KUALA LUMPUR, March 23 — “Why do people still get tuberculosis (TB) even though they had the BCG vaccine? I guess herd immunity isn’t real.”
This is among the misinformation spread by anti-vaccine proponents that has Dr Megat Mohamad Amirul Amzar Megat Hashim slapping his forehead – several times – by his account.
“The BCG (Bacille Calmette–Guérin) vaccine is a vaccine used against Mycobacterium tuberculosis. It protects us against tuberculous meningitis, an inflammation of membranes around the brain or spinal cord.
“However, it doesn’t prevent us from getting pulmonary tuberculosis – the kind that infects the lungs,” he told Bernama in an interview.
Better known as Dr Amirul Amzar, the Medical Mythbusters Malaysia’s Vaccination Campaign Strategic Planning exco said that it was crucial not to underestimate the importance of BCG jabs, especially when it comes to babies and children.
“Fifty-percent of babies who contract tuberculous meningitis will end up with a permanent disability, while 20 per cent will die despite getting treatment,” he revealed.
That means one in five babies will die, and one in two will be disabled. These are some grim statistics, and certainly, one that should not be taken lightly.
Although the protection from the BCG vaccine may wane off as children grow into adults, it was rare for adults to die of TB, he said. Death among adults who contract TB is usually due to other underlying problems, such as compromised immunity.
“It’s very rare for healthy adults to contract TB meningitis, and those who do usually are usually immuno-compromised – they may have AIDS or uncontrolled diabetes. Even then, the rate of recovery among healthy adults with TB meningitis is higher than that of babies.
“Adults who get pulmonary TB, meanwhile, can even recover fully from it with a proper regime of treatment,” he explained.
Aside from misinformation spread by anti-vaxxers, he said, those in rural areas also tend to delay in getting treatment for TB as they usually mistake TB symptoms for “mystical diseases”.
Rural folks tend to attribute symptoms like coughing up blood, losing weight and poor appetite to acts of black magic such as santau. So instead of going to the hospital, patients and their families would seek the help of bomoh (Malay shaman) or witch doctors, said Dr Amirul Amzar.
“They lose precious time that could have been used to get treatment for early symptoms of TB at government clinics and hospitals.
“To make it worse, the patient who is unaware of their condition would move about freely while ill and infect others, causing a spread of the disease within the community,” he said.
The situation would have been a lot different had the patient sought early treatment at the hospital.
Upon diagnosing a patient with pulmonary TB, the first thing a doctor would do is advise the patient to undergo a minimum quarantine period of 14 days. At the same time, the patient’s symptoms and condition would be recorded and contact tracing would be carried out.
“We would have been able to not only provide early treatment for the patient but prevent them from becoming an agent of transmission for the disease in their community,” he said.
Dr Amirul Amzar said that TB due to M. tuberculosis is spread via air particles and is among the oldest infectious disease in Malaysia.
TB does not only affect the lungs, brain and spinal cord. It also affects other sites within the body such as the lymph nodes, nervous system, and gut.
Health Ministry statistics for the years 2015 through 2020 reveal that six people die of TB every day while 66 others become infected with it.
Dr Amirul Amzar said one of the factors contributing to the rise of TB cases in the country is that foreign workers tend to get infected with the disease but refuse to seek treatment. This is perhaps due to the misperception that the cost of getting treatment for it would be exorbitant.
This is simply not true, because treatment for infectious diseases such as TB is free for everyone in Malaysia, as per the Prevention and Control of Infectious Diseases Act 1988, he said.
He hoped that this year’s observation of World Tuberculosis Day on March 24 would bring a renewed sense of appreciation of the importance of the BCG vaccine, as well as its role in lowering infant mortality.
— Bernama
