Research: BCG and new preventive Tuberculosis vaccines: implications for healthcare workers

03 May 2016
BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers
03 May 2016

Associate Professors Mark Hatherill and Tom Scriba have co-authored a paper, titled: "BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers" appearing in the April edition of Clinical Infectious Diseases Journal.  

BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers
Source: Dr Zweli Mkhize, Twitter handle.

Abstract:

Healthcare workers (HCWs) are at high risk of Mycobacterium tuberculosis ( Mtb ) infection and tuberculosis disease, but also play a crucial role in implementing healthcare. Preexposure tuberculosis vaccination, including revaccination with BCG, might benefit Mtb -uninfected HCWs, but most HCWs in tuberculosis-endemic countries are already sensitized to mycobacteria. A new postexposure tuberculosis vaccine offers greatest potential for protection, in the setting of repeated occupational Mtb exposure. Novel strategies for induction of mycobacteria-specific resident memory T cells in the lung by aerosol administration, or induction of T cells with inherent propensity for residing in mucosal sites, such as CD1-restricted T cells and mucosa-associated innate T cells, should be explored. The need for improved protection of HCWs against tuberculosis disease is clear. However, health systems in tuberculosis-endemic countries would need significantly improved occupational health structures to implement a screening and vaccination strategy for HCWs.

Conclusion: HCWs are a population at high risk of Mtb infection and incident tuberculosis disease who also fulfill a crucial role in implementing healthcare in tuberculosis-endemic communities. The need for improved protection of HCWs against occupational and community-acquired tuberculosis disease is clear. However, with the exception of Mtb -uninfected HCWs who might derive some benefit from BCG revaccination—the minority in tuberculosis-endemic countries—the current state of tuberculosis vaccine development is such that the needs of HCWs must be met by a combination of infection control measures, tuberculosis preventive therapy, and regular symptom screening, combined with new rapid diagnostics and early treatment for disease [ 61 ]. It is also clear that health systems in tuberculosis-endemic countries would need improved occupational health structures to implement a program of tuberculosis vaccination linked to prior screening of HCWs for Mtb infection. Future development of an effective postexposure tuberculosis vaccine is the key to providing HCWs with long-standing protection against tuberculosis disease

 

Citation: Hatherill M, Scriba TJ, Udwadia ZF, Mullerpattan JB, Hawkridge A, Mahomed H, Dye C. 2016. BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers. Clinical Infectious Diseases, 62 Suppl 3(Suppl 3):S262-7. Click here.