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BCG Facts BCG is the vaccine in use around the world for protecting against tuberculosis.  From time to time, controversies are repeated about the BCG vaccine.  The facts are thus: BCG vaccine is unable to prevent the child from getting the primary infection.  Thus, a primary complex may occur, and even spread within the lungs. BCG vaccine induced immunity does protect against bloodstream spread of the tuberculosis bacteria.  Thus the child is protected against severe forms like CNS tuberculosis and miliary tuberculosis. BCG is not an ideal vaccine, but it is the best we have against this terrible infection. In countries where Tuberculosis is widespread (like India), BCG is of great value.

Tuberculosis in Children

Tuberculosis is one of the most dreadful diseases that afflict mankind.  In adults, it is usually restricted to the lungs, but it is much more dangerous in children.  Because of their poor immunity, this disease can spread all over the body and affect various organs.  Tuberculosis of the brain and its coverings (CNS tuberculosis), and a disseminated form called miliary tuberculosis, are especially dangerous, with high death rates.

Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis.  It usually enters the body of the child through the lungs and localizes there.  The source of infection is an adult with active tuberculosis of the lungs and cough.  The initial focus of infection in the lungs usually spreads only to the nearby lymph nodes, and then becomes quiescent.  Before this however, the bacteria may have spread through the bloodstream to various organs and settled there.

The initial infection in the lungs, and the involved lymph nodes and vessels, are together called a Primary complex.  While not very dangerous in itself, it is a pointer to the presence of tuberculosis infection in the body, which may grow and spread at some time in the future, when conditions are favourable for the bacteria.  For example, whooping cough, measles, malnutrition, AIDS, and other disorders weaken the body's defense systems, and quiescent tuberculosis bacteria often take advantage to grow rapidly and cause serious disease.

This is the reason even a primary complex is treated with a full course of antitubercular drugs. The aim here is to eradicate the bacteria completely, making the child safe for the future.  Other forms of tuberculosis, like pneumonia and lymphadenopathy are also common manifestations in children, and require appropriate treatment by an expert.

Tuberculosis is returning to countries like the USA where it had ceased to be a major problem, because of the current epidemic of AIDS.  In India, tuberculosis has always been a major problem, and with the AIDS threat very real now, great caution is required.
 

Last revision: July 15, 2007

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