1. BCG VACCINATION

2. Bacillus Calmette-Guérin (or Bacille Calmette-Guérin, BCG) is a vaccine against tuberculosis that is prepared from a strain of the attenuated (weakened) live bovine tuberculosis bacillus, Mycobacterium bovis, that has lost its virulence in humans by being specially cultured in an artificial medium for years.
The bacilli have retained enough strong antigenicity to become a somewhat effective vaccine for the prevention of human tuberculosis.
At best, the BCG vaccine is 80% effective in preventing tuberculosis for a duration of 15 years;
however, its protective effect appears to vary according to geography

3. Antituberculous vaccination = prophylaxis, by strengthening the body resistance to specific protection offered by vaccination
50-80%- most important benefit of being able to avoid serious illness especially in children (disseminated forms, meningitisTB)
WHO recommends the use of BCG in newborn babies soon after birth-binding policy

4. WHO recommended obligatory vaccination in countries with high prevalence of tuberculosis
National Immunization Program - BCG vaccination requirements at least 95% of newborns
Following the emergence of HIV infection and HIV-TB is common association returns to BCG vaccination in developing countries

5. INDICATIONS
1. All newborns and infants up to 12 months and revaccination of those who do not have 6 months post-vaccination scars greater than 3 mm;
EXCEPTION: new born to mothers positive in sputum: these get first chemotherapy (or antituberculous therapy, if appropriate) and then vaccinated.
2. Infants and children with negative TST tuberculin:
a) are at increased risk of close and prolonged exposure to pulmonary tuberculosis in adults with untreated or treated inefficiently and can not be removed from the source of infection or can not receive long-term chemoprophylaxis or
b) are continuously exposed to persons with HIV and RMP resistant forms of tuberculosis .
3. Children born by HIV positive mothers, already infected, requiring BCG vaccination immediately after birth because:
- confers cross-protection against atypical mycobacteria

6. CONTRAINDICATIONS
Extensive skin disease or burns (acute dermatological disease)
persons with a positive tuberculin skin test
HIV positive
moderate or severe febrile illness
six months after viral hepatitis
active tuberculosis
weight <2500 g at birth
congenital immunodeficiency
leukemias, lymphomas, malignancies

7. Technique Vaccine is administered strictly intradermal
Injecting - 1 / 3 medium left arm, posterior-external face
local vaccination reaction 2-4 weeks- red node sometimes also ulceration
successful vaccination scars > 3 mm
vaccination failure-scars < 3 mm

8. COMPLICATIONS Ulcerations > 3 months
Local abscess- after subcutaneous administration
loco-regional adenopathies with necrosis
Koch phenomenon- the local allergically reaction with rapid evolution to ulceration
generalized infections or osteitis
Leukocytosis with eosinophilia
Moderate increase of VSH