Importantly, the choice of BCG strain may have clinical effects b

Importantly, the choice of BCG strain may have clinical effects beyond the protection against TB. Further large-scale comparative investigation of BCG strains with clinical primary outcomes would be valuable. This analysis was not part of our original trial design, so infants were not randomised to receive different BCG strains. This may have led to potential confounders,

for example, due to different seasonal exposures to infections, which we could not account for. However, we did identify differences in maternal helminth and infant malaria status between the groups and we adjusted for these variables in the analysis; adjusted results were similar to crude findings. One-year olds were appropriate subjects as it has been shown that IFN-γ, IL-5, IL-13 and IL-10 responses to BCG given at birth selleck inhibitor are detectable at one year with some effects waning by two years [28]. However, it was not possible to analyse TB outcomes or long-term effects. Further work will include a repeated analysis of the same cohort at five years, assessing TB prevalence and incidence as well as non-TB illnesses and overall mortality. This may provide the warranted longitudinal evidence of whether or not HSP phosphorylation strain-dependent effects observed at the

molecular level translate to clinical outcomes in this cohort. In the meantime, whenever multiple BCG strains are used in future research, or when the effects of BCG or other immunisation regimes are compared in different populations, accounting for BCG strain is vital. We thank the participants and staff of the Entebbe Mother and Baby Study, the midwives of the Entebbe Hospital Maternity Department, and the staff

of the Clinical Diagnostic Services Laboratory at the MRC/UVRI Uganda Research Unit on AIDS. We thank Dr Miliana Chouchkova of BB-NCIPD Ltd., Bulgaria and Mr S.M. Dodwadkar of Serum Institute of India, India, for providing Farnesyltransferase information on the BCG strains provided by their institutions. Conflict of interest statement: The authors of this paper do not have any commercial or other associations that may pose a conflict of interest. Funding: This work was supported by Wellcome Trust [grant numbers 064693, 079110]. Emily L. Webb was supported by the UK Medical Research Council. Mycobacterial antigens were provided through the National Institutes of Health [contract NOI-AI-25147]. “
“Influenza is a major cause of morbidity in people of all ages. The primary strategy for the prevention of influenza is vaccination. Inactivated influenza vaccines have been recommended since the 1960s for the elderly and those with underlying medical conditions. In 2004, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices recommended vaccination against influenza for all children aged 6–23 months [1]; in 2008, this recommendation was expanded to include all children and adolescents through 18 years of age [2].

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