著者

戸井田 一郎

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.75, no.1, pp.1-7, 2000-01-15 (Released:2011-05-24)

参考文献数

12

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BCG vaccination programme and BCG vaccination coverage in the world were summarized mainly based on the published informations from official organizations, such as World Health Organization (WHO), International Union Against Tuberculosis and Lung Disease (IUATLD) and Centers for Disease Control and Prevention (CDC).From this review, we can see how widely BCG has been used for the prevention of tuberculosis in the world.In most of the developing countries, especially in Africa, the Americas, and Pacific Region, BCG vaccination is carried out to newborn babies soon after birth by intradermal injection according to the recommendations from WHO, but some of the developing countries in Asia and Europe have their own modified BCG vaccination programmes.In economically developed countries, BCG vaccination programme has been established according to the tuberculosis status of each countries. Some countries have general vaccination policy, and other countries have selected vaccination policy, but there is no country where BCG vaccination is not carried out at all. Among G8 contries, as representatives of the economically developed countries, Japan, United Kingdom, France and Russian Federation have BCG-general vaccination policy for the specified age group. In these 4 coun tries revaccination (s) of BCG are still carried out. In Germany, some provinces have general vaccination policy and some others have selected vaccination policy. In the United States of America, BCG vaccination is recommended to selected high risk infants and health care workers by CDC.There are many debates as for the efficacy and safety of BCG vaccination, and the developement of new vaccine better than BCG has been actively discussed and some encouraging results in animal models have been reported from several laboratories. But, there is almost no possibility to be able to use a new vaccine in the routine practice within a couple of years. From the practical point of view, therefore, the operational researches for the better and more appropriate usage of BCG are equally important and more practical than the researches for the development of new vaccines.

著者

戸井田 一郎 中田 志津子

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.82, no.11, pp.809-824, 2007-11-15 (Released:2011-05-24)

参考文献数

84

被引用文献数

1

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1951年の結核予防法大改正によって凍結乾燥BCGワクチンの接種が法制化されてから2004年までに結核予防法によるBCG接種者総数は2億1380万人に達している。そのなかで接種局所および/または所属リンパ節の範囲を超えて身体他部位に重大な副反応が発生した症例を検索し,39症例(接種10万件あたり0.0182件)が同定できた。ほかに,BCGとの関連に疑問があるがBCG接種にひきつづいて起こった重大な有害事象症例として4症例の報告があった。39症例のうち19例では,慢性肉芽腫症(CGD),重症複合型免疫不全(SCID),Mendelian Susceptibility to Mycobacterial Disease(MSMD)などの先天性免疫不全を含め,何らかの細胞性免疫異常が報告されている。死亡の6例には全例に免疫異常が認められている。BCG接種の唯一の機会を逃す子供が生じないように,それと同時に,生後3カ月までの接種を避けて先天性免疫不全児へのBCG接種の危険を回避することができるように,公費によるBCG接種の期間を最短でも生後1年まで延長することが望まれる。

著者

戸井田 一郎 中田 志津子

出版者

一般社団法人 日本結核病学会

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.82, no.11, pp.809-824, 2007-11-15

参考文献数

84

被引用文献数

9

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1951年の結核予防法大改正によって凍結乾燥BCGワクチンの接種が法制化されてから2004年までに結核予防法によるBCG接種者総数は2億1380万人に達している。そのなかで接種局所および/または所属リンパ節の範囲を超えて身体他部位に重大な副反応が発生した症例を検索し,39症例(接種10万件あたり0.0182件)が同定できた。ほかに,BCGとの関連に疑問があるがBCG接種にひきつづいて起こった重大な有害事象症例として4症例の報告があった。39症例のうち19例では,慢性肉芽腫症(CGD),重症複合型免疫不全(SCID),Mendelian Susceptibility to Mycobacterial Disease(MSMD)などの先天性免疫不全を含め,何らかの細胞性免疫異常が報告されている。死亡の6例には全例に免疫異常が認められている。BCG接種の唯一の機会を逃す子供が生じないように,それと同時に,生後3カ月までの接種を避けて先天性免疫不全児へのBCG接種の危険を回避することができるように,公費によるBCG接種の期間を最短でも生後1年まで延長することが望まれる。

著者

戸井田 一郎

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.68, no.6, pp.435-444, 1993-06-15 (Released:2011-05-24)

参考文献数

42

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Bacille Calmette-Gubrin (BCG) has been widely used as a safe and effective vaccine for the protection of tuberculosis, but recent epidemic of human immunodeficiency virus (HIV) infection evoked serious concerns about the safety of BCG when vaccinated to HIV-infected persons: that is, because BCG is a live, though avirulent, bacterial vaccine, it might grow in immunocompromized host and might cause dissemination and/or exacerbated local adverse reactions. In fact, during the decade since the first report on AIDS in 1981, several reports were published on the adverse reactions, systemic or local, induced by BCG in HIV infected persons. In this paper, the present author attempted to review such reports as comprehensively as possible.From critical examinations of the literatures, it was concluded that:1) None of the reports dealing with dissemination of BCG provided satisfactorily enough evidence to identify the isolated mycobacteria as Mycobacterium bovis BCG. In some cases, infection with wild strain of M. bovis, instead of BCG, should be considered as more plausible pathogen. Especially, two reports, which suggested the late reactivation and dissemination of BCG vaccinated 30 years ago, could not be accepted without more detailed description of the procedures and results of the identification tests. In some cases, application of BCG were considered to be inappropriate. According to the present author's judgement, when BCG was applied appropriately as an anti-tubercul2) As for the local adverse reactions, many reported cases of outbreak of local adverse reactions, such as local ulceration and supprative lymphadenitis, were not related to HIV infection at all, but were due to the usage of an inferior vaccine produced by a specified manufacturer (Pasteur Institute, Paris). Conclusion was that BCG could be safely vaccinated to children born from HIV-seropositive mothers, even if children themselves were also infected with HIV, so long as BCG vaccine of good quality was used.osis vaccine, generalized infections were most plausively induced by BCG only in 4 cases during this decade.3) Positive conversion rate of post-vaccination tuberculin skin-test seemed to be lower in HIV-infected children than in children born from HIV-seronegative mothers. But, about 30% of the HIV-infected children converted to tuberculin-positive after BCG vaccination suggesting the effectiveness of the vaccination for the considerable fraction of the babies at the highest risk of tuberculosis infection. Positive conversion rate was much higher in HIVnoninfected children born from HIV-seropositive mothers.From these considerations, recommendations from WHO, which recommended to vaccinate BCG to HIV-infected babies, babies born from HIV-seropositive mothers as well as babies born from HIV-seronegative mothers so long as babies are asymptomatic, are completely justified.

著者

戸井田一郎

雑誌

呼吸器疾患 結核資料と展望

巻号頁・発行日

vol.48, pp.15-40, 2004

被引用文献数

1

著者

戸井田一郎著

出版者

「日本におけるBCGの歴史」出版委員会

巻号頁・発行日

2009