Пн, 10 окт 2016 Автор: педиатр МарияViktorova
Tuberculosis is a common severe infectious disease.
a disease in which the lungs are primarily affected, less often –
other organs and systems.
Russia is among the countries with the highest level
incidence of tuberculosis.
Поэтому, согласно национальному календарю atвивок, BCG at
the absence of contraindications is made to all newborns in
mandatory before discharge from the maternity hospital.
Contents
Стоит ли делать atвивку BCG новорождённому? How to
do?
This question concerns all parents.
Many fear that vaccination at such an early age may
lead to undesirable reactions. Вакцина BCG – это смесь
several types of live attenuated pathogens of tuberculosis, she
has been used in our country since 1921, that is, for a long time and,
therefore well studied. Реакции после atвивки BCG у
newborns arise for two reasons: due to improper
injection and vaccination techniques without consideration of contraindications. Healthy
children vaccination is fairly easy. It is believed that
the immune system of newborns is fully prepared to form
adequate response.
Another argument against vaccination is the belief that
the kid has nowhere to become infected with tuberculosis. However, it is believed that about
one third of the total population of our planet is infected with tuberculosis
stick, but only 10% of them develop signs of the disease.
Tuberculosis is an insidious disease, its typical manifestations are
like coughing and hemoptysis, do not appear immediately. Therefore many
people may not know at first that they are sick when they infect
this around. The causative agent of tuberculosis is quite stable in
environment. Therefore, places where a child can pick up
infection, not small: common entrance, elevator, clinic, where it can
come somebody’s sick relative. In recent years, tuberculosis
ceased to be a lot of alcoholics, drug addicts, those who returned from
places of imprisonment. Increasingly cases are recorded among quite
prosperous people: young, working, family men and
women
Information about harmful components allegedly included in the vaccine,
who actively spread on the Internet by opponents
vaccination, do not have any documentary evidence.
Следует знать, что atвивка не гарантирует
absolute protection against disease. Currently mycobacterium
acquired new properties, become more stable in the external environment
and drugs.
So why vaccinate if there is still a risk
get sick? Tuberculosis is dangerous for young children high
likelihood of the development of deadly forms: tubercular
meningitis (lesion of the meninges) and disseminated
(common) lesions of the lungs. Kids who were
сделана atвивка BCG, они к счастью, не встречаются.
Currently, scientists are developing a new, more
an effective vaccine option for this dangerous disease.
Когда нельзя делать atвивку BCG новорождённым?
Противопоказано проводить вакцинацию BCG:
• children, than birth weight was less than 2.5 kg;
• children born to women infected with HIV;
• children whose mothers had primary or secondary immunodeficiency
another reason;
• with intrauterine infection in the newborn;
• for moderate to severe hemolytic disease;
• with birth injuries with brain damage;
• with common pustular lesions of the skin;
• if there are people with tuberculosis in the child’s environment;
• if genetic diseases are detected (different fermentopathies,
Down’s disease);
• если есть сведения об осложнениях после вакцинации BCG у
close relatives (parents, brothers, sisters).
Children weighing from 2 to 2.5 kg put a lightweight version of vaccinations
BCG — BCG-М, в котором содержится половинная доза вакцины. With
Lower weight vaccination in the hospital do not.
Кроме родильного дома atвивку BCG новорождённому могут сделать
in the vaccination room of the children’s clinic (as a rule, for this
allocated a separate day of the week) or in the tuberculosis
dispensary. Mothers need to know that in private medical centers
vaccination against tuberculosis is not carried out.
Если atвивка BCG не сделана в роддоме в положенный срок, детям
older than two months later in the future before it is required
Mantoux reaction is put in order to diagnose the possible
TB infections. If this test is positive, the baby is already
успел где-то встретиться с микобактериями и тогда BCG ему не
is done.
For vaccination in the clinic to the list of contraindications
are added:
• any acute illness;
• oncology, radiation therapy;
• diseases requiring immunosuppressants.
At the age of 7, the issue of
необходимости ревакцинации BCG, которая проводится в случае
negative Mantoux reaction.
How to делать atвивку BCG новорождённым?
Withвивку BCG atнято проводить на 3-5 день жизни всем детям at
no apparent contraindications. Вакцина BCG водится в наружную
surface of the left shoulder, strictly inside the skin. Erroneous subcutaneous
или внутримышечное введение неизбежно atведёт к развитию
complications. Therefore, it is important to know exactly how to do it.
atвивку BCG новорождённым. The injection site is the middle and
upper third of the shoulder. Для вакцинации используют одноразовый шatц и
short needle with an oblique cut.
Immediately after the injection, a small bump of white is inflated on the skin.
colors that fade after a few hours. At the injection site in
for two or three days there may be a slight redness, even
suppuration, which then must also disappear (in a week).
It is important to know. Что BCG нельзя делать одновременно
с другими atвивками, поэтому в роддоме сначала проводится
иммунизация против гепатита В, и только после этого BCG.
Между проведением BCG и любой другой следующей atвивкой должен
pass a period of at least 30 days.
Нормальная реакция на atвивку BCG у новорождённых
After vaccination may increase the temperature to subfebrile
values. Такая реакция после atвивки BCG у новорождённых бывает
rarely enough. In any case, given the imperfection
mechanisms of thermoregulation in babies up to a year, link
subfebrile vaccination would not be entirely correct.
Реакция после atвивки возникает только через полтора — два
month and refers to deferred. It can manifest itself in different ways:
in the form of a small seal, red bubble, pustule,
crusted, or speck dark blue or even
Brown color. All these manifestations are considered completely
normal and should not cause concern to parents. Organism
reacts to pathogens of tuberculosis, forming immunity.
Корочка может периодически отпадать, наatмер, во время купания,
and form again. Do not handle an abscess
antiseptic, smeared with brilliant green or iodine. It may
disrupt the normal post-vaccination process. Can not squeeze
pus. If it flows out on its own, get wet enough
his sterile napkin. Место atвивки можно мочить, но нельзя
to rub.
Withмерно через 4 — 6 месяцев место atвивки заживает, корочка
finally disappears, and a small white scar is formed,
no larger than a centimeter. Its final formation
ends by the year. Subsequently, if medical
документы, взглянув на него, можно будет понять, atвит ли малыш
BCG или нет. In some children, a scar does not form, which
свидетельствует о неэффективности atвивки BCG. However there is
группа людей (их около 2%) с врожденной невосatимчивостью к
mycobacteria.
Какие реакции на atвивку BCG у новорожденных считают
pathological?
После любой профилактической atвивки могут возникнуть
нежелательные реакции и осложнения, и BCG к сожалению не является в
this plan is an exception. К осложнениям после atвивки относят
conditions requiring special treatment.
With появлении вокруг гнойничка отёка и покраснения кожи
parents need to consult a TB specialist, so
how this condition, although not related to complications, requires
doctor’s observations.
Complications are:
1. Холодные абсцессы — возникают, если atвивка BCG
the newborn was not done correctly, and the drug fell under
skin A typical period of their appearance is considered 1-1.5 months after
vaccination. They require surgical treatment, although they can open up and
on their own.
2. Инфильтраты — atчиной их развития заключается в
individual characteristics when the body reacts too violently
on the introduction of the pathogen or as the vaccine itself.
3. Extensive ulcer on the injection site. Возникает по тем же atчинам,
that and infiltrate.
4. Lymphadenitis – inflammation of the lymph nodes on the left,
развиваются at распространении инфекции из кожи. With значительном
increasing the site may require the help of a surgeon
5. Keloid scar formation is a gross skin change.
red color at the injection site; susceptibility to keloidosis
programmed at the genetic level
6. BCG-инфекция (или BCGит) — это самое тяжёлое осложнение,
which can be fatal. Tuberculosis,
developed due to the introduction of pathogens into the body. Is encountered
крайне редко и только at иммунодефицитных состояниях.
7. Постatвивочный синдром – относится к категории поздних
complications, and manifests itself in the form of various skin rashes.
8. Tuberculosis osteitis – damage to the bones of tuberculosis
process.
Сведения о любой неблагоatятной реакции заносятся в медицинскую
baby card and are a contraindication for later
ревакцинации BCG.
Most complications occur in the first six months after
atвивки.
In any case, the final decision for the parents.
Информированное согласие на проведение atвивок или отказ от них в
future mom signs a maternity hospital back in the women’s
counseling, so before giving birth she has time to think and weigh
все за и против и atнять правильное решение.
