1935. Leiden: Brill. While Chinese institutions in occupied territory continued their work under dramatically altered circumstances, the Japanese occupation regime made medical interventions of its own. In Austria with January 1st 1990 the routineously vaccinations of the newborns was stopped, and since this date only special indications for BCG-vaccination are recommended (high risk of Tbc-infection). “Xiyi chuan ru zhongguo: jiehebing anli yanqiu (1900–1967)” 西医传入中国：结核病案例研究 (1900–1967) [The transmission of Western medicine to China: The case study of tuberculosis (1900–1967)]. This is why it's used for intravesical therapy. So the danger of routineously made BCG-vaccinations in newborns got higher than the risk of Tbc-infections. "Danger in the Air: Tuberculosis Control and BCG Vaccination in the Republic of China, 1930–1949." Plague, smallpox, cholera, and malaria were endemic to the subtropical southwest, and their transmission was all the swifter in the context of wartime migrations and poverty. [3] Imamura claimed that the BCG vaccine was not very effective in terms of prevention, so it would be important to combine getting the vaccine with careful maintenance of personal and environmental hygiene. Bretelle-Establet, Florence. Cell Host Microbe. The immunity produced by contracting tuberculosis was not strong, and reinfection was relatively easy, so a vaccine—which generally worked by introducing the disease pathogen in an attenuated form to the body—would not be very strong, either. “Tuberculosis Control in Shanghai: Bringing Health to the Masses, 1928–Present.” In Medical Transitions in Twentieth-Century China, edited by Bridie Andrews and Mary Brown Bullock, 126–145. Tuberculosis typically spreads when one inhales an infected droplet that a tubercular person has exhaled. NLM You may report them to the FDA. BCG into the bladder. The framing of tuberculosis as a chronic, social, familial disease clashed with the financial and epidemiological priorities of the Republican government, even after the Nationalist Party rose to power in 1927 and established a Ministry of Health in 1928 that sought to expand and modernize medical administration in China. | BCG-sepsis. Qiao pointed out that mass immunization would cost “but an infinitesimal fraction of the millions of dollars it costs to run sanatoria [sic]” (Qiao 1948, 568). In 1948—the year the First International BCG Congress was held, in Paris—the success of this program led the nascent United Nations International Children Emergency Fund (UNICEF) and the World Health Organization (WHO) to fund a joint pan-European enterprise (Plotkin, Orenstein, and Offit 2012, 797; Comstock 1994, 528–529). Although the outbreak of the Second Sino-Japanese War (1937–1945) presented an obstacle to BCG research and development, it also provided new opportunities for members of China’s biomedical research community—many of whom had moved with the Nationalist government to the nation’s western hinterlands—to learn about new methods of producing vaccines and study methods of epidemic control. This ambiguity presented difficulties for the authors and translators of texts about tuberculosis in China, since the BCG vaccine was often discussed in the context of injected bacterial preparations that could prevent or treat disease. Oxford: Clarendon Press. All rights reserved. In 1933, the physician and researcher Wang Liang succeeded in a second transfer of the BCG strain, this time to Chongqing from Paris. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Get the latest research from NIH: https://www.nih.gov/coronavirus. NIH However, after its establishment in 1911, the Republican government did not prioritize tuberculosis in its epidemic control policies, focusing its efforts instead on programs that sought to control smallpox, cholera, plague, and other fading chuanranbing 法定傳染病 (notifiable infectious diseases) that caused swift-moving, devastating epidemics. This attention to means of employing vaccines in China’s distant borderlands likely reflected the experiences of microbiologists in the wartime hinterland, and indicated that microbiologists like Qiao were now thinking about vaccination on a national scale. On December 28, 1908, in the French city of Lille, physician Albert Calmette and veterinarian Camille Guérin announced that they had developed a weakened form of the tubercle bacillus (Gheorgiu 2011, 47–49; Plotkin, Orenstein, and Offit 2012, 797). | While some physicians were reading translated texts about BCG and discussing the new vaccine in the pages of journals and books, others sought to begin producing the vaccine domestically. During the early twentieth century, a host of epidemic diseases presented a crisis for the nascent Republic of China. Yet although the bureau occasionally produced a small amount of tuberculin, probably for diagnostic use (“Biao san” 1939, 18), it did not attempt to manufacture BCG vaccines during its extensive wartime work, instead focusing on producing immunizations for smallpox, plague, cholera, and typhoid fever. “Bacillus Calmette-Guérin (B.C.G.) “The Specificity and Sensitivity of the Tuberculin Reaction Following Vaccination with BCG.” American Journal of Hygiene 33, section B (2): 42–49. Brazelton, Mary Augusta. Non-specific Effects of Vaccines Illustrated Through the BCG Example: From Observations to Demonstrations. Cui Guchen. Prescribing Colonization: The Role of Medical Practices and Policies in Japan-Ruled Taiwan, 1895–1945. Heterologous effects of vaccination and trained immunity. Get the latest public health information from CDC: https://www.coronavirus.gov. Cambridge, MA: Harvard University Press. TB prevention and control would benefit from an improved method of BCG vaccination that simplifies logistics and eliminates dangers posed by hypodermic needles without compromising immunogenicity. There was a variety of biochemical preparations, many of which were loosely associated with the extract tuberculin and sought to use an attenuated form of the tubercle bacillus for therapeutic as well as preventive ends. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 United States License, Mary Augusta Brazelton, University of Cambridge. Indianapolis: Indiana University Press. Animal Experimentation and Prophylactic Immunization of Children: An Analysis and Critical Review.” American Journal of Public Health and the Nation’s Health 18 (7): 843–864. After the Second World War (1939–1945), the disease provoked a global crisis. “B.C.G. Shanghai: Shangwu yinshuguan. Zhu, Hengbi [H. P. Chu]. Bioinformatics for Vaccinology. doi: 10.1371/journal.ppat.1008969. Petroff, S. A., and Arnold Branch. In 1933, Wang carried the original BCG strain back to China from France, set up a small laboratory, and used it to immunize 248 children (He 2011, 117–118). It conducted epidemiological surveys and focused staffers’ efforts on diagnosis, quarantine, and disinfection (He 2011, 131–132). 2014. Throughout these transformations, and amid new outbreaks of infectious diseases, tuberculosis continued to present a major threat to the Chinese population. Hensel J, McAndrews KM, McGrail DJ, Dowlatshahi DP, LeBleu VS, Kalluri R. Sci Rep. 2020 Oct 27;10(1):18377. doi: 10.1038/s41598-020-75491-x. "Product Information. Flanagan KL, Best E, Crawford NW, Giles M, Koirala A, Macartney K, Russell F, Teh BW, Wen SC. Although Chinese researchers and physicians promoted the BCG vaccine domestically in medical journals and in popular media, actual immunization rates remained very low between 1945 and 1949, and exact figures remain elusive. 1948. Even if BCG vaccine is shown to be effective, that’s no reason to stockpile. Usually you have BCG into the bladder if you have a high risk of early bladder cancer coming back or spreading into the deeper layers of your bladder. They claimed that the global medical consensus on the vaccine was not clear and indicated that its identity as an immunization was not stable; it coexisted alongside a variety of other similar xizhuang ji 菌裝劑 (bacterial preparations) used for therapeutic as well as preventive purposes. Whereas most accounts of the introduction of BCG to China focus on the rapid expansion of immunization programs under the People’s Republic in the early 1950s, physicians and researchers working for the Nationalist administration actually laid the groundwork for these programs well before 1949. A year later, Shumin Qiao, at National Lanzhou University, also advocated for widespread BCG use. Cerner Multum, Inc. "UK Summary of Product Characteristics." Background: They took the United States, rather than Japan, as a model of immunization practice, and they participated in transnational anti-tuberculosis health programs. The dry vaccine was not as fresh, nor as effective, as the vaccine prepared in suspension, but to Qiao, its capacity for long-term storage was worth the trade-off. We review evidence for non-specific protection induced by BCG vaccination against viral infections, discuss possible mechanisms of action, and summarize implications for vaccination policies and vaccine discovery. The International Tuberculosis Campaign established an International Tuberculosis College to train epidemiologists, physicians, and laboratory staff; a research unit to evaluate data collected by fieldworkers; and field units that distributed BCG vaccines from laboratories in Denmark, Sweden, Paris, India, and Mexico. Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China. In July 1921, the pediatrician Benjamin Weill-Hallé successfully gave an oral vaccine using live, attenuated tubercles to a Parisian infant (Gheorgiu 2011, 50; Liu et al. https://cross-currents.berkeley.edu/e-journal/issue-30/brazelton. Having seen news of BCG in French medical literature, in 1931 he arranged to undertake research in Calmette’s laboratory at the Pasteur Institute. Barnes, Nicole Elizabeth. By identifying the factors that impact the non-specific effects of BCG, we will take an important step towards novel therapeutic options and vaccination strategies, which might lead to a reduction in severe morbidity and mortality associated with viral infections. 2018 Aug;13(10):1193-1208. doi: 10.2217/fmb-2018-0026. By 1948, it had distributed 7,500 BCG vaccines in Shanghai (Chen, Wei, and Zhu 1982, 437). 1935. Because the tubercle bacillus reproduces slowly, it is possible for infected persons to become disease vectors without displaying any obvious symptoms or realizing the extent of their illness. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. He refers to scholarship by American biologist Joseph Aronson promoting the BCG vaccine in the United States on the basis of experiments distributing it in Native American communities (Aronson, Parr, and Saylor 1941; Aronson and Palmer 1946; Aronson 1948). More tuberculosis, more poverty!” Wu stressed the effectiveness of the vaccine, commenting, “BCG vaccine, as an immunological agent used in conjunction with general measures of socio-economic improvements, will greatly hasten the process and bring tuberculosis under control much faster” (Wu 1947, 383). 1999. The most common side effects include fever, headache and swollen glands. After the Second Sino-Japanese War, as Nationalist and Communist forces lurched toward a renewal of civil war, physicians and medical researchers promoted BCG vaccination as an effective, cost-efficient means of preventing tuberculosis transmission that could save China from economic ruin. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Although the campaign originally earmarked $500,000 for work in China, it ultimately spent only $27,191 there—yet most of this sum went toward a donation of laboratory equipment for production of BCG, in a departure from typical spending patterns on non-European countries that participated in the campaign (International Tuberculosis Campaign 1951, 19, 30–32). 2020 Oct 16;11:586984. doi: 10.3389/fimmu.2020.586984. Indeed, concerns about treating and preventing tuberculosis were not limited to China during this period. Brimnes, Neil. “Medical Education during the Anti-Aggression War.” Chinese Medical Journal 64 (1–2): 17–23. Progress and Pitfalls in the Quest for Effective SARS-CoV-2 (COVID-19) Vaccines. Most children develop a sore at the injection site. After Japan’s surrender, in the tumultuous later years of the Chinese Civil War (1945–1949), health administrators began to plan the implementation of BCG vaccination on a large scale in China for the first time. NLM During the war, Japan’s Meiji government assumed a strong role in developing programs to control tuberculosis (Johnston 1995). In the last two decades the incidence of tuberculosis in Austria has lowered very dramatically. Other side effects include: arthralgia. 3. 疫苗接種的效果 [The effectiveness of BCG vaccination]. A survey of medical research and writing shows that Chinese researchers and physicians participated actively in global efforts to promote the BCG vaccine in the immediate postwar era, when the disease swept Europe. If efforts to control tuberculosis in China during the Republican period were largely characterized by official neglect and professional concern, then the emergence of the BCG vaccine for the disease changed this calculus. Recently, the effect of BCG on an experimental viral infection in humans has been demonstrated. Feijiehe zheng zaifa zhi yufang 肺結核症再發之預防 [Prevention of the reoccurrence of tuberculosis]. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Aronson, Joseph D., Erma I. Parr, and Robert M. Saylor. 1941. The Second Sino-Japanese War (1937–1945) interrupted these efforts, but the war was not a simple obstacle to research and development. He proposed the use of the National Vaccine and Serum Institute (formerly the National Epidemic Prevention Bureau until it was renamed in January 1946) as the first site for BCG vaccine production, and the establishment of a center for training technical personnel in production methods, followed by mobile laboratory units that could help distribute the vaccine in China’s interior. This opinion supported the view that only social change over long periods of time could adequately control tuberculosis. Beiping: Tianran liaoyangyuan. eCollection 2020. The outbreak of formal war with Japan in 1937 initially disrupted, but ultimately facilitated, efforts to introduce BCG. The most common side effects include fever, headache and swollen glands. 2012. The vaccine itself proved difficult to produce and implement, but its promotion reflected the transformations that war had wrought in China’s public health system, as well as the particular meaning that physicians gave to the economic implications of the tuberculosis crisis and their engagement with global networks of bacteriology. The quantity of purulent lymphadenitis is dependent from the vaccine-type; "normal" vaccines cause 0.3%, the BCG-Pasteur Intradermal P-Vaccine caused 7.5%! It was in this context of a bankrupt state that scientists, physicians, and members of the public turned to the belief that BCG vaccination could save public health and, by extension, the Chinese economy. The Lübeck incident also shaped Chinese attitudes to the BCG vaccine. ], and Chengzhou Guo [C. C. Kouo]. N.p. BCG has been one of the most successful immunotherapies. “The BCG Story: Lessons from the Past and Implications for the Future.” Reviews of Infectious Diseases 2, supplement 2: S353–359. 2000. “If BCG was not effective, it would have been abandoned a long time ago,” he claimed, “and would not have reached a point today where American scholars plan to establish manufacturing offices to produce the vaccine for American children” (Wang 1948, 15). The complex technical requirements of BCG demanded special consideration in planning for its production on a large scale, and authors’ willingness to consider these issues indicated their commitment to the project, as well as their wartime experiences in setting up large-scale immunization programs. 2009, 70; Fine 1989, S353). Heterologous effects of infant BCG vaccination: potential mechanisms of immunity. When UNICEF deliberated over the funding and nature of the campaign in March 1948, it was China that formally proposed to extend the work from Europe (as it had originally been conceived) to activities in Asia, Latin America, and Africa (Brimnes 2007, 411). Copenhagen: Dyva and Jeppesens Bogtrykkeri. It also established treatment facilities and sanatoriums outside urban areas, focusing its efforts on Shanghai, where a branch of the organization was established in October 1938 (Core 2014, 129). Shanghai: Heji yinshuguan. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Under Japanese occupation, Shanghai, previously the epicenter of anti-tuberculosis work, saw a substantial rise in infection rates as refugees flooded into the region and air raids destroyed sanatoriums and clinics. Serious side effects from the BCG vaccine, such as a serious allergic reaction (anaphylactic reaction), are very rare. Even if BCG vaccine is shown to be effective, that’s no reason to stockpile. [Comparative evaluation of the effectiveness of vaccination of newborn infants with BCG and BCG-M vaccines]. See below for a comprehensive list of adverse effects. 1982. 1939. “Lun BCG fanglao yimiao zhi xiaoyong” 論BCG防癆疫苗之效用 – [Discussion of the efficacy of the BCG vaccine]. This work was centered chiefly, but not exclusively, in Kunming, where the National Epidemic Prevention Bureau (Zhongyang fangyi chu)—the chief governmental agency that took responsibility for manufacturing biological products in China—made its wartime headquarters. Saving Lives in Wartime China: How Medical Reformers Built Modern Healthcare Systems Amid War and Epidemics. 2011. Xin Chongqing 2 (1): 13–16. Because it was a disease with social causes, and not easily treatable or preventable, public health programs with limited resources did not target tuberculosis (Lei 2010, 251–254).