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TB, BCG and your Baby

BCG vaccineWhat is BCG vaccine?

BCG vaccine contains a weakened form of the bacteria (germs) that cause TB. Because it is weakened it doesn't actually cause TB, but it helps your baby develop protection (immunity) against the disease in case he or she ever comes into contact with it.

What is TB?

TB is a serious infectious disease that can lead to TB meningitis (swelling of the lining of the brain) in babies. In young people and adults it usually affects the lungs, but it can also affect the glands, brain or bones. Most people in this country recover fully after treatment, but this takes several months.

How is TB caught?

You can only catch TB from someone whose lungs or throat are already infected and who is coughing. When they cough, a spray of tiny droplets is produced that contain the germs. If you breathe in the droplets you too can catch the disease. Although these droplets can stay in the air for quite long periods of time, in general, it takes close and lengthy contact with an infected person for the disease to spread.

How common is TB?

In the UK in the 1950s, there were over 50,000 new cases of TB every year. Today, this number has dropped to about 9000 new cases a year, but this is still an increase from around 5500 new cases a year in the early 1990s. So, while it is unlikely that you will get infected, everybody should be aware of the symptoms of TB. This is especially important because TB is a widespread disease worldwide. With increasing numbers of people travelling around the world, the risk increases that people who have lived or worked in countries with high rates of TB will come into contact with the disease or bring it into this country.

What are the symptoms of TB?

TB can affect practically any part of the body, so the symptoms vary and the signs of the disease in a baby may be different from those in an adult. However, as TB is infectious, it is important that you can recognise the disease in someone else.
You should contact a doctor if your baby, or any other member of your family, or a friend has any of the following:

  • a cough that lasts for more than 3 weeks
  • a fever
  • sweating, especially at night
  • weight loss
  • feeling tired, or
  • coughing up blood.

Why is my baby being offered BCG?

In the UK, like many other countries, BCG is offered to babies who are more likely than the general population to come into contact with someone with TB. This is because they either live in an area with high rates of TB or their parents or grandparents came from a country with high rates of TB (see page 7 for weblink).
The vaccination is usually offered after the birth while your baby is still in hospital, but it can be given at any time.

How is my baby immunised?

Your baby will be given the BCG vaccination in the upper part of the left arm.

Are there any side effects?

Immediately after the injection, a raised blister will appear. This shows that the injection has been given properly.

Within two to 6 weeks of the injection a small spot will appear. This may be quite sore for a few days, but it should gradually heal if you don't cover it. It may leave a small scar.

Occasionally, your baby may develop a shallow sore where they had the injection. If this is oozing fluid and needs to be covered, use a dry dressing – never a plaster – until a scab forms. This sore may take as long as several months to heal.
If you are worried or you think the sore has become infected, see your doctor.

Are there any reasons why my baby shouldn't have the BCG vaccination?

As with most other immunisations, the injection should not be given or should be delayed if your baby:

  • has a high fever
  • is having treatment for cancer or other serious conditions that weaken the immune system
  • is HIV positive, or
  • is suffering from a generalised skin condition, for example, eczema.

Do I need to know anything else?

Your baby can start their routine immunisations at 2 months of age regardless of when they have their BCG.

However, you should make sure that your baby is not given another injection in the same limb as the BCG for at least 3 months afterwards, otherwise the glands in that area may swell.

Also make sure that there is a record of the BCG vaccination in your child's Personal Child Health Record (PCHR) for future reference.

Countries with high rates of TB

Countries with high rates of TB are taken from World Health Organization (WHO) data. Further details can be found on the Health Protection Agency website, see related links.

If you answer 'Yes' to any of these questions your baby should have a BCG vaccination if he or she hasn't already had one.

  • Are you, your family or your baby's father or his family from a country with high rates of TB? If in doubt, talk to a health professional
  • Will you and your baby be going to live for more than a month or travel frequently in 1 of these countries in the near future?
  • Is there anyone in your house, or anyone else who is likely to have longterm contact with your baby, who either has TB, or has had it in the past, or comes from one of these countries?
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