Giuseppe
Emeritus
Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009 (abstract)
[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 16, Issue 12, 24 March 2011
Research articles
Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009
I Abubakar 1,2, T Matthews 2,3, D Harmer 3, E Okereke 4, K Crawford 3, T Hall 3, T Collyns 5, G Smith 6, A Barrett 7, S Baugh 8
1. Tuberculosis Section, Health Protection Agency Centre for Infections, Colindale, London, United Kingdom
2. These authors contributed equally to the manuscript
3. North Yorkshire and Humber Health Protection Unit, Hull, United Kingdom
4. Health Protection Agency Yorkshire and Humber, Leeds, United Kingdom
5. Leeds Teaching Hospitals Trust, St James' University Hospital, Leeds, United Kingdom
6. Health Protection Agency Regional Centre for Mycobacteriology, Birmingham, United Kingdom
7. Health Protection Agency Regional Centre for Mycobacteriology, Newcastle, United Kingdom
8. Northern Lincolnshire and Goole Hospitals National Health Service Foundation Trust, United Kingdom
Citation style for this article: Abubakar I, Matthews T, Harmer D, Okereke E, Crawford K, Hall T, Collyns T, Smith G, Barrett A, Baugh S. Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009 . Euro Surveill. 2011;16(12)
ii=19826. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826
Date of submission: 08 February 2011
The contribution of travel to high incidence countries and the impact of the discontinuation of universal Bacillus Calmette?Gu?rin (BCG) vaccination to the recent rise in tuberculosis (TB) in the United Kingdom remain unclear. An outbreak in a college presented an opportunity to assess these. A cohort of students answered a questionnaire assessing risk factors for TB. Participants were screened with an interferon gamma release assay (IGRA). Unadjusted and adjusted odds ratios (OR) were calculated using logistic regression. Among 2,284 students, 400 (17.5%) were diagnosed with TB infection. A higher risk was noted for travel to a high incidence area in the past two years (OR: 1.39; 95% confidence interval (CI): 1.04?1.89) and among those with the greatest exposure to the index case (OR: 3.94; 95% CI: 2.60?5.97). There was no association between BCG and risk of infection (OR: 1.05; 95% CI: 0.80?1.39). The lack of a protective effect by BCG on TB infection supports the discontinuation of universal vaccination. The association with foreign travel suggests the need to assess the cost-effectiveness of serial IGRA testing and treatment of positive persons among returning travellers.
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[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 16, Issue 12, 24 March 2011
Research articles
Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009
I Abubakar 1,2, T Matthews 2,3, D Harmer 3, E Okereke 4, K Crawford 3, T Hall 3, T Collyns 5, G Smith 6, A Barrett 7, S Baugh 8
1. Tuberculosis Section, Health Protection Agency Centre for Infections, Colindale, London, United Kingdom
2. These authors contributed equally to the manuscript
3. North Yorkshire and Humber Health Protection Unit, Hull, United Kingdom
4. Health Protection Agency Yorkshire and Humber, Leeds, United Kingdom
5. Leeds Teaching Hospitals Trust, St James' University Hospital, Leeds, United Kingdom
6. Health Protection Agency Regional Centre for Mycobacteriology, Birmingham, United Kingdom
7. Health Protection Agency Regional Centre for Mycobacteriology, Newcastle, United Kingdom
8. Northern Lincolnshire and Goole Hospitals National Health Service Foundation Trust, United Kingdom
Citation style for this article: Abubakar I, Matthews T, Harmer D, Okereke E, Crawford K, Hall T, Collyns T, Smith G, Barrett A, Baugh S. Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009 . Euro Surveill. 2011;16(12)
ii=19826. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19826Date of submission: 08 February 2011
The contribution of travel to high incidence countries and the impact of the discontinuation of universal Bacillus Calmette?Gu?rin (BCG) vaccination to the recent rise in tuberculosis (TB) in the United Kingdom remain unclear. An outbreak in a college presented an opportunity to assess these. A cohort of students answered a questionnaire assessing risk factors for TB. Participants were screened with an interferon gamma release assay (IGRA). Unadjusted and adjusted odds ratios (OR) were calculated using logistic regression. Among 2,284 students, 400 (17.5%) were diagnosed with TB infection. A higher risk was noted for travel to a high incidence area in the past two years (OR: 1.39; 95% confidence interval (CI): 1.04?1.89) and among those with the greatest exposure to the index case (OR: 3.94; 95% CI: 2.60?5.97). There was no association between BCG and risk of infection (OR: 1.05; 95% CI: 0.80?1.39). The lack of a protective effect by BCG on TB infection supports the discontinuation of universal vaccination. The association with foreign travel suggests the need to assess the cost-effectiveness of serial IGRA testing and treatment of positive persons among returning travellers.
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