ANALYSIS: The confirmation yesterday of the State's first probable case of Severe Acute Respiratory Syndrome (SARS) and the discovery of a likely case of Legionnaires' disease could not have come at a worse time.
With public health doctors working-to-rule and not available over the weekend, there is no medical expertise with which to follow up these cases and help protect the nation's health.
Specialists in public health medicine work exclusively in the public service, and are essential in protecting the State's health. Whenever there is an outbreak of food poisoning or measles, they use their expertise to trace the source of the infection.
Essentially they are "medical detectives", painstakingly seeking out the cause of an infectious disease outbreak and ensuring that preventive vaccination or antibiotic cover is administered to people at high risk of further infection.
Take the current outbreak of bacterial meningitis as an example. Normally, public health doctors from the Southern Health Board would spend this weekend ensuring that close contacts of those infected are identified. They then administer preventive antibiotics to family members and others in contact with the victim, thus preventing a wider outbreak of meningitis and bacterial blood poisoning, both of which have a high death rate.
The identification of a case of Legionnaires' disease is a relatively rare event.
The legionella bacterium causes pneumonia, which, once identified, is easily treated with an antibiotic. But the difficulty is in identifying the organism and tracing others who may have been exposed to the same source of stagnant water.
With the potential to affect people using office blocks, hotels and leisure centres, it is vital that no time is lost in following up all possible cases.
Public health specialists also have a key role in disseminating information about the outbreak to hospital doctors so that other patients with pneumonia are checks for Legionnaires' disease.
National Disease Surveillance Centre (NDSC) specialists are also working to rule. They spent last weekend responding to a worldwide alert from the World Health Organisation as SARS cases began to multiply. The Irish Times understands that they worked all three days of the bank holiday weekend on a pro-bono basis and without pay.
"We are like medical detectives in relation to the identification and management of infection. Our availability out of normal office hours can be likened to a murder investigation in which no evidence-gathering takes place over a weekend," a public health doctor said last night.
It is yet another poor reflection of the management of health services in the State that no proper arrangements have been put in place to guard against threats to our public health.