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Clin Infect Dis. 2016 May 15;62 Suppl 3:S262-7. doi: 10.1093/cid/ciw025.

BCG and New Preventive Tuberculosis Vaccines: Implications for Healthcare Workers.

Author information

1
South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa.
2
Department of Respiratory Medicine, P. D. Hinduja National Hospital, Mumbai, India.
3
Directorate of Health Impact Assessment, Western Cape Government Department of Health, Cape Town.
4
Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University Metro District Health Services, Western Cape Government Department of Health, Cape Town, South Africa.
5
Office of the Director General, World Health Organization, Geneva, Switzerland.

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.

KEYWORDS:

healthcare workers; prevention; tuberculosis; vaccine

PMID:
27118856
PMCID:
PMC4845890
DOI:
10.1093/cid/ciw025
[Indexed for MEDLINE]
Free PMC Article

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