Soapbox

I'm not quite sure if I'm confused, perplexed or just mis-informed.

Our local health centre is not inoculating against TB for travellers to forrin parts where the disease is known to exist. In fact, they do not give TB jabs at all - even for ready money. I could get neither reason nor explanation, nor could I find out if the BCG jab is still mandatory for children.

Any medics out there?

BCG in adults is not at all efficient - an, unless you live in or are ggoing to a high risk area for an extended period of time, its not worth it.

For instance - I live in Southport so cant get it and wont be given it.  However, there are certain postcodes in Manchester where I would have had it already.

Much more important is Hep A and B - so a medic tells me.

Hmm - thanks chaps. However, TB isn't something I want my son to catch during his month in India. He'll have a week in Delhi, ten days working on school maintenance, and the rest up in the Himalaya (lucky little git). Now perhaps those areas aren't high risk, but why is any risk necessary?

What really worries me is that in this country TB is already on the rise and it seems the NHS has stopped innoculations - anyone know if kids still get a BCG jab? And no, I don't read the Daily Mail, blame Radio 4 for my concerns.

GOM - Hep A&B were top of my list for inoculations. Doesn't mean I wouldn't like the lad to have the TB jab too.

GrumpyOldMan wrote (see)

BCG in adults is not at all efficient ...unless you live in or are ggoing to a high risk area

For instance - I live in Southport so cant get it and wont be given it.  However, there are certain postcodes in Manchester where I would have had it already

Woozle - does that mean the inoculations worked, so NHS stopped them? I accept NHS monies have to be spent cost-effectively, but I wonder how long it will be before regular childhood immunisation is re-introduced.

And your suggestion he has it done in India is worth considering. Or he could go to Manchester and get the jab. It's been stopped in Croydon (nearest metropolis) even though the main hospital there has a regular intake of patients.

Perhaps there is a kind of herd immunity developed in the population so the jab no longer effective. I don't klnow but those figures as stated  could imply that 93 people the jab wasn't needed in 193 to find the 1 person who needed the innoculation to prevent it. Whereas in 1988 11,999 people were naturally immune for each single person who wasn't and needed the jab. Just one interpretation of the figures. Wording with statistics is important as well as the figures. Is that being pedantic? I'm sometimes pedestrian so pedantic would be new to me.

Like everything with two sides cost calculations will always be done. What I mean is the cost of the jab for 12,000 people compared to the cost to treat 1 person once they get TB. Unfortunately that sort of balance has always been done to some degree. With improved treatments and often expensive drugs they really have to look at cost balances with treatments and prevention vs treatment situations. Harsh if your son is the 1 person in however many people it is now. Sorry about that and I hope your son stays healthy whether or not he has the jab somehow.

I just wonder if having a jab out in India would work. Don't vaccinations require a degree of time for the body to detect it and develop antibodies for it? If you get the jab out there you might have to wait a couple of months before there are enough antibodies in your system to provide protection. How long is he going for? Perhaps check whether he will get the jab out there only for it to start being effective once he is home.

You've hit it right on the thumb, there Lil. Immunisation worked, so less of the herd had it, so immunisation was stopped.

How heavy a load to bear that must be - having to decide which diseases to inoculate against. Having to stop those jabs which have been effective because a new threat is on the rise. My point is there is an old threat - TB - looking for a way back in, and we might have left the gate open.

Hey ho, it won't stop the lad going to India, and I'll be worried about him whatever jabs he has had. I think his greatest threat is from the cohort he's going with, but don't get me going on teenage morality!

"Routine immunization with BCG was withdrawn in 2005 because of falling cost-effectiveness: whereas in 1953, 94 children would have to be immunized to prevent one case of TB, by 1988, the annual incidence of TB in the UK had fallen so much that 12,000 children would have to be immunized to prevent one case of TB"

The trouble is that more people now travel, and travel to and from areas where TB is rife, and the incidence is rising.

Not only that, but the logic is rather twisted; the low incidence of TB is because of immunisation.  Remove the immunisation, and the incidence is likely to rise again...  The other thing is that GPs have forgotten about TB, so the diagnosis is often late, whereas in 1953, GPs would have dealt with TB on a regular basis (my mother's sister died of it, a little earlier than that).

As Grumps said, I think we may have left the back door open.  It's a little parochial to consider only the incidence in the UK, given the 'global village'.  It suggests that the thinking is "well, if you want to travel to dirty johnny foreigner land (you traitorous fool), jolly well pay for your own vaccination"...

Fine IF you can get a TB jab. But if GP's, travel clincs won't supply jab, even if you want to pay for it your self. How are you going to get it?

 I do remember when I was at school, about a week or so before the jabs where due, you got a 'test' with this 'ring thing with around 6 or so needles'. If you reacted in a certian way it meant you did't need a BCG, otherwise you got the jab.

 Maybe you could check with your GP if you can still get this test. Might put your mind at rest.

 As he is going to a country where Rabies is rife, I'd also get this, 3 jabs over 3 weeks. You will probably have to pay for this, if it's the same as NI. I got mine 3yrs ago, cost £120, don't know what it is now.

Don't rely on that rabies jab, Huskyman. When I got one a few years back I was told it only delays onset to give you time to get treatment.

TB jabs - I've found a London clinic prepared to give them for a very large wad of dosh. So I find myself with the same choice the NHS decision maker has - does the risk involved justify the outlay of money? But with a personal interest in the matter. And I'm still following leads for a more affordable, more local, alternative. Such procrastination  means I probably won't be going up to Harley St any time soon. Hmmm.

Grumps, I was told the same thing, re. Rabies jab. but gives you an amount of time to get medical help. Around 2wks IIRC,

 If you do get bitten or scratched by a rabid animal, you could be dead with in a week. Depending on how far animal is into infection.

 To me, it's worth the expense, as gives you time to get to medical treatment.It's a bit like Maliarla, even taking the drugs to prevent it, with the new strains going around you can still get it.

 The jabs/drugs are not totally effective, but they help you to get to medical help. 

Just paid for my daughter to have a rabies jab - she is off to Equador.  Without it, you need to get medical attention inside 24 hours and need immunoglobulin (so I have been told). 

Immunoglobulin is in short supply worldwide.....

with it, a two week grace and you dont need immunoglobulin.