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Slide 170 Interventions for Tuberculosis Control and Elimination
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is it possible to reconcile all these observation in a simple manner? It is if we hypothesize based on these observations that a primary infection is usually mild and often self-limiting but it primes the immune system in such a way that it remembers it for some ten years and during this time it can, but must not necessarily do so, provide protection against a first infection (in the case of BCG vaccination) or re-infection with M tuberculosis. Conversely, a second infection can lead to an enhance tissue-destroying hypersensitivity reaction and cavitary disease.

it is thus also conceivable that where BCG vaccination does not protect, it results in a more extensive and damaging manifestation of tuberculosis. And indeed, there are indications and reports from the past that this may indeed be the case.

   
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Last update: September 29, 2010