§ Mr. CohenTo ask the Secretary of State for Health what consideration he has given to making MRSA a notifiable disease; what representations he has received, and from whom, on this matter: what assessment he has made of the effect of the non-notifiability of MRSA on its recorded incidence; and if he will make a statement. [10269]
Mr. Alan W. WilliamsTo ask the Secretary of State for Health if he will assess the advantages of making MRSA a notifiable disease. [10594]
§ Mr. HoramNo representations that methicillin-resistant staphylococcus aureus—MRSA—should be made a notifiable disease have been received in recent years.
The statutory notification system requires doctors who are directly responsible for patient care—not laboratories—to notify diagnosed and suspected cases who are suffering from certain diseases. About 80 per cent. of people who acquire MRSA. do not develop any infection and are not therefore suffering from a disease. When MRSA infection does occur, it can take the form of many different diseases, ranging from trivial skin infections to pneumonia or septicaemia, all of which are more commonly due to other causes. MRSA infection cannot be diagnosed clinically but only by laboratory tests. Notification of clinically suspected cases of all these diseases would be wholly impracticable. Appropriate control measures are taken in hospitals when MRSA is identified—such control action is not dependent on whether or not MRSA is notifiable.
Current data on the incidence of MRSA are compiled by the central public health laboratory of the Public Health Laboratory Service. The PHLS believes that its data on the incidence of MRSA are among the most complete of any country in the world.
§ Mr. CohenTo ask the Secretary of State for Health what guidance he has given to social services departments on the treatment of patients with MRSA discharged from hospital; and if he will make a statement. [10268]
§ Mr. HoramThe Department held a seminar in December 1995 on methicillin—resistant staphylococcus aureus in the community which was attended by representatives from social services departments: a further seminar is being planned. The Department intends to issue guidance shortly to social services departments about MRSA and to provide them with leaflets, which are currently being prepared, for distribution to nursing and residential homes.
Mr. Alan W. WilliamsTo ask the Secretary of State for Health what is his Department's annual expenditure on(a) research into MRSA and (b) developing new antibiotics. [10598]
§ Mr. HoramThe Department of Health is currently funding, through the regional research and development programme, two research projects totalling £46,000 per year into the detection and prevalence of methicillin—resistant staphylococcus aureus. It is also spending £2 million on studies on the surveillance and costs of hospital acquired infection including MRSA infections. The16W regional research and development programme includes many projects which involve antibiotics. Of these, two, totalling about £300,000 per year, are on research into antibiotics. There are also eight RHA-funded research projects relating to antibiotics totalling about £210,000 per year.
About 20 per cent. of the NHS drugs bill goes into research and development of new drugs by the pharmaceutical industry and the industry in the United Kingdom is currently spending in excess of £1.5 billion. This includes research into antibiotics, some of which are intended specifically for use against MRSA.
The Public Health Laboratory Service is conducting research into the genetics of MRSA and into the behaviour and virulence of different strains of MRSA, and is also co-operating with the pharmaceutical industry on testing new antibiotics.
The MRC, which receives its grant-in-aid from my right hon. Friend the President of the Board of Trade, is funding a research project costing £538,000 over five years into staphylococcus aureus, including MRSA.
Mr. WilliamsTo ask the Secretary of State for Health if he will make a statement on the severity of the problem of MRSA in(a) Britain and (b) France, Germany, Italy and the United States of America. [10596]
§ Mr. HoramMethicillin-resistant staphylococcus aureus was a considerable problem in British hospitals in the mid-1980s, then receded, but has increased again in the last two to three years. Data on incidents of MRSA are compiled by the central public health laboratory of the Public Health Laboratory Services—PHLS, which defines an incident as three or more patients with the same strain of the organism. About 80 per cent. of patients with MRSA are only carrying the organism and have no infection from it. In 1994, the PHLS recorded 1,081 incidents of MRSA and in the first six months of 1995 there were 750 incidents. Most of these incidents were short lived.
Whilst it is clear from papers published in the medical literature that the other countries have problems with MRSA in some hospitals, the Department is not aware of any central collation of data on MRSA in any of these countries and we are unable to assess the severity of the problem there.
Mr. WilliamsTo ask the Secretary of State for Health if he will make a statement outlining the department's policy on controlling the spread of MRSA. [10597]
§ Mr. HoramThe Department's policy on the control of methicillin-resistant staphylococcus aureus in hospitals is contained in guidance published jointly by the Hospital Infection Society and the British Society for Antimicrobial Chemotherapy, circulated to the NHS in September 1994 under cover of EL(94)74 entitled "Improving the Effectiveness of the NHS".
The Department also published guidance on the control of infection in hospitals in March 1995 under cover of HSG(95)10 "Hospital Infection Control". This includes new advice on the surveillance of MRSA. Copies of both documents are available in the Library.