An outbreak of severe BCG axillary lymphadenitis in Saint Lucia, 1982-83

ABSTRACT

An epidemic of BCG auxillary lymphadenitis affected at least 37 children, primarily infants, in Saint Lucia in late 1982 and early 1983. Eleven infants had spontaneous rupture or required incision and drainage of supportive lymph nodes. Cases developed auxillary lymphadenitis from 1-22 weeks after immuniazation with Connaught BCG vacine, first introduced into the country in September, 1982. No single factor could be reliably implicated as the sole cause of the epidemic. More potent BCG vaccines, such as the Connaught product, give better protection but more reactions than weaker BCG vaccines and may reduce patient compliance with the Expanded Programme on Immunization in general. Those in BCG programmes should be alert to adverse reactions and scrupulous in storing, reconstituting, and administering the correct dose of BCG vaccine intradermally. Keeping good vaccination records and vials of each lot of vaccine used can help to determine whether epidemics of adverse reactions are occuring and what their cause might be. (AU)