The verses were not the remedy, but the relief: “I know I’m going to die… inside my chest / a terrible evil eats my life“. On July 6, 1871, Castro Alves, just 24 years old, succumbed to tuberculosis. The biggest novelty in the fight against this respiratory disease, which mainly affects the lungs, would only appear 50 years after the death of the poet from Bahia: the vaccine. The immunizing agent was the result of long research by the French Léon Calmette and Alphonse Guérin. They attenuated a bacterium, named Bacillus de Calmette and Guérin (hence, the acronym BCG), and announced, on that July 1, 1921, a way to eradicate the bacillus of Koch, which causes tuberculosis.
“It was a great victory against this disease, which killed so many people around the world and even today has the most vulnerable as its main victims”, says Dr. Dilene Nascimento, a researcher at the Oswaldo Cruz Foundation (Fiocruz) and a scholar of the history of diseases in the Brazil. There are records of tuberculosis cases in Brazil since the colony period. The disease is transmitted by inhalation of contaminated droplets and eliminated by breathing, coughing or sneezing.
The researcher explains that, even before the discovery of the vaccine in France, Brazil had initiatives to try to protect the population from this evil. One of them was the Brazilian League against Tuberculosis, a civil entity composed of researchers and intellectuals, which would later become the Ataulpho de Paiva Foundation, in Rio de Janeiro, a philanthropic entity that is still responsible for producing BCG in the country. In fact, in Brazil, the development of the vaccine initially took place through research by scientist Arlindo de Assis (1896-1966) after he received, in 1925, a sample of the virus strain. in vitro for study.
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In 1927, the foundation created laboratories and started to follow instructions to prioritize the vaccination of the youngest and also the most vulnerable, says professor Dilene Nascimento. The researcher understands that this victory of science is essential today, for example, for Brazilian babies to receive this vaccine right after they are born. “It has great efficacy against severe forms of the disease, as occurs, for example, with the vaccine against covid-19. It was a great learning experience”. Until the 1970s, BCG also existed in the oral modality. The drug produced by the Ataulpho de Paiva Foundation was recognized in 16 laboratories certified by the WHO and is considered one of the most immunogenic in the world.
On the next 8th and 9th of July, Fiocruz will hold a debate event (check schedule) on the legacy of the BCG vaccine, administered free of charge at health centers, for immunization programs in Brazil. In an interview with Brazil Agency, the researcher tells the trajectory of the fight against tuberculosis in the country, and what role the BCG vaccine played in this story.
Brazil Agency: What was the context of the search for this vaccine?
Dilene Nascimento: In the late 19th and early 1900s, tuberculosis killed more than any other disease. There was no public policy for the control of tuberculosis, which is an endemic disease. Development may be slow, but it leads to death. It is necessary to put in context that the bacillus of Koch, despite infecting anyone, usually leads to death those who are in a more vulnerable situation, and with compromised immune systems. The TB vaccine was being exhausted by scientists. Even the researcher Robert Koch, who discovered the causative bacillus, also announced tubercholin. Initially, it was thought that it could be a drug, but it actually proved to be a test to diagnose the disease. It was an advertisement with a lot of pomp, but the conclusion was reached that tuberculin identified tuberculosis, not treated it. Until, in 1921, Léon Calmette and Alphonse Guérin provided the discovery of a vaccine. They advertised at the French Academy of Medicine. The immunizing agent was found to be effective against the aggravation of the disease.
Listen to an excerpt from the interview with the researcher:
Brazil Agency: And what was the Brazilian reality at that time?
Dilene Birth: The situation was serious. In 1900, the Brazilian League against Tuberculosis was created by doctors and intellectuals – mainly from Rio de Janeiro. They were concerned about the high death rate. The speech, at the time, was that Brazil (which had ceased to be a monarchy in 1889) was entering modernity and should abandon the late 19th century. It was this league that later became the Ataulpho de Paiva Foundation (philanthropic entity until today responsible for the production of the vaccine in Brazil).
Learn more about the history of tuberculosis in this video from the Ataulpho de Paiva Foundation:
Brazil Agency: Where were the people affected by the disease?
Dilene Nascimento: At the beginning of the 20th century, dispensaries were created – one in 1902 and another in 1911. There was a tripod for care: the sanatorium (place to have rest, hygiene and food), the dispensary (outpatient clinic with medical treatment) and the preventive ( place where the children of tuberculosis patients were, where the children even had to maintain their studies). There were attempts to create separate sectors within hospitals for those who had tuberculosis. The Santas Casas had this initiative, for example. But deaths remained high.
Brazil Agency: And how was the development of the vaccine here in the country?
Dilene Birth: Researcher Arlindo de Assis, who was the scientist who worked at the Instituto Vital Brazil, received the inactivated strain of the virus from a Uruguayan researcher, in order to be able to develop the vaccine in Brazil. This took place in 1925. He began to develop the vaccine and made an articulation with the Brazilian League against Tuberculosis, which was chaired by Ataupho de Paiva. The entity decided to take over the application of vaccines in dispensaries and schools. Arlindo de Assis then transferred to the entity and started to produce the BCG vaccine. The League understood that the priority should be children and students. With the creation of the Department of Public Health, there was a public policy regarding tuberculosis. Posters were produced. At the time, very painful surgeries were still being performed to try to resolve tuberculosis, called pneumothorax. It was not a simple treatment.
Listen to the researcher’s explanation about the priority audiences to receive the BCG:
Brazil Agency: Why did the disease kill so many people?
Dilene Birth:The main victims of the disease are people with compromised immune systems. The precarious working relationships of that early 20th century also aggravated the situation. Furthermore, housing conditions also interfere with the spread of the disease. Over the course of the century, there was an improvement in living and working conditions. In 1942, we had the first antibiotic drug for treatment. Four years later, the state created a national campaign to combat tuberculosis and also to vaccinate. It had a budget, for example, to create sanatoriums in the various Brazilian capitals. Still in the 1940s, legislative decrees started to force the vaccination of children.
Brazil Agency: AND today, families can apply for BCG as soon as the child is born.
Dilene Birth: This is an achievement. Since 1976, this obligation exists. All maternity hospitals apply BCG vaccine to newborn children. The immunizing agent does not prevent 100% from becoming infected with the bacillus, but it does make an eventual evolution of the disease occur in a less serious way, as happens with vaccines against covid nowadays as well. The vaccine is indicated for children aged 0 to 4 years (according to Ordinance No. 452, of December 6, 1976, of the Ministry of Health, the immunizing agent is mandatory for children under one year old).
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source https://pledgetimes.com/100-years-of-bcg-how-the-vaccine-changed-the-history-of-combating-tuberculosis-istoe-dinheiro/
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