Written by Ng Jiajin, AA Pharmacist.
If you ever have sign and symptoms of cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats, you should visit your nearest clinical service centre immediately because you might be infected with Tuberculosis, also known as TB.
Tuberculosis (TB) is a curable and preventable respiratory disease caused by bacteria (Mycobacterium Tuberculosis). TB spreads from an individual to individual through air droplet. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person will easily be infected with merely a few inhalation of these germ. About one-quarter of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.
In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease. Due to the disaster brought by TB, a vaccine has been invented to prevent the spreading of this tragedy disease which is Bacillus Calmette–Guérin (BCG) vaccine.
What is BCG?
The BCG vaccine was first used in humans in 1921 when it was given to a child in Paris by Dr Weil-Hale. The baby’s mother, who had tuberculosis, had died just after the baby was born, and the baby was due to be brought up by its grandmother who also had tuberculosis. The baby was given 6 mg. of BCG orally, and was said to have developed into a perfectly normal boy.
In the absence of scientific evidence that vaccination confers protection, World Health Organization (WHO) Global Programmes on Tuberculosis and on Vaccines in 1995 did not recommend repeat BCG schemes, but recommended a single dose of the BCG vaccine at or soon after birth in all countries with a high incidence of TB infection.
In Malaysia, the National BCG Vaccination Program was initiated in 1961. Routine BCG vaccination is given to newborns at birth (primary BCG vaccination). Thereafter, an additional booster dose is given to children at the age of seven (Sabah) and twelve years (other states) administered by the school health team who visited primary schools every year. The program was modified in July 2002 by which the additional booster dose was discontinued. The revaccination, however is still given to those children without BCG scar or with no BCG vaccination history, without prior Tuberculin Skin Test.
However, according to the a study which involved 21582 subjects in Malaysia, about One-fifth of TB patients had unfavourable outcomes.
How to prevent?
Stay away from patient with TB infection especially those who are under treatment for less than 2 weeks as it is highly contagious. If you are unavoidable (healthcare workers), wear face mask tightly to reduce the risk.
- Centres for disease control and prevention, tuberculosis. (https://www.cdc.gov/tb/publications/factsheets/prevention/bcg.htm) Accesed on 18 FEB 2018
- World Health Organisation, tuberculosis
(http://www.who.int/mediacentre/factsheets/fs104/en/) Accessed on 19 FEB 2018
- Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry, Liew SM, Jul 2015.
- TB facts org, information about tuberculosis.
(https://www.tbfacts.org/tb-prevention/) Accessed on 19 Feb 2018
- BCG Revaccination, Health Technology Assessment Section Medical Development Division
Ministry of Health Malaysia 009/2011. Accessed on 19 Feb 2018