Scar Formation and Tuberculin Conversion Following BCG

2021 ◽  
Vol 15 (11) ◽  
pp. 3056-3057
Author(s):  
Muhammad Sarfraz ◽  
Zahid Jamil ◽  
Muhammad Naim Ashraf ◽  
Saima Arshad ◽  
Zirwa Sarfraz ◽  
...  

Objective: To determine frequency of scar formation and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age presenting at outpatient department of Fauji Foundation Hospital Lahore. Study Design: Descriptive case series. Place and Duration of Study: Outdoor Department of Pediatrics, Fauji Foundation Hospital, Lahore from 1st July 2020 to 30th December 2020. Methodology: Ninety seven children were included. Base line demographic information of patients (age, gender, weight on weight machine) was recorded. 0.5 ml BCG was administered in right arm. Tuberculin skin test was assessed as per operational definition. After 48 to 72 hours, scar formation was assessed after 1 month. Data regarding scar formation and positive tuberculin conversion test was recorded. Results: The mean age was 3.20±1.46 years, 39 (40.21%) were male whereas 58 (59.79%) were females. The scar formation following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age was 59 (60.82%) and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years was recorded in 47 (48.45%). Conclusion: Most babies have developed a post-vaccination scar. The combination of the BCG scar and the positive skin testing tuberculin was very important. The development of BCG scars had no effect on age or sex. Greater trials are advised in order to detect the true extent of the problem and to evaluate regularly the BCG vaccination programs. Keywords: Infants, Tuberculosis, BCG vaccination, Scar formation, Positive tuberculin conversion test

2017 ◽  
Vol 24 (5) ◽  
Author(s):  
Gareth J. Jones ◽  
Mick Coad ◽  
Bhagwati Khatri ◽  
Javier Bezos ◽  
Natalie A. Parlane ◽  
...  

ABSTRACT Mycobacterium bovis BCG vaccination sensitizes cattle to bovine tuberculin, which compromises the use of the current bovine tuberculosis (TB) surveillance tests. Although the performance of a blood test (that utilizes antigens expressed by Mycobacterium bovis but not by BCG) capable of discriminating infected from vaccinated animals (DIVA interferon gamma test [DIT]) has been evaluated in naturally infected TB field reactors, there is a need to perform similar analysis in a BCG-vaccinated M. bovis-infected population. Furthermore, we explored different scenarios under which a DIT may be implemented alongside BCG vaccination: (i) serial testing to resolve potential false-positive skin test results or (ii) a standalone test to replace the single intradermal comparative cervical tuberculin (SICCT) skin test. Our results demonstrated significantly better relative test sensitivity when the DIT was evaluated in a serial test scenario. Direct comparison of pre- and post-skin test blood samples revealed that the SICCT test induced significant boosting of the gamma interferon response in M. bovis-infected animals to both the ESAT-6–CFP-10 and Rv3615c peptide cocktails that comprise the DIT, which persisted for the ESAT-6–CFP-10 reagent for at least 14 days. Importantly, no similar boosting effects were observed in noninfected BCG vaccinates, suggesting that DIVA blood testing after a recent skin test would have minimal impact on test specificity.


Author(s):  
Florian Stehlin ◽  
Rima Mahdi-Aljedani ◽  
Loris Canton ◽  
Véronique Monzambani-Banderet ◽  
Alix Miauton ◽  
...  

Background: The newly developed mRNA-based COVID-19 vaccines can provoke anaphylaxis, possibly induced by polyethylene glycol (PEG) contained in the vaccine. The management of persons with a history of PEG allergy, or with an allergic-like reaction after the first dose remains to be defined.  Methods: We studied two cohorts of individuals: one pre-vaccination, the second post-vaccination. Skin testing was performed with COVID-19 mRNA vaccines. Upon negative skin test, a two-step (10%-90%) vaccination protocol was performed. Positive skin tests were confirmed with basophil activation tests (BAT). Vaccine-sensitized patients were offered a five-step induction protocol. Results: We identified 187 patients with high-risk profiles for developing anaphylaxis. In parallel, among 385’926 doses of vaccine, 87 allergic-like reactions were reported to our division for further investigations: 18/87 (21%) were consistent with anaphylaxis, 78/87 (90%) were female, and 47/87 (54%) received the BNT162b2 mRNA vaccine. Vaccine skin tests were negative in 96% and 76% in the pre- and post-vaccination cohorts, respectively. A two-step vaccination was tolerated in 232/236 (98%) of individuals with negative tests. Four individuals experienced acute asthma exacerbation during the two-step challenge. Vaccine-positive skin tests were consistently confirmed by BAT; CD63 and CD203c expression was selectively inhibited with ibrutinib, suggesting an IgE-dependent mechanism. Finally, 13 sensitized patients were successfully vaccinated with a five-step vaccination protocol. Conclusion: A two-step 10%-90%-vaccination protocol can be safely administered upon negative skin testing. Yet, it should be delayed in individuals with poorly controlled asthma. Importantly, mRNA vaccine sensitized individuals may receive a five-step vaccination protocol.


2020 ◽  
Vol 20 (3) ◽  
pp. 284-290
Author(s):  
Jocelyn Chan ◽  
Yue Wu ◽  
James Wood ◽  
Mohammad Muhit ◽  
Mohammed K. Mahmood ◽  
...  

Background and Objectives: Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh. Methods: We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 – 23 November 2016) and OVID EMBASE (1974 – 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh. Findings: Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero–positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh. Conclusion: The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.


2020 ◽  
Vol 8 (5) ◽  
pp. 1728-1732.e1 ◽  
Author(s):  
Cosby A. Stone ◽  
Shailesh Choudhary ◽  
Megan F. Patterson ◽  
Christine R.F. Rukasin ◽  
David T. Coleman ◽  
...  

2021 ◽  
Vol 100 (5) ◽  
pp. 124-130
Author(s):  
V.A. Aksenova ◽  
◽  
A.V. Gordina ◽  
S.A. Sterlikov ◽  
D.A. Kucheryawaya ◽  
...  

Objective of the study: to assess the effect of the frequency of administration of the BCG vaccine on the nature and structure of clinical forms of tuberculosis (TB) in children. Materials and methods of research: a cohort observational retrospective continuous comparative multicenter crosssectional study was carried out. The data (registration form № 089/u-tube) of 3253 children of 7–14 years old with newly revealed changes in the lungs of a specific genesis, registered in 2019–2020 in the institutions of the anti-tuberculosis service of the Russian Federation were analyzed. Two comparison groups were identified: group 1 (observation group) – children who received a double injection of BCG vaccine (vaccination and revaccination) (n=184), group 2 (comparison group) – children who received a single BCG vaccination (n=3358). To achieve this goal, 5 null hypotheses were identified for testing which groups are formed from the received data array with the necessary parameters. The data were analyzed using univariate and multivariate analyzes (including confounding factors). Results: it was found that BCG revaccination does not reduce the risk of TB compared with residual changes after, it does not reduce the proportion of generalized forms of TB compared with localized forms (OR=2,4, p=0,08). The frequency of vaccination has not a statistically significant effect on the frequency of bacterial excretion (aOR=1,6, p=0,15) and destruction of lung tissue (OR=1,1, p=1). Revaccination has a statistically significant effect on the ratio of primary and secondary forms of TB, reducing the likelihood of its primary forms (aOR=0,4, p<0,001). In the course of multivariate analysis, it was found that the formation of primary or secondary TB, as well as the frequency of bacterial excretion in the comparison groups, was significantly influenced by confounding factors. Conclusion: this work has demonstrated the absence of a pronounced protective effect of repeated administration of the BCG vaccine on the clinical course of a specific process.


1977 ◽  
Vol 86 (5) ◽  
pp. 655-660 ◽  
Author(s):  
Paul H. Ward ◽  
David Morledge ◽  
George Berci ◽  
Harmon Schwartz

Coccidioidomycosis is a fungal disease endemic to the southwestern United States. The primary form of the disease is relatively benign and many patients, after exposure by inhalation of the sapyrophytic form of the organism, convert from negative to positive skin testing without significant clinical symptoms. The less common disseminated form represents a serious life-threatening disease and can present with granulomatous changes in the larynx. The authors' experience with disseminated coccidioidomycosis presenting in the larynx of adults and infants successfully treated with amphotericin B are presented and discussed.


2001 ◽  
Vol 7 (1-2) ◽  
pp. 211-220
Author(s):  
R. Awad

The relationship between post-BCG complications and the practices of administration and/or use of certain batches of BCG vaccine was investigated. A questionnaire were given to nurses administering BCG vaccination. An abstraction sheet was used to analyse cases with BCG complications among infants [n = 552] and schoolchildren [n = 97]. The rate of complications was 14.7/1000 among infants and 2.5/1000 among schoolchildren in 1997. The complications rate was 19.1/1000 at UNRWA and 8.3/1000 at governmental health services. It was found that a single batch of BCG 2611-11 combined with incorrect administering of the vaccine was responsible for this outbreak of complications. Therefore, the establishment of a surveillance system to monitor adverse events following immunization is needed.


Author(s):  
Maganga Sambo ◽  
Katie Hampson ◽  
Joel Changalucha ◽  
Sarah Cleaveland ◽  
Tiziana Lembo ◽  
...  

Estimates of dog population sizes are a prerequisite for delivering effective canine rabies control. However, dog population sizes are generally unknown in most rabies-endemic areas. Several approaches have been used to estimate dog populations but without rigorous evaluation. We compare post-vaccination transects, household surveys and school-based surveys to determine which most precisely estimates dog population sizes. These methods were implemented across 28 districts in southeast Tanzania, in conjunction with mass dog vaccinations, covering a range of settings, livelihoods and religious backgrounds. Transects were the most precise method, revealing highly variable patterns of dog ownership, with human: dog ratios ranging from 12.4:1 to 181.3:1 across districts. Both household and school-based surveys generated imprecise and sometimes inaccurate estimates, possible due to low sample size. Transect data were subsequently used to develop a predictive model for estimating dog populations in districts lacking transect data. We predicted a dog population of 2,316,000 (95% CI 1,573,000-3,122,000) in Tanzania and an average human: dog ratio of 20.7:1. Our modelling approach has the potential be applied to predicting dog population size in other districts where mass dog vaccination is carried out, given census and livelihood data. We recommend transects as a rapid and effective method to refine dog population estimates across large geographic areas and guide dog vaccination programs.


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