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At least 163 records · Page 9Linked to original sources
PubMed2006

Tuberculosis contact investigation with a new, specific blood test in a low-incidence population containing a high proportion of BCG-vaccinated persons.

BACKGROUND: BCG-vaccination can confound tuberculin skin test (TST) reactions in the diagnosis of latent tuberculosis infection. METHODS: We compared the TST with a Mycobacterium tuberculosis specific whole blood interferon-gamma assay (QuantiFERON-TB-Gold In Tube; QFT-G) during ongoing investigations among close contacts of sputum smear positive source cases in Hamburg, Germany. RESULTS: During a 6-month period, 309 contacts (mean age 28.5 +/- 10.5 years) from a total of 15 source cases underwent both TST and QFT-G testing. Of those, 157 (50.8%) had received BCG vaccination and 84 (27.2%) had migrated to Germany from a total of 25 different high prevalence countries (i.e. >20 cases/100,000). For the TST, the positive response rate was 44.3% (137/309), whilst only 31 (10%) showed a positive QFT-G result. The overall agreement between the TST and the QFT-G was low (kappa = 0.2, with 95% CI 0.14.-0.23), and positive TST reactions were closely associated with prior BCG vaccination (OR 24.7; 95% CI 11.7-52.5). In contrast, there was good agreement between TST and QFT-G in non-vaccinated persons (kappa = 0.58, with 95% CI 0.4-0.68), increasing to 0.68 (95% CI 0.46-0.81), if a 10-mm cut off for the TST was used instead of the standard 5 mm recommended in Germany. CONCLUSION: The QFT-G assay was unaffected by BCG vaccination status, unlike the TST. In close contacts who were BCG-vaccinated, the QFT-G assay appeared to be a more specific indicator of latent tuberculosis infection than the TST, and similarly sensitive in unvaccinated contacts. In BCG-vaccinated close contacts, measurement of IFN-gamma responses of lymphocytes stimulated with M. tuberculosis-specific antigen should be recommended as a basis for the decision on whether to perform subsequent chest X-ray examinations or to start treatment for latent tuberculosis infection.

Adult↗
PubMed1966

Tuberculin allergy in infants vaccinated with Czechoslovak, Danish or Swedish BCG vaccine.

It is well known that BCG vaccination in the newborn is particularly difficult to carry out with satisfactory results. The allergic response is delayed and weak in comparison with that in older children, and attempts to compensate for this by using a more potent vaccine often result in a high incidence of regional lymphadenitis. The preliminary results of a blind comparative trial, in newborn children, of BCG vaccine from Czechoslovakia. Denmark and Sweden are reported. There was no case of lymphadenitis in any of the three vaccine groups. The allergic reactions induced by the Danish and Swedish vaccines were of equal strength, although the vaccination scars from the Swedish vaccine were slightly larger. The vaccine from Czechoslovakia produced strikingly weaker allergic reactions as well as definitely smaller scars than the other two vaccines.

BCG Vaccine↗
PubMed1998

[Recurrent soft tissue infections after accidental inoculation with BCG vaccine].

Complications after BCG vaccine (bacilli Calmette-Guérin) occur rarely. They can reach from a local acute abscess to chronic ulceration's. Therapeutically concepts of these complications range from conservative to operative treatment. In the following case history recurrent soft tissue infections occurred after accidental inoculation with BCG vaccine. The time course of these recurrent infections with its therapeutic options is discussed and a treatment strategy is suggested. Currently, radical excision combined with antituberculotic treatment seems to be the most promising therapy of this specific soft tissue infection.

Antitubercular Agents↗
PubMed1986

Significance of the number of viable units in BCG vaccines.

The objective of the study was to establish the incidence of suppurative lymphadenitides in newborns vaccinated with BCG vaccines of different strength and to investigate the postvaccination tuberculin positivity of the children involved in the study. Lyophilized vaccines prepared from the Pasteur strain were used. Altogether 51,000 children were included in the study. One group, consisting of 30,000 newborns was vaccinated with a BCG lot containing 2 X 10(5) viable units (VU) per dose. The other group, consisting of 21,000 newborns, was given a BCG lot containing 0.5 X 10(5) VU per dose. The incidence of suppurative lymphadenitides per 1,000 vaccinated infants was 6.84 and 0.87 in the two groups, respectively. Tuberculin tests were carried out 2 years after the vaccination. Two units of RT-23 tuberculin were used. In 3,821 children vaccinated with the stronger vaccine the rate of tuberculin positivity was found to be 19.8 per cent, while it was 16.4 per cent among 5,035 children who had been given the weaker lot.

BCG Vaccine↗
PubMedDate not supplied

[Can the Mantoux test be used in BCG vaccinated children?].

This prospective trial was realized in 371 children previously vaccinated with BCG in the first month of life in whom the Mantoux tuberculin test was done and read 48-72 hours afterwards. Among 371 BCG-vaccinated children, 106 (28.57%) were Mantoux reactive, 10 of whom with clinical tuberculosis. There was no statistically significant difference in the tuberculin test between the control group (59 non-BCG-vaccinated children) and 180 vaccinated children, considering those under 6 years old. When we compared by age, we verified that just 36.36% of the children at the age 2 reacted positively to PPD.

English Abstract↗
PubMed1987

BCG vaccination and the EPI.

BCG vaccination for newborns has been compulsory by law in the RSA since 1973. From limited published information, it appears that coverage has now reached more than 80%. However, the effectiveness of the vaccinations in terms of disease prevention in the young is unknown. Small studies indicate protection of approximately 60% against all forms of tuberculosis in infants, but this figure is not generalisable. It is pointed out that the contribution of BCG vaccination to an overall decline of tuberculosis rates is minimal and should not be considered as a measurement of success of the EPI. The prevalence and risk of infection in southern African children is such that a policy of reduction or withdrawal of BCG vaccination from some sections of the community is not feasible. The current strategy of compulsory BCG vaccination at birth, followed by repeat vaccination 3 months later in children without evidence of reactivity at the vaccination site, as well as revaccination at school entry and school leaving, is both adequate and necessary. A standardised immunisation data recording format and full exchange of information at all decision-making levels between the EPI and the tuberculosis control programme is called for.

Adolescent↗
PubMed1995

Cytokine mRNA expressed in tuberculin skin test biopsies from BCG-vaccinated and Mycobacterium bovis inoculated cattle.

To obtain a better understanding of the delayed-type hypersensitivity reaction to Mycobacterium bovis, we measured the expression of cytokine mRNA from tuberculin skin test biopsies of cattle. Non-vaccinated and BCG-vaccinated cattle were inoculated intratracheally with a low dose of virulent M. bovis or sham-inoculated and 20 weeks later were skin tested with tuberculin. At necropsy 1-2 weeks later, tuberculous lesions were found in six of the nine non-vaccinated and three of the nine BCG-vaccinated animals. All of the lesioned and the majority of the non-lesioned M. bovis inoculated cattle showed a distinct skin swelling response to tuberculin, irrespective of vaccination. However, cattle with tuberculous lesions displayed larger skin swelling responses than non-lesioned cattle. Tuberculin-induced expression of IFN-gamma, IL2, IL4, IL10 and TNF-alpha mRNA occurred in the skin biopsies of all of the lesioned, M. bovis inoculated animals except for an absence of tuberculin-induced TNF-alpha mRNA expression in two animals. A lower proportion of the non-lesioned M. bovis inoculated cattle displayed tuberculin-induced expression of the five cytokine mRNA. There was no evidence of a unique pattern of cytokine expression which could be used to distinguish between diseased and protected animals. By 28 weeks after vaccination, the three BCG-vaccinated, sham-inoculated cattle displayed minimal skin swelling response to tuberculin, but tuberculin-induced expression of IFN-gamma, IL2, IL4, IL10 and TNF-alpha mRNA was observed in skin biopsies of all of these animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

Protective effect of neonatal BCG vaccines against tuberculous meningitis.

Neonatal BCG vaccination reduces the risk of tuberculosis and provides protection higher than 80% against the development of meningeal and miliary tuberculosis in newborns. Tuberculosis meningitis remains a major problem and also an important cause of death in some countries. In countries with high and moderate incidence of tuberculosis, prevention from the most severe complications of tuberculosis can be achieved only with a high coverage of the universal BCG neonatal immunization, being higher than 98% in the cohort of newborns. The decrease in BCG immunization coverage within immunization program during the year 2003 in Bosnia and Herzegovina influenced the increase in tuberculous meningitis. During 2002, when coverage with BCG vaccination in cohort of newborns was 90%, the incidence rate of tuberculous meningitis was 19. 04%oo. With the 68% decrease in BCG immunization coverage in the cohort of newborns in Bosnia and Herzegovina during the year 2003, the incidence of tuberculous meningitis raised to 33 33%oo. It has been proven that the 22% decrease of the neonatal BCG immunization coverage in the cohort of newborns /vaccination program of children/ caused 175 times higher number of the tuberculous meningitis cases. Newborns affected by the tuberculous meningitis were not BCG vaccinated. BCG vaccine provided effective protection against tuberculous meningitis, as well against the death of newborns caused by tuberculosis.

BCG Vaccine↗
PubMed1992

[Nonspecific immune stimulation with BCG in Herpes simplex recidivans. Follow-up 5 to 10 years after BCG vaccination].

The efficacy of a single intracutaneous BCG injection in prevention of recurrent herpes simplex (HS) was investigated in Tine-test-negative people. Most patients had a recurrence rate of HS of at least once per month. Between 1976 and 1983 109 patients were BCG-vaccinated (BCG sec Berna). Tine-test was negative in all subjects and converted to positive in 106 out of 109 patients after vaccination. Patients suffered from HS for many years and thus acted as their own controls comparing them before and after BCG. After vaccination all patients remained herpes-free for at least 4-6 months. In a separate study a follow-up up to 10 years was done. This showed a decreasing effect of BCG over the years with still 21 (19%) completely herpes-free patients after 3 years. 10 patients (9%) even had been free of herpes for more than 6 years. Reduction of frequency and duration of HS after BCG was statistically significant (p less than 0.01). Since the BCG vaccination can be assumed to be virtually without risk, a Tine-test followed by BCG vaccination should be considered as treatment of choice in patients with recurrent HS for prevention of recurrences.

Adolescent↗
PubMed2001

Comparative genomics of BCG vaccines.

Bacille Calmette-Guérin (BCG) vaccines have been given to more people than any other vaccine. They have also probably resulted in as much controversy as any other vaccine. In clinical trials, the efficacy of BCG vaccination against pulmonary TB has been widely variable. At the same time, a number of investigators have observed phenotypic differences between BCG daughter strains, raising the possibility that differences between BCG products may in some way translate into different outcomes. With recent genomic analysis of BCG strains, it has become possible to piece together the molecular events that have resulted in current BCG vaccines. Between the derivation of BCG in 1921 and the lyophilization of BCG Pasteur 1173 in 1961, there have been at least seven genetic events, including deletions, duplications and a single nucleotide polymorphism. The phenotypic relevance of these changes in BCG vaccines remains to be explored.

BCG Vaccine↗
PubMed1988

Potency testing of BCG vaccines on white mice: influence of variables on survival time, lung findings and vaccine assessment.

In protection tests on white mice vaccinated with BCG vaccine and challenged with a pathogenic strain of Mycobacterium bovis, the survival times are considerably altered by several variables. In the strains of mice used mainly in this study (NMRI and Albany), the median survival time of a group was roughly doubled in the sensitive range of the test system either by a twofold increase in the immunization period, a threefold decrease in the challenge dose or a 100-fold or less increase in the vaccine dose. The shape of the survival curve of an animal group depends on the median survival time achieved. The Gaussian distributions (sum curves) of the logarithms of the individual survival times are near linearity and parallelity in groups of animals which either survive for short or very long periods. In an intermediate range, however, the survival curves show a flatter and sometimes S-shaped course. This intermediate range of survival corresponds to the time at which the lung findings shift from acute to chronic. The occurrence of acute or chronic findings depends on the individual survival time after challenge. The autopsies show that both findings are equally frequent approximately equal to 35 days after challenge. Individual survival times should be evaluated by non-parametric methods due to their non-normal (bimodal) distribution. Evaluation of the gross lung findings supports these results but is, however, less efficient. The discriminating power of the test system can be altered by changes in any of the variables and is best when animal groups attaining less than 20 days median survival time are compared with groups attaining greater than 30 days. A twofold increase in the median survival time generally provides evidence of significance that may already be obtained 30 days after challenge. With a vaccination-challenge interval of 21 days or more, a 50 microliter vaccine dose generally induces a significant increase in the survival times of the vaccinated animals versus non-vaccinated controls. With increasing immunization periods (vaccination-challenge interval), however, a difference in the efficacy of several vaccines or vaccine doses will be evened out.

Animals↗