BCG unable to prevent TB in adults

GEORGE TOWN: The little round scar on your left upper arm – your BCG (Bacillus Calmette-Guerin) vaccination – will not stop you from being infected with tuberculosis (TB) as an adult.

It was given to you at birth or at the age of seven to prevent you from getting deadly forms of TB infections which children are at high risk of, says a lung specialist.

“Mycobacterium tuberculosis can attack other organs, including your brain, which we call meningitis TB. It can destroy the cells in other organs such as the liver, pancreas and spleen, which we generally call military TB, ” he said, adding that the same bacteria that caused pulmonary TB could easily cause meningitis or military TB in children.

The specialist said worldwide, 75% of TB deaths involved young adults stepping out of childhood and beginning to lose the strength of the BCG vaccination, making them susceptible to pulmonary TB.

Pulmonary TB is an active infection of the lungs, which is highly contagious due to the mode of droplet transmission.

TB victim Carmen Yee, 19, the specialist believed Yee contracted pulmonary TB.

“Since 1961, all newborns in Malaysia are given the BCG vaccine almost immediately after being born. In primary school, nurses will check the pupils’ upper left arm and if there is no BCG scar, they will revaccinate the children.

“It induces the body to develop immunity. If the child is exposed to the wild bacteria, it will prevent the infection from getting serious, ” he said.

Meanwhile, a former medical officer of the Chest Department of Penang Hospital said it was relatively common for people to have the TB bacteria lying dormant in them.

“I don’t want to scare people but many of us have already inhaled the TB germ. It is a tough bacteria.

“When a TB patient coughs or sneezes, the bacteria comes out and can stay alive for days outside the human body, waiting to enter the next host. Just inhaling a few of the germs is enough.

“But if you are healthy, strong and well-nourished, the germ cannot destroy your body cells. Your white blood cells will keep them in check, ” he said.

The doctor said the infection risk was less in open spaces and more in confined areas such as offices, trains and planes and even jail cells.

“If one TB patient coughs in a confined space, it is possible for everyone in that space to get the bacteria, ” he said.

He said in the past, TB patients were kept in sanitariums for months to keep them away from the population, but with modern antibiotics, there was no need to ward them unless there were severe complications.

“The day TB patients start their antibiotics course, they will get better. And after two months, they should no longer be contagious, ” he said, adding that the antibiotic treatment usually lasted six months.

Meanwhile, commenting on the death of Yee, MCA deputy president Datuk Dr Mah Hang Soon said he was against labelling the 33 students and teachers from SMJK Heng Ee as having latent TB.

These 33 were found to have the TB bacteria lying dormant in them after Yee, who studied in Heng Ee, died from the disease on Aug 26.

Dr Mah, a cardiologist, said the incubation period for TB bacteria was two to 12 weeks.

“Those suspected of having latent TB can only be identified after the incubation period.

“According to World Health Organisation, those who are most at risk of progressing from latent to active TB include people who have had recent contact with an infectious patient.

“These 33 suspects had recent contact with Yee and therefore must be given medical attention and treatment when needed, ” he said at a press conference in Seberang Jaya yesterday.

Dr Mah urged the Health Ministry to reveal the reports on TB cases to the public.

“We do not want to cause panic but they should be reminded of the possibility of being in contact with TB germs.

“The Health Ministry should look into this issue and give us a solid solution. They should give more attention to TB cases as this disease can be treated, ” he said.

Source: TheStar