Why India desperately needs a new tuberculosis vaccine

Vice-President M. Venkaiah Naidu on Wednesday urged scientists to develop a new vaccine for tuberculosis (TB). He was speaking at the 50th Union World Conference on Lung Health in Hyderabad. Currently, babies as young as one-day-old are given the Bacillus Calmette-Guérin or BCG vaccine in Indian hospitals to protect them from TB. However, the effects of BCG wear off after 15-20 years. BCG is also almost a century-old - it was first used in 1921! [caption id=“attachment_7579971” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption]

India figures

With an estimated 30 lakh TB cases and more than 20 lakh new cases registered each year, India is among the top 30 countries burdened with TB, according to the World Health Organization’s Global Tuberculosis Report 2019. The WHO report further shows that children account for 13% of TB cases in India (men account for 56% of TB cases in India, and women for 31%). Data also show that over 4.49 lakh Indians died from TB in 2018. And more than 27.4 lakh new TB cases came to light in 2017.

Can TB be prevented?

TB is a serious infection caused by the bacteria  Mycobacterium tuberculosis  - it usually affects the lungs though it can develop in other parts of the body as well. Patients experience persistent coughing with sputum for more than two weeks. Sometimes patients also cough blood, complain of chest pain, weakness, weight loss, fever, and sweating in the middle of the night. When someone with TB coughs, sneezes, shouts or even sings, infectious droplets enter the air around them. Transmission occurs when a healthy person inhales those airborne bacterias. Bacillus Calmette-Guérin vaccine is used across the world to prevent TB. Infants up to a year old get the vaccine through an injection on the upper arm: they are given 0.05 mL of BCG. Adults are given 0.1 mL of the vaccine by injection.   Even after the administration of the vaccine, new cases of TB have been reported daily as BCG is not enough to control the disease at a global scale. Additionally, people with latent TB do not show any symptoms and they do not spread the disease to others. But if their germs become active, they can develop the disease. Pharma major GSK has made a new vaccine — M72/AS01E — specifically for latent TB in adults. So far, tests have shown that the vaccine offers protection from the disease for three years with 54% efficacy. However, final tests are yet to be done on this vaccine.

WHO recommendations

WHO has given seven recommendations in 2019 to reduce the risk of transmission among health workers and others who come in contact with the patient.

1. Treat the very sick first:  Make a triage for TB patients; prioritize their treatment based on the severity of their condition.
2. Isolate the patient:  Respiratory separation/isolation of people who have infectious TB or are supposed to have the disease is recommended.
3. Start treatment asap:  Prompt initiation of effective treatment of people with TB disease is recommended.
4. Show patients the right way to cough:  Respiratory hygiene should be taught to in people with presumed or confirmed TB, including cough etiquette.
5. Prep for the patients’ room to kill germs:  Upper-room germicidal ultraviolet (GUV) systems, composite interventions and luminaires in the patient’s rooms and common areas are recommended.
6. Use an air filter:  Other than portable room-air cleaner appliances, ventilation systems like natural, mixed-mode, mechanical ventilation and recirculated air through high-efficiency particulate air (HEPA) filters are recommended.
7. Wear a mask:  Under respiratory protection programme, particulate respirators, commonly known as air-purifying respirators like N-95 respirator mask, are recommended. This is especially important because TB can be transmitted by particles as small as 1-5 microns. A micron is one-thousandth of a millimetre.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on   Tuberculosis: Symptoms, Treatment and Prevention_._