales have had 45 cases this year alone. In the long term, what extra help can be directed towards urgent medical research into the disease?

What action are the Government taking to ensure that adequate advice is given to those who need it? Parents and others need to be reassured: although there is no need for panic, there is every reason to be aware of the disease, of what to look for and of what to do if there is any suspicion that someone has the disease. The Meningitis Research Foundation and the National Meningitis Trust carry out those functions, but demands on their time and resources have increased tremendously over recent months. What can be done to assist them?

Do the Government intend to issue fresh guidelines, not just to general practitioners but to schools and universities? The Minister will be aware of other outbreaks in the area over recent months. What is being done to ensure that sufficient vaccines and antibiotics are made available, as the hon. Member for Cynon Valley asked?

The latest outbreak is worrying, and follows others not just in south Wales but in other parts of the country. Normally, the cycle would have peaked, but 1997 saw the highest incidence of meningitis since the second world war. What national strategy and action are the Government considering to ensure adequate assistance, and that the current cycle and the spate of outbreaks are urgently and properly contained?

Mr. Jones

The Government recognise that urgent vaccine development is required. In the coming year, £1 million will be put into such development. Vaccines and antibiotics have been made available in the south Wales area. Additional antibiotics and vaccines have been brought into the area from Bristol and the west midlands to ensure that adequate supplies are available. The monitoring committee, which is considering developments on the ground, is meeting at 6 o'clock tonight. I know that it is considering whether further vaccination should be called for and delivered to other schools.

It has been recognised over the past few years, partly as a result of the outbreak in Cardiff in 1996, that some people are particularly vulnerable, especially first-year students who are staying in halls of residence. I know that many health authorities have been issuing vaccines to such students as a matter of course when they go to university.

Ms Julie Morgan (Cardiff, North)

May I express my deepest concern for the families involved, especially given that my constituency neighbours that of my hon. Friend the Member for Pontypridd (Dr. Howells). Will the Under-Secretary confirm exactly what strain of meningitis has been identified? Will he advise parents whether they should send their children to school in such circumstances? I know that a number of parents are understandably keeping their children at home, and such advice would be useful. I also know that a number of teachers who have children of their own are concerned about whether they should be going to school. Will my hon. Friend please offer some advice?

Mr. Jones

The strain responsible for most of the cases is C2A, which is a new strain to the area, but not to the country. It has been known for the past four years, and has proved particularly virulent in this outbreak. One of the patients has been infected by a different strain—1B. The schools that have been affected have closed, although I do not believe that that was done on medical advice. It is up to the medical authorities to advise when and whether schools ought to close.

Mr. Lembit Õpik (Montgomeryshire)

The Liberal Democrats share the great concern of all in the House about the tragic deaths, and the worry that the outbreak is causing parents and children who live in fear of contracting the infection. We welcome the speedy response of the health service during this very difficult time. Does the Minister agree that it is vital that parents follow the advice of local physicians and that, if asked, for example, to take their children to a school for vaccination, they should not ignore such a request out of misplaced, albeit understandable, loyalty to their children and worry of further exposure to the infection?

Mr. Jones

I concur completely with the hon. Gentleman's remarks. My hon. Friend the Minister for Competition and Consumer Affairs, who is sitting beside me, is not only the local Member but a parent of children at one of the schools affected. He has informed me that almost 100 per cent. of parents have responded and that the way in which the education and health authorities have co-ordinated work in Pontypridd has been exemplary.

Mr. Elfyn Llwyd (Meirionnydd Nant Conwy)

I, too, offer my sincere condolences and those of my party to the bereaved families. In view of what the Minister said earlier about the complex nature of the disease and its many and varied symptoms, will he redouble the Department's efforts to ensure that all general practitioners are made acutely aware of those symptoms and of the need for urgent action when they appear?

Mr. Jones

All the general practitioners in the area have been given detailed guidance about this outbreak, and they periodically receive advice about outbreaks in general.

Mr. Malcolm Savidge (Aberdeen, North)

I express my condolences to those affected by the tragedies in south Wales. Will the Minister join me in expressing relief that Claire Booth, the 16-year-old schoolgirl in my constituency who was reported just last night to be fighting for her life against this virulent strain of meningitis, is today reported to be showing signs of making a remarkable recovery? Will he join me in wishing her a full and early recovery? In the light of the experience in south Wales, will he also join me in urging everyone to show the utmost vigilance in fighting the spread of this terrible disease?

Mr. Jones

Yes, obviously I am delighted that the girl is making a recovery. As a parent, I cannot imagine anything more worrying than the thought of my child falling ill with a disease that is so swift in its action and possibly fatal in its outcome. I only hope and pray that the Pontypridd child who is now critically ill in the University hospital of Wales makes a recovery.

Mrs. Cheryl Gillan (Chesham and Amersham)

I, too, offer my sympathies to the constituents of the hon. Member for Cynon Valley (Ann Clwyd), who raised this question. The Minister might recall that in my constituency, last July, there was an outbreak of meningococcal meningitis in a scout camp. Happily, the children who were affected recovered, and the doctor who was originally consulted, Buckinghamshire health authority and the scout leaders reacted rapidly in giving information to the parents and children and administering the necessary antibiotics.

Will the Minister join me in congratulating those concerned on their prompt action on that occasion and agree with me that the co-ordination of public services by the health authority in the event of such an outbreak plays a pivotal role in preventing unnecessary anxiety and meeting the need for swift medical action? Will he consider what extra resources he may make available to health authorities that find themselves facing those extra, demanding responsibilities?

Mr. Jones

I share the hon. Lady's commendation of the work in her constituency to identify the disease early. Prompt action can be, and usually is, successful in treating those affected, but it is difficult to diagnose the illness because its symptoms are so similar to those of many other conditions. It is understandable that sometimes those symptoms are initially missed. We must ensure that, where there is an outbreak, we direct sufficient resources to the area and bring the problem to the attention of GPs and parents so that prompt action will be taken, if not in all cases, at least in the vast majority of them, so that we can stamp out the outbreak as fast as possible.