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ST3EFTCOCU? ANTI BCG
Ey C. ZSarl Albrecht, h'.D. , Territorial
Commissioner of Health
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Streptomycin, an anti-biotic mold, and tho ,
tuberculosis vaccine ICG have hold the -|
spotlight during tho oast year in the fiol c
cf tuberculosis control. Tuberculosis spec
ialists moating at tho recent San Francisco
convention of tho National Tuberculosis
Association carefully rcvxorod the nork don!
me' examined all the data available on both
?oday, aliacst 10 years later, rhat do vo
mov- about the efficacy of BCG vaccination
is a preventive measure in tuberculosis
control? A sho? t time ago a /group of ex
perts on tuberculosis control conferred in
:ho offices of the Tuberculosis.Control
Division of the United States Public
’ Health Service. On the basis of caroful
reviev: of the ->apors presented at this
neeting the member s drov: uo sovoral con
iclusions and recommendations in tho uso_
of BCG vacci.no;
, J . J. I/ 111 CUiU :
-L
Cert?in ty-cs of tuberculosis- have respondod 2,
tc streptomycin therapy: nrncly, tuborculous
neninyit is, rhich at+acks the me mbrancs of
the brain and spinal cord; miliary tuborcu -
lesis, rapidly spreading generalized form;
and tuberculous sinuses arising from infect- 3.
cr?. b-ncp and glands. It ras found benefi
cial also in other forms cf the disease
such as laryngeal tuberculosis, particu- 4, .
larly the ulcerative lesions cf the tracheo
bronchial tree, and acute ulcerative tube*- 5.
cvlcv.s enteritis, ^hit streptomycin so far
has failed to live up to the prophesies
made about it. 6.
The use of streptomycin as an adjunct in •
the treatment of tuberculosis is still con
sidered to be one of the most hopeful"mod- 7
icinos” yet discovered. The successful
studies reported thus far.arc sufficient tc
ra rant continued use of streptomycin in 8.
he treatment of certain forms of tubercu
losis.
ICC, the attenuated bovine strain of tuber
cle bacilli, has likerise "received “a "groat’
deal of attention during the past year. gt
The principle of the vaccine is to confer
a degree -f immunity on a non-tuberculous
p:rson by using 3C0. 'The effect is simi
lar to the nature1 immunity acquired bya
person rho has been ill rith tuberculosis.
The body’s natural disease ’i.ghting forcos
ra?ly to create an overall resistance to
t? c germs, -hich often • revents further and
mere virulent attacks.
10
11.
Advocates of midc-scalcd BCG yaccin.itian
P'int to tic oxr orimcr.ts 01. American Ind
io's. In 1938 certain Indians of 12 conmu
nitios of Southeast Alaska t ore among those
'■elected for BCG vaccination. These Ind
ians ranged in ago from 1 to 20 yoers, in
clusive, and v.-erc free from tuberculosis
as indicated by their failure to re .ct to
tie tuberculin test. The in oculations
"■ ere made in connection' rith a limited con
trcllcd study or the value of 3C§ vaccine
rather than vith an uncontrolled broad-scale
prorrsm of vaccination. The study ras'con- Surol
HA ct od by the Office of Indian Affairs, Hon^,coor
ry Fhinps Tnstituto, and U.S. Tuclic Health ^ino
Service. The United States fublic Health ngG 0
for vice found that non-vac hfatCd ltd tans’'' losis
contacted ar:d died fron tuberculosis four
a seven times more frequently than vac
cinated Indians.
vaccine unouia nov do maao ua..—
norcially available at nrosont.
From studios presented at the con
ference, it appoars that BCG vac
cine confers increased resistance
to tuberculosis for tho limited per
iod covered in these studios,
llodical literature fails to rcve&l
any proved cases of progressive dis-’
case as a result of BCG vaccination.
rCG vaccination can bo done rithout
causing severe local reaction.
The intracutaneous method of vacci
nation is recommended for use at the
present.
In the Studios presented, BCG .vacci
nation converted a lar{to percent'...a
of npnrcactors (to the tuberculin,
tost) ante reactors.
Feed for re vac.? ination and the ti:o
interval botmoon vaccination require
further study.
It -as rccormondod that a sinplo lab
oratory be established, by.tho Tuber
culosis Control Division to produce
3C& vaccine for the entire United
Statos for use in research programs
■nrouosed at tho conference.
Extensive investigations should jo
carried on cooperatively rith roe -
niued research groups throughout the
nation, esp ocially in population
gfcoups highly oxnosod to tuberculous
infect ion.
It • -os roe or; ended that the Tuber
culosis Control Division set un a
controlled study in''a community ■' it.
a population of 100,000 or more, to
dotemine immediate and long-ran :o
results.
Eurthcr research is- strongly roc re- -
mended- to determine the efficiency
of vaccination and also to aite:r?6
to develo' a vaccino composed of
dead bacilli. It -as recommended
that method'- bo developed to stand
ardise tcchnir.uos of preparation :-f
■notont and stable vaccine for use in
the United States and, if possible,
through-at te -orId.
y, in the light of roe out successful
ts in Doranaidc and in the use of ~ac
among selected grouns in America,
[Tors us renemod hope that tuhcrcu
may be controlled in Alaska.