Recognition of BCG Scars Dr. Earl Hershfield Ms. Barbara Roche Tuberculosis Research Unit University of Manitoba, 2004
Recognition of BCG Scars
Dr. Earl HershfieldMs. Barbara Roche
Tuberculosis Research UnitUniversity of Manitoba, 2004
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• International (current): http://www.who.int/immunization_monitoring/en/globalsummary/timeseries/tscoveragebcg.htm
• Canada (current and historical): http://www.phac-aspc.gc.ca/tbpc-latb/index.html
BCG Vaccine Usage
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Distinguishing a BCG scarfrom a Smallpox scar
BCG Scar Classic Features
• Raised centre
• Left upper arm or, much less commonly, on thigh or forearm
Smallpox Scar Classic Features
• Depressed with radiating lines to edges
• Routine use stopped in the late 1970’s
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• 37 years old
• Black
• Female
• Born in Rwanda in 1965
• Left deltoid
BCG
Smallpox
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• 37 years old
• Black• Female• Born in
Rwanda in 1965
• Left deltoid
BCG
Smallpox
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• 44 years old• Caucasian• Female• Born in
Montreal in 1958
• Lived in Spain 1962-66 and
1976-81• Graduated as a
nurse in Manitoba, 1983
BCG
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• 44 years old• Caucasian• Female• Born in Montreal
in 1958• Lived in Spain
1962-66 and 1976-81
• Graduated as a nurse in Manitoba, 1983
BCG
8
• 32 years old• Asian• Female• Born in the
Philippines in 1970
• Left deltoid
BCGBCG
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• 32 years old• Asian• Female• Born in the
Philippines in 1970
• Left deltoid BCG
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• 13 years old
• Male
• Born in Iraq in 1990
• Left deltoid
BCG
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• 13 years old• Male• Born in Iraq in
1990• Left deltoid
BCG
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• 46 years old• Female• Born in
Trinidad in 1956
• Left upper arm and shoulder
BCG
Smallpox
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• 46 years old
• Female
• Born in Trinidad in 1956
• Left upper arm and shoulder
BCG
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• 18 years old• Asian• Female• Born in the
Philippines in 1984
• Left deltoidBCG
BCG
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• 60 years old
• Asian
• Male
• Born in the Philippines in 1943
• Left deltoidBCG
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• 60 years old
• Asian
• Male
• Born in the Philippines in 1943
• Left deltoid
BCG
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• 38 years old
• Male• Born in
Kerala State, India in 1965
• Left arm
BCG
Smallpox
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• 38 years old
• Male
• Born in Kerala State, India in 1965
• Left arm
BCG
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• 38 years old
• Male
• Born in Kerala State, India in 1965
• Left arm
Smallpox
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• 38 years old• Caucasian• Female• Born in
Winnipeg, Manitoba
• Health care worker
• Received BCG vaccine in 1983
• Left deltoid
BCG
Smallpox
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• 55 years old• Caucasian• Female• Born in
Hungary in 1947
• Left deltoid
Smallpox
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• 26 years old
• Black
• Male
• Born in Sierra Leone in 1976
• Right arm
SMALLPOX
BCG
BCG
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• 26 years old• Black• Male• Born in
Sierra Leone in 1976
• Right armSmallpox
BCG
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And once again…Distinguishing a BCG scar
from a Smallpox scar
BCG Scar Classic Features
• Raised centre
• Left upper arm or, much less commonly, on thigh or forearm
Smallpox Scar Classic Features
• Depressed with radiating lines to edges
• Routine use stopped in the late 1970’s