Tuberculosis in Newborns: The Lessons of the "Lübeck Disaster" (1929-1933)

PLoS Pathogens
Gregory J FoxErwin Schurr

Abstract

In an accident later known as the Lübeck disaster, 251 neonates were orally given three doses of the new Bacille Calmette-Guérin (BCG) antituberculosis (TB) vaccine contaminated with Mycobacterium tuberculosis. A total of 173 infants developed clinical or radiological signs of TB but survived the infection, while 72 died from TB. While some blamed the accident on BCG itself by postulating reversion to full virulence, such a possibility was conclusively disproven. Rather, by combining clinical, microbiological, and epidemiological data, the chief public health investigator Dr. A. Moegling concluded that the BCG vaccine had been contaminated with variable amounts of fully virulent M. tuberculosis. Here, we summarize the conclusions drawn by Moegling and point out three lessons that can be learned. First, while mortality was high (approximately 29%), the majority of neonates inoculated with M. tuberculosis eventually overcame TB disease. This shows the high constitutional resistance of humans to the bacillus. Second, four semiquantitative levels of contamination were deduced by Moegling from the available data. While at low levels of M. tuberculosis there was a large spread of clinical phenotypes reflecting a good degree of innate...Continue Reading

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Citations

Aug 21, 2019·Immunity, Inflammation and Disease·Lydia MedawarJayne S Sutherland
Dec 31, 2019·PloS One·Mustapha FellagMichel Drancourt
Jan 10, 2019·Human Genomics·Haiko SchurzMarlo Möller
Mar 5, 2020·Journal of Internal Medicine·M KremenovicD J Lee
Aug 18, 2018·Mammalian Genome : Official Journal of the International Mammalian Genome Society·Monica Dallmann-SauerErwin Schurr
Feb 16, 2019·Frontiers in Immunology·Frida ArreyStefan H E Kaufmann
Dec 2, 2015·Proceedings of the National Academy of Sciences of the United States of America·Jean-Laurent Casanova
Oct 16, 2018·Frontiers in Immunology·Marlo MöllerEileen G Hoal
Jan 30, 2020·Human Vaccines & Immunotherapeutics·Marco Antonio Yamazaki-NakashimadaRicardo U Sorensen
Oct 18, 2019·Frontiers in Genetics·Wilian Correa-MacedoErwin Schurr
Dec 1, 2020·The Journal of Infectious Diseases·Marcel A BehrErwin Schurr
Feb 4, 2021·The Journal of Infectious Diseases·Marcel A BehrErwin Schurr
May 18, 2021·New Microbes and New Infections·M FellagM Drancourt

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