THE SUNDAY EDITORIAL

(SCIENCE OF THE WEEK)

 100 Years of BCG Vaccine
Everything you need
to know about
Tuberculosis
and BCG
THE SUNDAY EDITORIAL
(SCIENCE OF THE WEEK)
 HIGHLIGHTS OF THE WEEK

01 Sunday News

0202 100 years of BCG

About TB

ü TB is caused by a bacterium called Mycobacterium

tuberculosis, belonging to the Mycobacteriaceae
family consisting of about 200 members.
ü Some of these cause diseases like TB and leprosy in
humans and others infect a wide range of animals.
ü Mycobacteria are also widely dispersed in the
environment.
ü In humans, TB most commonly affects the lungs
(pulmonary TB), but it can also affect other organs
(extrapulmonary TB).
About TB

ü Transmission: TB is spread from person to person

through the air. When people with TB cough, sneeze or
spit, they propel the TB germs into the air.
ü Symptoms: Cough with sputum and blood at times,
chest pains, weakness, weight loss, fever and night
sweats.
ü Treatment: TB is a treatable and curable disease. It is
treated with a standard 6-month course of 4 antimicrobial
drugs that are provided with information, supervision and
support to the patient by a health worker or trained
volunteer.
About TB

ü Anti-TB medicines have been used for decades and

strains that are resistant to 1 or more of the medicines
have been documented in every country surveyed.
1. Multidrug-resistant tuberculosis (MDR-TB) is a form
of TB caused by bacteria that do not respond to
isoniazid and rifampicin, the 2 most powerful, first-line
anti-TB drugs. MDR-TB is treatable and curable by
using second-line drugs.
2. Extensively drug-resistant TB (XDR-TB) is a more
serious form of MDR-TB caused by bacteria that do not
respond to the most effective second-line anti-TB drugs,
often leaving patients without any further treatment
options.
Who developed the Vaccine?

ü BCG was developed by two Frenchmen, Albert

Calmette and Camille Guerin, by modifying a strain of
Mycobacterium bovis (that causes TB in cattle) till it lost
its capacity to cause disease while retaining its property
to stimulate the immune system.
ü It was first used in humans in 1921.
Vaccine - BCG

ü Currently, BCG is the only licensed vaccine available for

the prevention of TB.
ü It is the world’s most widely used vaccine with about 120
million doses every year and has an excellent safety
record.
ü In India, BCG was first introduced in a limited scale in
1948 and became a part of the National TB Control
Programme in 1962.
Historical traces of TB

ü TB is a very ancient disease and has been documented

to have existed in Egypt as early as 3000 BC.
ü Sadly, unlike other historically dreaded diseases like
smallpox, leprosy, plague and cholera that have been
either eradicated or controlled to a large extent due to
advances in science and technology, TB continues to be
a major public health problem in the world.
ü According to the WHO’s Global TB Report, 10 million
people developed TB in 2019 with 1.4 million deaths.
ü India accounts for 27% of these cases.
Vaccine – BCG (Geographical Factors)

ü One intriguing fact about BCG is that it works well in some

geographic locations and not so well in others.
ü Generally, the farther a country is from the equator, the higher is the
efficacy.
ü It has a high efficacy in the UK, Norway, Sweden and Denmark; and
little or no efficacy in countries on or near the equator like India,
Kenya and Malawi, where the burden of TB is higher.
ü These regions also have a higher prevalence of environmental
mycobacteria. It is believed that these may interfere with the
protective effect against TB.
Indian Initiatives for TB

ü India is committed to eliminate TB as a public health problem by 2025.

ü To achieve this goal, we would not only need better diagnostics and
drugs but also more effective vaccines.
ü Over the last ten years 14 new vaccines have been developed for TB and
are in clinical trials.
ü Of particular interest is a Phase 3 clinical trial by the ICMR, of two
vaccines; a recombinant BCG called VPM 1002 and Mycobacterium
indicus pranii (MIP).
ü MIP was identified and developed into a vaccine in India.
ü Results of this trial are eagerly awaited.
Indian Initiatives for TB

ü The Nikshay Ecosystem: It is the National TB information system which

is a one-stop solution to manage information of patients and monitor
program activity and performance throughout the country.
ü Nikshay Poshan Yojana (NPY): This scheme is aimed at providing
financial support to TB patients for their nutrition.
ü TB Harega Desh Jeetega Campaign: Launched In September 2019 it is
showcasing the highest level of commitment for the elimination of TB.
ü The Saksham Project: It is a project of the Tata Institute of Social
Sciences (TISS) that has been providing psycho-social counselling to
DR-TB patients.
Other profits of BCG Vaccine

ü In addition to its primary use as a vaccine against

TB, BCG also protects against respiratory and
bacterial infections of the new-borns, and other
mycobacterial diseases like leprosy and Buruli’s
ulcer.
ü It is also used as an immunotherapy agent in
cancer of the urinary bladder and malignant
melanoma.
THANK YOU!