Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: KEGG:D03063 (BCG vaccine)
1,125 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Increasing numbers of immigrants from the former Soviet Union are settling in the United States each year, making it imperative for clinicians to know how to find and interpret immigrant children's immunization records. Records show that these children have usually received immunizations against tetanus, diphtheria, pertussis, poliomyelitis, measles, mumps and tuberculosis (BCG). They are occasionally vaccinated against influenza, smallpox and tularemia, but never against rubella, hepatitis B or H. influenzae meningitis. The Soviet immunization schedule differs significantly from the U.S. schedule only in BCG vaccine and polio immunization. Contrary to widespread belief in the United States, BCG vaccination does not necessarily render a child's tuberculin skin test positive, and it certainly does not confer total immunity to tuberculosis. MMR vaccination is essential for all Soviet immigrant children. A single update of all the other immunizations may be a wise approach when handling Soviet children's immunizations.
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PMID:Clinical management of immigrants' immunization histories: a focus on Soviet health records and BCG. 157 76

Manifestations of tuberculosis infection were studied in 168 infants aged 3 months to 3 years of whom 32.7% had not been given BCG vaccine at birth and 67.3% received improper vaccination (the postvaccinal skin signs were absent in all patients). In 58.9% of the infants, local tuberculosis ran along with complications: dissemination into the lungs and other organs were detected in 44.4%, bronchopulmonary lesions in 42.4%, destruction of lung tissue in 18.2% and tuberculous extrapulmonary lesions in 28.3% of the infants. Specific changes were located in several organs in 9.1%. Tuberculosis of the intrathoracic lymph nodes and primary tuberculosis complex had a complicated course 2.2 times and 3.2 times more frequently, respectively, in BCG unvaccinated than in vaccinated infants. Acute tuberculosis (tuberculous meningitis, miliary and progressive tuberculosis with fatal outcome) in infancy is common in 75-100% of the unvaccinated children. Hence immunoprophylaxis of tuberculosis in newborns must be developed and improved.
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PMID:[Tuberculosis in young children not vaccinated with BCG]. 180 64

The BCG vaccine is the most given throughout the world, and the immunization coverage is the highest: 72% in 1989 for children under one year of age. Following doubts which appeared in 1980 concerning its efficacy, many epidemiological studies confirmed the protective potency of this immunization against the severe forms of tuberculosis in children. Recent problems of tolerance arose but are now resolved by the adaptation of the vaccine concentration to the routine immunization of newborns. The world wide epidemic of AIDS and the concomitant recent increase in tuberculosis cases encourage to sustain the effort of immunization of infants. However, questions of theoretical interest have been shelved on this subject: is it reasonable to immunize HIV positive children in absence of clinical signs in countries with high prevalence? Is the vaccine effective in these special cases? Is it safe? In any case, it is the only effective and cheap way, and probably with no risk, of preventing child tuberculosis meningitis in endemic disease countries.
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PMID:[Role of BCG in the enlarged program of vaccination]. 181 32

A field evaluation of efficacy of BCG vaccine to prevent tubercular meningitis was undertaken in a case control study in Delhi during 1988-89. Each case of tubercular meningitis was matched by age and neighbourhood with 2 controls from the community. Thirty-seven cases of tubercular meningitis were matched with 74 controls and thus 37 triplets were analysed. ODDS RATIO between BCG vaccinated and non vaccinated individuals for acquisition of tubercular meningitis was 11.3. This gives 84 per cent efficacy of BCG vaccine in the prevention of TB meningitis under the field conditions prevailing in Delhi. Paired matched analysis of tubercular meningitis with the control group 1 and 2 separately revealed the ODDS RATIO to be 9.5 and 15 respectively. The corresponding BCG vaccine efficacy worked out were 90 and 93 per cent respectively. Authors suggest that this method of evaluating BCG vaccine efficacy is fairly reliable and cost effective. This methodology could be further simplified by using hospital patients as control and be introduced to evaluate BCG vaccine efficacy in different areas with reference to its role in preventing tubercular meningitis under the programme of immunisation.
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PMID:Epidemiological evaluation of BCG vaccine efficacy in Delhi--1989. 261 48

This paper reports the 15-year results of a controlled clinical trial of BCG and vole bacillus vaccines in the prevention of TB. Among 54 239 participants, 583 cases of TB developed, of which 70% were of pulmonary TB and 15% of tuberculous pleural effusion without evidence of pulmonary TB. The annual incidence (per 1 000) of TB was 0.28 among the 13 598 BCG-vaccinated participants and 1.28 among the tuberculin-negative unvaccinated participants admitted concurrently (a 78% reduction); for vole bacillus vaccine (5 817 participants) the figures were 0.29 and 1.50 (an 81% reduction). Protection extended to all forms of TB (in particular, 10 cases of tuberculous meningitis or miliary pulmonary TB developed in unvaccinated, and none in vaccinated, participants) and was similar in the two sexes. It decreased gradually during the period but was still substantial (59% for BCG vaccine and 73% for vole bacillus vaccine) 10-15 years after vaccination; no definite conclusion can yet be reached on the level of protection after 15 years. The annual incidence of TB in those with strong positive reactions to tuberculin on entry was particularly high (3.75) in the first 2.5 years, reflecting active infections acquired before entry; those with weaker positive reactions on entry had a lower incidence throughout than the tuberculin-negative unvaccinated group, indicating that a degree of naturally acquired immunity (though less than that conferred by vaccination) was associated with the low-grade tuberculin sensitivity. The incidence of every form of TB decreased steeply during the 15 years, except for genito-urinary TB of which there were 3, 5, and 14 cases in successive 5-year periods, principally among initially tuberculin-positive participants. This report also presents the findings with respect to nontuberculous diseases, discusses the place of vole bacillus vaccination, and describes a method for assessing the applicability of mass BCG vaccination in a given epidemiological situation.
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PMID:BCG and vole bacillus vaccines in the prevention of tuberculosis in adolescence and early adult life. 453 55

Tuberculosis is a major global public health problem with 8 million new cases of pulmonary tuberculosis in the world per year and 2.89 million deaths. In India in 1989, the approximate morbidity of tuberculosis was 2%, i.e., there were 15 million cases of pulmonary tuberculosis. Of these 25% were sputum positive, posing a serious threat of transmitting the infection to children. Of the 4 million infectious patients, over 1 million would be considered as chronic or relapsing cases who have been partially treated. The Indian National Tuberculosis Program (NTP) has now completed 25 years. Every year, 1 million new cases of adult tuberculosis are detected. 70% of these patients do not complete standard regimens and 45% do not complete short course regimens. In 1983 about 80.71 million children under 16 years old in India were infected. In a survey carried out in 1990 in urban and rural areas of Delhi, BCG vaccination coverage was 90% in the urban and 84.7% in the rural areas. Impact of BCG vaccination has demonstrated that classical or generalized tuberculosis meningitis, miliary TB, disseminated tuberculosis, and other serious complications of primary infections go on occurring in malnourished BCG-vaccinated children. The variable efficacy of the present BCG vaccine observed in different prospective human trials has shown the necessity of conducting research of immunoregulatory mechanisms, and developing newer vaccines for global control of tuberculosis. Other topics include immune responses to the present BCG vaccine (cellular immunity, macrophage, T-lymphocytes); BCG vaccination and tuberculin test; BCG vaccination by nebulization (aerosol BCG vaccine) by the respiratory route; a booster dose of BCG vaccine in the preschool period; protein energy malnutrition and delayed hypersensitivity reaction; BCG test in non-vaccinated and vaccinated children; HIV infections or their symptoms as a contraindication to BCG vaccination; and BCG lymphadenitis in children (7% in seropositive HIV children).
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PMID:BCG vaccination in India and tuberculosis in children: newer facets. 774 45

Several case-control studies evaluating the effectiveness of BCG vaccine in the last decade have presented contradictory results like previous prospective studies. Methodological differences could explain some of the case-control study results. This study explores the possibility that contradictory results could be imputed to the choice of different series of controls. Three controls were compared for each case of tuberculous meningitis: neighbourhood, hospital and household. BCG effectiveness estimates were 86.8%, 92.0% and 29.5%, respectively. The data indicated an interaction between BCG vaccine status and tuberculous focus. This could have influenced the lower effectiveness estimates found when cases were compared with household controls. The paper discusses aspects related to case-control studies applied to evaluate BCG effectiveness such as: incubation period and sufficient time since vaccination to allow development of an immune response; the presence of a tuberculous focus among the groups of cases and controls and the interaction between focus and BCG vaccination; recall bias; and optimum selection of controls in case-control studies in the context of infectious diseases.
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PMID:Methodological considerations in case-control studies to evaluate BCG vaccine effectiveness. 844 36

The reported efficacy of BCG vaccine in preventing pulmonary tuberculosis varies from 0-80%; however, its efficacy in preventing tuberculous meningitis ranges from 52%-84%. A case-control study was conducted to assess the efficacy of BCG in preventing tuberculous meningitis in children. New cases of tuberculous meningitis, confirmed bacteriologically, were registered as cases. Controls were children suffering from febrile convulsions attending the same hospital. A total of 107 cases and 321 controls, block matched for age, were registered. Vaccination status was determined from the history reported by the mother and by BCG scar reading. Data regarding socioeconomic status, crowding, and nutritional status were collected. Using multiple logistic regression analysis the odds ratio obtained for the presence of BCG scar was 0.23 (95% confidence interval (CI) 0.14 to 0.37) and the protective efficacy of BCG vaccine in preventing tuberculous meningitis in children was found to be 77% (95% CI 71 to 83%).
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PMID:Does BCG vaccine prevent tuberculous meningitis? 897 77

BCG vaccination is one of the tuberculosis control means. Since 1921, more than 3 thousand millions doses of BCG vaccine have been administered in 172 countries in the world. Vaccine, technical and side effects are today well known but we do not know nearly anything about the ideal age for initial vaccination and about the need, or not, of repeated vaccinations. Especially, its effectiveness is debated. Recent meta-analysises conclude to the protecting effectiveness of BCG in countries with a high annual risk of infection. The main rates of protection, from 60 to 90%, are obtained against tuberculous meningitis and miliary tuberculosis. So, the BCG vaccine is indicated in developing countries where the prevalence rate of tuberculosis is high. Administered in the first days of life, with a strict observance of the rules of preparation, of administration and of the conservation of the vaccine, this vaccination is the best prophylaxis of severe and disabled forms of tuberculosis. In these countries, the monitoring of the vaccine effectiveness by tuberculin skin tests and repeated BCG vaccinations do not seem to be useful. Spared money could be allowed to the screening and the treatment of cases.
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PMID:[Update on the BGC vaccine. Indications for use in Europe and in developing countries]. 892 81

Studies in animal models and analysis of human genetic defects leading to severe mycobacteriosis, establish the major role of cellular immune responses in the control of tuberculosis. The BCG vaccine protects infants against severe forms of tuberculosis (meningitis and miliary tuberculosis). However its protective efficacy against the adult forms of tuberculosis is highly variable, ranging from 0% to 90% in different vaccine trials. Different attempts are being made to isolate new vaccines. Protein antigens exported by Mycobacterium tuberculosis provide some level of protection when delivered as recombinant protein antigens or as DNA vaccines. Attenuated strains of M. tuberculosis are obtained by targetted inactivation of a variety of genetic involved in virulence. Their potential as new live vaccine is being studied. In addition a single mutation at the purC locus inactivating the purine biosynthetic pathway was shown to result in dramatic attenuation. The purC M. tuberculosis mutant strain provided protection against an aerosol challenge in guinea pigs. Future protocoles for vaccination against tuberculosis may include new attenuated strains with multiple well characterised mutations and a series of exported antigens.
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PMID:[Search for new tuberculosis vaccines]. 1062 22


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