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Change to Finland’s vaccine programme sees rise in kids' mycobacterial infections

Before 2006, all newborns received the TB shot, but as cases of tuberculosis diminished over the years, the shot was cut from the national vaccine programme.

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Children’s mycobacterial infections have increased significantly since Finland stopped administering the anti-tuberculosis BCG vaccine to newborns in 2006. The finding suggests that the BCG shot controlled cases of infection by non-tuberculosis mycobacterium, according to a new research paper by Helsinki University and the National Institute of Health and Welfare THL.

Up to 2006, all newborns in Finland were given the BCG vaccination, but as reported cases of tuberculosis had diminished over the years, the shot was dropped from the national immunisation programme. However, some newborns may still receive the jab in maternity hospitals on the basis of a recommendation from a pre-natal clinic.

The study reviewed cases of non-tuberculosis mycobacterial infections diagnosed between 1995 and 2016 in infants under the age of four years old born in Finland. The analysis identified 97 cases and the majority of them were caused by Mycobacterium avium, which is associated with lung infections.

Although the absolute number of cases was not high, the study noted that they had multiplied since BCG was eliminated from the national vaccine programme. In the past an estimated 0.2 children in 1,000 had been diagnosed with the infection, but after 2006, the rate of infection jumped to 3.9 children in 1,000 on average.

Treatment with antibiotics and surgery

The researchers concluded that the BCG shot, which aims to prevent tuberculosis infections, also protected youngsters from non-tuberculosis mycobacteria and related diseases. They added that this link may also explain why mycobacterial diseases have become more widespread in many countries.

Mycobacterial infections in children may cause lymphadenitis or inflammation of the lymph nodes, but the infection often targets the lungs. The symptoms of such lung infections are similar to tuberculosis in that they include coughing, fatigue, shortness of breath, weight loss and coughing up phlegm and blood. Mycobacterial diseases are generally treated with antibiotics and surgical interventions.

The THL and Helsinki University research team published the results of the study in the Clinical Infectious Diseases journal on 28 September. Researchers were Antti Kontturi, Hanna Soini, Jukka Ollgren and Eeva Salo.

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