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Man has always had to protect himself
against numerous dangers,
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and enemies of all sorts.
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He used to be defenceless
against the invisible enemies
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that caused great epidemics
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wreaking havoc on humanity
throughout centuries.
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Then, his only protection
was isolating the sick.
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In the Middle Ages,
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lepers were excluded
from the community for life.
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Those with infections
were treated with caution.
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Doctors wore this strange outfit
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when caring for people with the plague.
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In the 19th century, scientists
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started exploring
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the infinitely small.
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They discovered parasites, germs,
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and viruses.
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This knowledge
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gave us an efficient weapon:
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vaccination.
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With this means of protection,
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dreadful diseases such as diphtheria,
smallpox, yellow fever
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have become rare.
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As will poliomyelitis, very soon.
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However, the danger remains.
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Swift epidemics
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are still to be feared.
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That's why vaccination
is still necessary.
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WHAT ABOUT TUBERCULOSIS?
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Tuberculosis
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is far from a rare disease.
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It is still responsible for the death
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of 3 million worldwide every year.
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In my own unit,
where we have about 100 beds,
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since January, we've admitted
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28 children with tuberculosis,
2 of which had meningitis.
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They were contaminated by people
who were unaware of their condition
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or by patients who didn't follow
their treatment properly,
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thus becoming
a potent source of contamination.
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These children wouldn't have got TB
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had they had the BCG vaccination.
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And yet, currently in France,
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less than one in two children
has this protection.
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One wonders why.
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- You need to sign this paper.
- Let me see.
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Another vaccination?
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So sorry to bother you.
I'm a little upset.
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Isabelle has just given me
this notification for the BCG vaccine.
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What do you think?
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BCG.
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We've discussed it a lot.
We should really make our minds.
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If we decided to have her vaccinated,
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the vaccine could tire her.
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Her friend, Catherine,
had the same vaccine,
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and had to go to the mountains.
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What do you think, for our daughter?
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But everyone doesn't agree on that.
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Many have been vaccinated
without incident.
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But there's still a risk and...
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Isabelle may never be vaccinated.
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It's the same for many children.
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Jean-Paul won't get the vaccine.
Nobody has TB at home.
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And tuberculosis isn't a danger anymore.
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Indeed,
the number of TB patients has declined.
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But don't forget that 40,000 patients
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enter a sanatorium each year.
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Tuberculosis is no longer as grim.
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Properly treated, it can be cured.
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But it always brings about
its share of hardships.
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At the beginning,
I couldn't see the problem.
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But then the doctor told me
that it's a very long disease,
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and that I had to stay in a sanatorium
for at least 6 months.
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So I began to realize
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that it would really change everything.
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First, for my family,
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my wife and I had never been apart
since our wedding.
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And suddenly, we were separated.
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Then, financially...
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I had a career, you know,
a career in the arts,
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but everything stopped overnight.
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I was isolated.
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Well, this has raised
major challenges for me.
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First,
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I was separated
from my very young daughter.
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And there was also the possibility
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that my husband had been contaminated.
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My husband is OK
but I've been separated
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from my daughter for a long time,
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and that's really hard.
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Here's the thing.
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I had a shop for 24 years.
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I'd just finished renovating it
thanks to a government-backed loan,
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which I hadn't paid off yet.
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I have 3 children.
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I had to stop working.
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My wife had to quit her job.
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It causes incredible problems.
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As my wife was seriously ill,
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the doctor said
we all had to have X-rays,
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all 4 children and me.
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Out of 4, 3 children were ill.
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We were all admitted to hospital.
We stayed there for 4 months.
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My wife and I went from hospital
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to a sanatorium for 6 months.
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After the children were discharged,
they spent 12 months in a preventorium.
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And so we see
that tuberculosis remains a great risk
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in our country,
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much more so
than in most European countries.
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In France, there are
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twice as many TB-related deaths
as in England,
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and 6 times as many as in Denmark.
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And yet,
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it was French scientists, Calmette
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and Guérin,
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who discovered the TB vaccine, BCG.
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It was first used in Paris in 1921.
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How does BCG work inside the body?
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To understand it, imagine
our organism is a new, empty house.
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BCG is like a good tenant
moving into this new, empty house.
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He leads a quiet life.
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He builds
a strong fence around his house,
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to stop the intrusion
of the tubercle bacillus.
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If the tubercle bacillus,
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aka Koch's bacillus, arrives,
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he finds the house occupied
and well protected.
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He won't be able to get in
because the place is already taken.
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However, if the tubercle bacillus
is the first to move into the new house,
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he behaves like a bad tenant,
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and causes untold damage to the house.
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These damages can be tiny
and invisible from the outside.
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But it's paramount to keep a close eye
on the bad tenant for a long time.
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The entry of the tubercle bacillus
into the body
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is called a primary infection.
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It enters most often through the trachea
and bronchial tubes,
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and settles in the lung.
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When a GP discovers a primary infection,
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he prescribes treatment
and monitors closely the infected child.
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At the next stage,
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the bad tenant causes
real damage to the house.
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Specialized workers
will have to repair it.
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In the body, the primary infection
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comes with lymph node involvement
and pulmonary lesions.
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The affected child
needs to go to a preventorium.
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Schooling is stopped,
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and family ties are severed.
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If the house is fragile
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and the tubercle bacillus
especially nasty,
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the damages are vast
and sometimes beyond repair.
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In the body,
the bacillus disseminates to all organs,
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the most serious outcome being
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tuberculous meningitis,
always dreadful,
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for it can cause
permanent after-effects.
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To prevent all this damage,
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it is crucial to put BCG
in empty houses fast,
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as the good tenant.
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But how can we know
whether the house is empty or occupied?
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To "knock on the door",
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a cutireaction
or any other TB test is performed.
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If the house is empty,
there is no response.
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The cutireaction is negative.
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If the house is occupied,
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either by the good tenant, BCG,
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or the bad tenant,
the tubercle bacillus,
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the tenant answers by showing his card.
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The cutireaction is positive.
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How do you "knock on the door"?
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How is the TB test done?
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The cutireaction is the best known
and most common test.
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A patch can also be used.
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But the best, most accurate,
most sensible test
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is the intradermal reaction.
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We read the tests after 3 days.
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Here are 2 tests.
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The first one is negative.
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The second one is positive.
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Here are 2 positive tests,
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one after BCG,
the other without BCG.
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In the first case, all is well.
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The vaccine is working,
the subject is protected.
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In the second case,
this boy was to be vaccinated,
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his test was negative 3 months ago.
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The intradermal is positive now.
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He's come in contact
with Koch's bacillus,
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the skin test is positive,
he needs to see his doctor.
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Although we have similar results,
these are very different cases.
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There's no ambiguity whatsoever.
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In the first case, we know
the subject has been vaccinated.
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In the second case,
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we know he hasn't.
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The reading of a negative test
is followed by the BCG vaccination.
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It is usually done intradermally,
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on the inner side of the arm
or on the hip.
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Scarification can also be used.
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After vaccination,
a vaccine reaction appears.
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It proves that the vaccine is working,
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that the vaccination is successful.
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It fades within 6 to 8 weeks,
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leaving a small scar.
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BCG doesn't tire children.
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No need to take any special precaution
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after vaccination.
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The vaccinated child
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can lead a normal life.
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Vaccination-induced protection
diminishes with time.
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Protection is demonstrated
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by the positive response to the TB test.
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When the response is negative again,
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a booster shot needs to be given,
as with all other vaccines.
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TheAcadémie de médecine
recommends
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vaccinating children
in their first months.
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At any rate,
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children need to be vaccinated
by the age of 6,
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either by their GP,
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or at a vaccination centre,
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or at school.
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Vaccination squads
travel to rural schools.
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Vaccination is offered to students
who aren't immunized yet
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or who need a booster shot.
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Some professional categories
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particularly need to be
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protected.
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Such is the case
for people working in the food industry,
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and airline companies.
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WHAT EVIDENCE DO WE HAVE
OF THE EFFICACY OF BCG?
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Children who have been
properly vaccinated with BCG
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are usually well protected
against tuberculosis.
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We have ample evidence of this.
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For example,
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we can recall the story of 300 girls
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who attended the same school in Denmark.
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A teacher had tuberculosis.
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Among the children,
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one group was vaccinated,
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and the other wasn't.
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In the non-vaccinated group,
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70 children became ill,
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11 of which got severe tuberculosis
and one died.
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In subsequent years, 5 more got TB.
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However,
in the group of vaccinated children,
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there were only
2 benign primary infections.
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All the other girls stayed healthy,
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even after 12 years.
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Here's another example,
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from France.
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In a Parisian hospital unit,
a study was conducted of 126 families
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who all had
a tuberculosis patient at home.
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As chance would have it,
among these families,
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about half of the children
had been immunized by BCG.
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The others hadn't.
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Out of the 239 vaccinated children,
only 9 had a primary infection.
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The other 230 stayed healthy.
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Out of the 250 non-vaccinated children,
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143 fell ill,
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and only 107 stayed healthy.
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In England,
vaccination isn't compulsory,
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but all schoolchildren
get BCG, with parental consent.
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An international survey was made there.
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It started in 1950.
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It involves 56,700 children,
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half of which were vaccinated
while the others weren't.
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After 5 years,
the results are convincing.
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There are 6 times fewer TB patients
among vaccinated children
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than among the others.
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To prove how efficient BCG is,
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we'll just have to remember
that it is used practically worldwide,
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often on a wide scale.
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In Brazil,
2.5 million children are vaccinated.
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In Japan, 6 million.
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In India, 7 million.
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In the USSR,
4 million newborns each year,
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and 10 million schoolchildren.
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The World Health Organization
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has undertaken mass vaccination
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in newly independent countries
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in Africa and Asia.
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It chose BCG vaccination
as one of the primary weapons
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to fight tuberculosis.
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Over the last few years,
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170 million children
have been vaccinated.
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Vaccination often takes place
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in countries with precarious
health infrastructures.
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Vaccination is performed
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in the bush,
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under a tent.
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Hundreds of mothers bring their children
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to have them vaccinated.
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This is really
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a crusade against TB
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using the BCG vaccine
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as its weapon.
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"What about France?", you ask.
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In France,
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over the past 10 years,
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approximately 6 million children
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were vaccinated.
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But 6 million more
haven't been vaccinated yet.
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Let us hope,
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for their families and themselves,
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that they will be very soon.
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THE NATIONAL COMMITTEE
AGAINST TUBERCULOSIS
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AND THERAPLIX
PRESENTED
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BCG WILL PROTECT YOU
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PRODUCED BY
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WITH
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DIAGRAMS BY
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00:19:36,200 --> 00:19:37,200
COMMENTARY
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00:19:38,800 --> 00:19:40,840
THIS FILM WAS MADE
WITH THE HELP OF
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GRATEFUL THANKS ARE DUE
TO ALL THE PARTICIPANTS OF THIS FILM
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ICONOGRAPHY
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Subtitles:
Ariane Fénart & Élisabeth Fuchs