Hard questions over superbug outbreak

Published on Tuesday 24 June 2008 22:46

DEATHS from the superbug Clostridium difficile at a Scottish hospital have shocked the nation, leading to heavy criticism of the health board involved.

But what is starting to emerge as a major cause of concern is the fact that the large number of cases of the bug – affecting more than 50 patients and involved in 18 deaths – was only spotted when clinicians looked back at cases, by which time it was too late for many.

You would like to think that once cases of the potentially deadly infection reached a certain level, alarm bells would start ringing. Not so, if the Vale of Leven Hospital is anything to go by.

One leading scientist told The Scotsman that it was "very surprising" that surveillance systems did not pick up the cases until so far down the line.

"It is very simple – you could work it out on the back of an envelope," he said. "Perhaps they were short of pencils."

But there are fears the situation at the Vale of Leven may not be isolated.

The scientist asked: "If it could happen there, why couldn't it happen anywhere else?"

And questions also need to be asked further up the line, such as why the central surveillance system at Health Protection Scotland (HPS) did not react to the large number of cases being seen at the Vale. Was the agency even sent the figures in the first place?

No doubt these are questions which should be answered by the review ordered by Nicola Sturgeon, the health secretary.

Statistics are often troubling for organisations like HPS.

When The Scotsman last year asked for surveillance figures for C difficile a few months after the programme started, HPS was reluctant to supply them ahead of official publication.

It was only after appealing and asking for a second time that these figures were supplied, revealing up to 6,000 patients in Scotland were being struck with the bug in a year.

Figures also obtained by The Scotsman showed that, in 2006, there were 164 deaths where C difficile was the main cause.

But one thing is sure. In future, such figures will be more widely available, lest the Scottish Government is accused of trying to hide the scale of the problem.

The result of the review ordered by Ms Sturgeon is likely to reveal a series of errors leading to the situation at the Vale.

"It is probably going to be the result of lots of little things going wrong to make one bad situation," the scientist said. "But there is something wrong with the system if these things are not being picked up."