St James’s Hospital launches Dr Noel Browne Medal in Tuberculosis for Specialist Registrars in Respiratory Medicine
Ruth Browne, daughter of the late Minister for Health presents inaugural medal to Dr Rachel Mulpeter and Dr Ciara Ottewill
The inaugural Dr Noel Browne Medal in Tuberculosis was presented yesterday, Wednesday 4 May. It was to Dr Ciara Ottewill and Dr Rachel Mulpeter and given by Ruth Browne. She is the daughter of the late Minister for Health Noel Browne. It was in a ceremony at the Royal College of Physicians. The prize was initiated by Prof Anne Marie McLaughlin, Consultant Respiratory Physician at St James’s Hospital. It was to recognise excellence in Specialist Registrars (SPRs) in Respiratory Medicine across Ireland.
During the event yesterday evening, six finalists delivered presentations on their experiences in managing challenging cases of Tuberculosis (TB). The presentations delivered important learnings to assist in the treatment of TB at St James’s Hospital. This is as well as educating SPRs in Respiratory Medicine across Ireland in best practice of patient treatment and TB management.
Co-winner Dr Rachel Mulpeter presented on paradoxical reactions in TB. It can occur when medication is started in a patient who is already immunosuppressed due to coexisting conditions or medications. Dr Ciara Ottewill in her presentation analysed the use of BPaL and BPaLM regimens in treatment of multidrug resistant TB (MDRTB). The BPaLM regimen was approved as a shorter regimen in treating MDRTB this month.
Awarding the Dr Noel Browne Medal in Tuberculosis, Ruth Browne said:
“I am very proud to present the inaugural Dr Noel Browne Medal in Tuberculosis and to see the legacy of my father’s important work highlighted by St James’s Hospital. My father both lived with TB, and lost his sister and mother to the disease. As Minister for Health from 1948 – 1951, he was devoted to improving TB care in Ireland. With the ultimate goal of eradicating the disease.”
Consultant Respiratory Physician Prof Anne Marie McLaughlin delivered a lecture on the legacy of Dr Noel Browne. “As Minister for Health, Noel Browne was a trailblazer in raising capital for improved health services in Ireland. He implemented funding for new sanatoria and isolation facilities which radically improved treatment of Tuberculosis,” she explained.
St James’s Hospital is a national leader in the treatment of TB. Its three TB clinics are led by a multidisciplinary team. This is including Consultant Respiratory Physicians Prof Anne Marie McLaughlin and Prof Joseph Keane. This is in addition to TB Clinical Nurse Specialist Lorraine Dolan, and a contact tracing clinic staffed by public health doctors and nurses. The Irish Mycobacterial Reference Laboratory (IMRL) tests all samples taken from patients presenting at St James’s Hospital. It assesses whether a particular isolate of TB is treatment resistant.
Tuberculosis Clinical Nurse Specialist Lorraine Dolan explained:
“We are seeing an increase in the numbers of patients presenting to St James’s Hospital. Today’s presentations highlighted important advances and best practice in treating challenging cases of TB. Here at St James’s we treat drug resistant patients as well as patients who cannot tolerate particular medicines. This is in addition to patients presenting with advanced disease, multiorgan disease or significant disability. As Ireland’s largest adult acute teaching hospital, located in Dublin’s city centre, our multidisciplinary team is also experienced in navigating cultural and language barriers when treating TB patients,”
Tuberculosis is an infectious disease caused by a group of Mycobacterium species. It typically affects the lungs but untreated, can spread to the kidneys, brain and spinal cord. Much like COVID-19, TB is transmitted from person to person. For example, an individual expels bacteria into the air by coughing.
The World Health Organisation recently said that TB is the second most common infectious diseases killer after COVID-19, with rates of infection increasing during the COVID-19 pandemic for the first time in over a decade. The latest joint WHO and ECDC data for TB prevalence in Europe reported almost 260,000 TB cases in the WHO European region in 2019, with 266 cases recorded in Ireland.
Tuberculosis primarily affects vulnerable populations, namely migrants, prisoners and people living with HIV.
Around 10% of the world’s population will develop TB disease during their lifetime, with a much higher risk among immunocompromised individuals. TB is typically treated with a six-month regimen of medication with an 85% success rate, although drug-resistant strains require longer treatments with lower success rates.
Ukraine has one of the highest instances of TB in the greater European area, and one third of those with TB are drug resistant. The recent Russian invasion of Ukraine in addition to subsequent influx of refugees into EU countries, including Ireland, is expected to impact on TB treatment in Ireland.
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