Recognition of BCG Scars

1
Recognition of BCG Scars

• Dr. Earl Hershfield
• Ms. Barbara Roche
• Tuberculosis Research Unit
• University of Manitoba, 2004

2
BCG Vaccine Usage

• International (current) http//www.who.int/immun
  ization_monitoring/en/globalsummary/timeseries/tsc
  overagebcg.htm
• Canada (current and historical)
  http//www.phac-aspc.gc.ca/tbpc-latb/index.html

3
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 1970s

4

• 37 years old
• Black
• Female
• Born in Rwanda in 1965
• Left deltoid

BCG

• Smallpox

5

• 37 years old
• Black
• Female
• Born in Rwanda in 1965
• Left deltoid

BCG
Smallpox
6

• 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
7

• 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

• BCG

BCG
9

• 32 years old
• Asian
• Female
• Born in the Philippines in 1970
• Left deltoid

• BCG

10

• 13 years old
• Male
• Born in Iraq in 1990
• Left deltoid

• BCG

11

• 13 years old
• Male
• Born in Iraq in 1990
• Left deltoid

• BCG

12

• 46 years old
• Female
• Born in Trinidad in 1956
• Left upper arm and shoulder

• BCG

Smallpox
13

• 46 years old
• Female
• Born in Trinidad in 1956
• Left upper arm and shoulder

BCG
14

• 18 years old
• Asian
• Female
• Born in the Philippines in 1984
• Left deltoid

BCG

• BCG

15

• 60 years old
• Asian
• Male
• Born in the Philippines in 1943
• Left deltoid

BCG
16

• 60 years old
• Asian
• Male
• Born in the Philippines in 1943
• Left deltoid

BCG
17

• 38 years old
• Male
• Born in Kerala State, India in 1965
• Left arm

• BCG

Smallpox
18

• 38 years old
• Male
• Born in Kerala State, India in 1965
• Left arm

BCG
19

• 38 years old
• Male
• Born in Kerala State, India in 1965
• Left arm

Smallpox
20

• 38 years old
• Caucasian
• Female
• Born in Winnipeg, Manitoba
• Health care worker
• Received BCG vaccine in 1983
• Left deltoid

BCG
Smallpox
21

• 55 years old
• Caucasian
• Female
• Born in Hungary in 1947
• Left deltoid

Smallpox
22

• 26 years old
• Black
• Male
• Born in Sierra Leone in 1976
• Right arm

SMALLPOX
BCG

• BCG

23

• 26 years old
• Black
• Male
• Born in Sierra Leone in 1976
• Right arm

Smallpox
BCG
24
And once againDistinguishing 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 1970s