Transcript TESTUL TUBERCULINIC(

BCG VACCINATION
• Bacillus Calmette-Guérin (or Bacille Calmette-Guérin, BCG)
is a vaccine against tuberculosis that is prepared from a
strain of the attenuated (weakened) live bovine tuberculosis
bacillus, Mycobacterium bovis, that has lost its virulence in
humans by being specially cultured in an artificial medium
for years.
• The bacilli have retained enough strong antigenicity to
become a somewhat effective vaccine for the prevention of
human tuberculosis.
• At best, the BCG vaccine is 80% effective in preventing
tuberculosis for a duration of 15 years;
• however, its protective effect appears to vary according to
geography
• Antituberculous vaccination = prophylaxis, by
strengthening the body resistance to specific
protection offered by vaccination
• 50-80%- most important benefit of being able
to avoid serious illness especially in children
(disseminated forms, meningitisTB)
• WHO recommends the use of BCG in newborn
babies soon after birth-binding policy
• WHO recommended obligatory vaccination in countries
with high prevalence of tuberculosis
• National Immunization Program - BCG vaccination
requirements at least 95% of newborns
• Following the emergence of HIV infection and HIV-TB is
common association returns to BCG vaccination in
developing countries
INDICATIONS
• 1. All newborns and infants up to 12 months and revaccination of
those who do not have 6 months post-vaccination scars greater
than 3 mm;
• EXCEPTION: new born to mothers positive in sputum: these get first
chemotherapy (or antituberculous therapy, if appropriate) and then
vaccinated.
• 2. Infants and children with negative TST tuberculin:
• a) are at increased risk of close and prolonged exposure to
pulmonary tuberculosis in adults with untreated or treated
inefficiently and can not be removed from the source of infection or
can not receive long-term chemoprophylaxis or
• b) are continuously exposed to persons with HIV and RMP resistant
forms of tuberculosis .
• 3. Children born by HIV positive mothers, already infected,
requiring BCG vaccination immediately after birth because:
• - confers cross-protection against atypical mycobacteria
CONTRAINDICATIONS
• Extensive skin disease or burns (acute dermatological
disease)
• persons with a positive tuberculin skin test
• HIV positive
• moderate or severe febrile illness
• six months after viral hepatitis
• active tuberculosis
• weight <2500 g at birth
• congenital immunodeficiency
• leukemias, lymphomas, malignancies
Technique
• Vaccine is administered strictly intradermal
• Injecting - 1 / 3 medium left arm, posteriorexternal face
• local vaccination reaction 2-4 weeks- red node
sometimes also ulceration
• successful vaccination scars > 3 mm
• vaccination failure-scars < 3 mm
COMPLICATIONS
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Ulcerations > 3 months
Local abscess- after subcutaneous administration
loco-regional adenopathies with necrosis
Koch phenomenon- the local allergically reaction with rapid
evolution to ulceration
• generalized infections or osteitis
• Leukocytosis with eosinophilia
• Moderate increase of VSH