General discussion about treating tuberculosis - By: Groshan Fabiola

United States are using Mantoux as a diagnosing method for tuberculosis. Other countries prefer BCG, or bacilli Calmette Guerin. This vaccine is used especially in countries where tuberculosis is an often seen disease and for preventing childhood tuberculosis, meningitis or miliary disease. BCG is not oftenly used in the United States because of the low risk of infection with Mycobacterium tuberculosis or because the vaccine’s possible interference with tuberculin skin tests. This type of vaccine is recommended to be given only to persons who meet specific criteria and consult a tuberculosis expert.

For each category of persons the indications and recommendations are different. For example this type vaccine should only be prescribed for children who have negative tuberculin skin test and who are exposed to other persons with tuberculosis.

Health care workers are also a possible affected category of people. For them the BCG vaccine should be considered in the following conditions: first of the conditions is that a high percentage of tuberculin patients to be infected with M. tuberculosis strains resistant to both isoniazid and rifampin. The second condition for giving this vaccine to health care workers is to be an ongoing transmission of such drug resistant M. tuberculosis strains to health care workers and subsequent infection is likely. The third and last condition is that no other tuberculosis infection control precautions have been successful. It is also good to know for the health care workers that BCG vaccination involves risks too especially when this vaccine is associated with treatment of latent tuberculosis infection.

Even if its effects are generally positive this BCG vaccine is not recommended at all for some categories of persons. For example we might remember the persons who are immunosuppressed such as persons with HIV. The risk is to become immunocompromised.

Another category of persons who are not allowed to take this vaccine is the pregnant women. It is recommended for them to avoid taking this vaccine during pregnancy. No complications have been observed during pregnancy but further studies want to prove this treatment’s safety before allowing this it to be prescribed for this category of persons.

A problem was also noticed for people that have been vaccinated with BCG. This problem consists of the positive reaction to the tuberculin skin tests. This might complicate the later decisions about prescribing treatment. Despite this potential problem that may occur these tests are not contraindicated for persons who have been vaccinated with BCG.

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