Epidemiology of Tuberculosis in France in 2015. Impact of the suspension of mandatory BCG vaccination on childhood tuberculosis, 2007–2015.
Introduction: France, where tuberculosis-related morbidity and mortality have declined significantly, is considered a country with low endemicity. BCG vaccination of children is one of the means of preventing the disease. In 2006, the multipuncture vaccine was replaced by the intradermal BCG vaccine, and in 2007, mandatory vaccination was replaced by a recommendation to vaccinate children most at risk of tuberculosis. We present data on reported cases of active tuberculosis in France in 2015, focusing on children born after 2006 to assess the impact of changes in vaccination protocols on the incidence of childhood tuberculosis. Results: The number of active tuberculosis cases reported in France in 2015 was 4,741, including 3,422 cases with pulmonary involvement, representing rates of 7.1 cases per 105 inhabitants and 5.1 per 105 for pulmonary forms. Children under 5 years of age accounted for 2.5% of reported cases (n=121), representing a reporting rate of 3.1 per 105. The highest reporting rates of the disease were observed in three regions (Mayotte: 25.9 per 105, French Guiana: 18.3/105, and Île-de-France: 14.5/105), as well as among certain specific populations: homeless individuals (166.8/105), incarcerated individuals (91.3/105), and individuals born abroad (35.1/105). The annual number of active tuberculosis cases among children born after 2006 decreased in Île-de-France and increased in metropolitan France outside Île-de-France. The number of severe tuberculosis cases among children born after 2006 averaged 2.2 cases of meningitis and 1.3 cases of miliary tuberculosis per year between 2007 and 2015. Conclusion: these data show a continued decline in the number of reported tuberculosis cases in France. Data on children do not indicate any impact of the new BCG vaccination protocols beyond what was expected. However, it is important to continue closely monitoring trends in tuberculosis incidence, particularly among younger generations of children, especially given the current concerns arising from uncertainties regarding the supply of the BCG vaccine.
Author(s): Guthmann JP, Ait Belghiti F, Levy Bruhl D
Publishing year: 2017
Pages: 116-26
Weekly Epidemiological Bulletin, 2017, n° 7, p. 116-26
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