BCG should be available through the

Nassau County Department of Health.
safe, effective and inexpensive. every that government officials and healthcare wonks hate.
see eg faustmanlab.org and pubmed.org faustman dl

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Professor Nigel Curtis Professor of Paediatric Infectious Diseases Postgraduate Co-ordinator and Chair of Graduate Research Degree Committee Department of Paediatrics, The University of Melbourne www.paediatrics.unimelb.edu.au Head of Infectious Diseases Unit Department of General Medicine The Royal Children's Hospital Melbourne www.rch.org.au/infectious_diseases Joint Leader Infectious Diseases & Microbiology Group Infection, Immunity & Environment Theme Murdoch Childrens Research Institute www.mcri.edu.au/pages/research/research-group.asp?G=34 PAGE CONTENT : 1. Overview | 2. Current research | 3. Research team | 4. Publications | 5. Other information | 6. Contact details Current Research A) BCG immunisation and the immune response 1 Susceptibility of BCG vaccine strains to antituberculous antibiotics The Bacille Calmette-Guérin (BCG) vaccine is the most commonly administered vaccine worldwide. Complications associated with the vaccine are rare, but are increasingly reported in immunocompromised children. Previously, little data existed regarding the susceptibility of different BCG strains to antibiotics. In this study we determined the susceptibility of five genetically distinct strains to twelve anti-tuberculous drugs, showing that the susceptibility patterns vary between different BCG vaccine strains. Project led by Dr Nicole Ritz and Prof Nigel Curtis. Publication: Susceptibility of Mycobacterium bovis BCG vaccine strains to antituberculous antibiotics. 2 Influence of BCG vaccine strain on the immune response and protection against tuberculosis The Bacille Calmette-Guérin (BCG) vaccine is the only currently available vaccine to protect against tuberculosis (TB). As a result of its development, several different vaccine strains are used worldwide. Animal and limited human data suggests that the particular BCG strain used influences the immune response to the vaccine and thereby efficacy of protection against TB. We are currently conducting a NHMRC funded randomised study, comparing the immune response of infants immunised with three different BCG vaccine strains (http://www.anzctr.org.au/trial_view.aspx?ACTRN=12608000227392). We aim to determine which of these commonly used BCG vaccine strains provides the best protection against TB. Project led by Dr Nicole Ritz and Prof Nigel Curtis. Publication: Influence of BCG vaccine strain on the immune response and protection against tuberculosis. 3 Comparison of the immune response to BCG in children and adults The Bacille Calmette-Guérin (BCG) vaccine protects children against disseminated forms of tuberculosis (TB) but has much lower efficacy for protection against pulmonary disease in adults. One possible explanation is that in adults the immune response to BCG immunisation is less protective. By analysing the cellular immune response and corresponding cytokine profiles in children and adults after BCG immunisation, we aim to identify whether there are significant differences the immune response induced by BCG vaccine at different ages.Project led by Dr Nicole Ritz and Prof Nigel Curtis. 4 Non-specific effects of BCG immunisation The Bacille Calmette-Guérin (BCG) vaccine is primarily given to protect against tuberculosis (TB). However, studies show that children who have been immunised with BCG vaccine also have a lower mortality related to diseases other than TB. We are investigating how BCG immunisation influences the immune response to routine childhood immunisations given in the first year of life. B) Tuberculosis in children 1 Comparison of commercial interferon gamma releases assays in children Tuberculosis (TB) accounts for significant morbidity and mortality in children worldwide. The diagnosis of childhood TB remains challenging as signs and symptoms are often non-specific and cultures for the causative agent, Mycobacterium tuberculosis, often remain negative. The recently launched global plan to Stop TB 2006-2015 highlights the need for accurate, simple and low cost diagnostic tests for the detection of TB.  Previously, the century old tuberculin skin test was the only diagnostic test available for the detection of latent TB (a ‘dormant’ stage of the disease). Recently, new immunodiagnostic tests, interferon-gamma release assays (IGRA), based on the in vitro T cell responses to M. tuberculosis-specific antigens, have become available. These blood tests appear to perform well in adults but our studies suggest they may be less reliable in children. We have compared the performance of commercially available IGRA with the tuberculin skin test for the diagnosis of TB in at risk children and found significant discordance between the results of TST and IGRA (predominantly TST positive/IGRA negative). Project led by Dr Tom Connell and Prof Nigel Curtis. Publications: A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children. Performance of a whole blood interferon gamma assay for detecting latent infection with Mycobacterium tuberculosis in children. QuantiFERON-TB Gold: state of the art for the diagnosis of tuberculosis infection? Early detection of perinatal tuberculosis using a whole blood interferon-gamma release assay. 2 Improving the diagnosis of tuberculosis in children Based on the results of our previous studies, we are currently exploring the immunological basis for discordance between TST and IGRA and the and the potential benefit of measuring additional immunological parameters to improve the performance of immunoassays for the diagnosis of TB in children. Project led by Dr Marc Tebruegge and Prof Nigel Curtis 3 Breath analysis and electronic nose system for the diagnosis of tuberculosis We are investigating the use of a novel electronic nose to detect volatile organic compounds produced by M. tuberculosis. Project led by Dr Marc Tebruegge and Prof Nigel Curtis. 4 Epidemiology of childhood tuberculosis in Victoria 5 Tuberculosis contact tracing in children in Victoria top of page Research Team Prof Nigel Curtis 9345 6366 rncurtis@ unimelb.edu.au Dr Penelope Bryant 9345 5522 penelope.bryant@ rch.org.au Dr Vanessa Clifford 9356 4990 vanessa.clifford@rch.org.au Dr Tom Connell 9345 4857 tom.connell@ rch.org.au Mr Ben Forbes 9345 6664 ben.forbes@ mcri.ed.au Ms Susie Germano 9345 6664 sgermano@ unimelb.edu.au Mr Milton Mui 9345 6664 m.mui@ugrad.unimelb.edu.au Ms Clare Oates 9345 6664 clare.oates@ mcri.edu.au Dr Frances Oppedisano 9345 6664 frances.oppedisano@ mcri.edu.au Dr Nicole Ritz 9345 4990 nicole.ritz@ rch.org.au Dr Marc Tebruegge 9345 4857 marc.tebruegge@ rch.org.au Dr Christel Zufferey 9345 4990 christel.zufferey@ mcri.edu.au Please also see - http://www.mcri.edu.au/pages/research/research-group-team.asp?G=34   Publications List of Publications top of page Contact information 4th Floor Front Building Department of Paediatics Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne Royal Children's Hospital Melbourne Flemington Road Parkville Victoria 3052 Australia tel: +61 3 9345 6366 fax: +61 3 9345 6667 email: rncurtis@ unimelb.edu.au web: www.paediatrics.unimelb.edu.au top of page