The age range for eplglotitis was from 0. This infection also had a case fatality rate of 4. On the basis of these findings there are invasive H. Influenzae infections in children annually in Switzerland total population of 6. A vaccine, such as the PRP-D conjugated polysaccharide vaccine used in Finland, could prevent severe infections, 6 to 8 deaths and around 20 cases of permanent neurological sequelae annually.
You can also search for this author in PubMed Google Scholar. Reprints and Permissions. Gnehm, H. Among children younger than age 5 years in , the rate of invasive H. An additional 9 cases of Hib are estimated to have occurred among the reports of invasive H. From —, 36 Hib cases in patients younger than age 5 years were reported to ABCs. Two 5. Eight Secondary cases of Hib disease occur but are rare. Secondary attack rates are higher among household contacts younger than age 48 months 2.
Among children born during —, The vaccine had low efficacy and is no longer available in the United States. The characteristics of the Hib polysaccharide vaccine were similar to other polysaccharide vaccines.
The response to the vaccine was typical of a T-independent antigen, most notably an age-dependent immune response and poor immunogenicity in children age 2 years or younger. In addition, no boost in antibody titer was observed with repeated doses, the antibody that was produced was relatively low-affinity IgM, and switching to IgG production was minimal.
Conjugation is the process of chemically bonding a polysaccharide to a more effective protein carrier. This process changes the polysaccharide from a T-independent to a T-dependent antigen and greatly improves immunogenicity, particularly in young children.
In addition, repeat doses of conjugate vaccines elicit booster responses and allow maturation of class-specific immunity with predominance of IgG antibody. Hib vaccines are administered by intramuscular injection. Monovalent Hib vaccines contain no antibiotic or preservative.
Specific ingredients to combination vaccines containing Hib vaccine differ. All infants should receive a primary series of Hib conjugate vaccine monovalent or combination vaccine beginning at age 2 months. The number of doses in the primary series depends on the type of vaccine used.
A booster dose is recommended at age 12 through 15 months, regardless of which vaccine is used for the primary series. Haemophilus influenzae type b Hib Routine Vaccination Schedule. The recommended interval between doses in the primary series is 8 weeks, with a minimum interval of 4 weeks.
At least 8 weeks should separate the booster dose from the previous 2nd or 3rd dose. Limited data suggest Hib conjugate vaccines administered before age 6 weeks can induce immunologic tolerance, reducing the response to subsequent doses of Hib vaccine. Therefore, Hib vaccines, including combination vaccines containing Hib conjugate vaccine, should never be administered to a child younger than age 6 weeks.
The monovalent Hib conjugate vaccines are interchangeable. A series that includes vaccine of more than one brand will induce a protective antibody level. If a child receives different brands of Hib vaccine at age 2 and 4 months, a 3rd dose of any brand should be administered at age 6 months to complete the primary series.
Any of these vaccines may be used for the booster dose, regardless of which vaccines were administered for the primary series. Data on the interchangeability of Hib combination vaccine with monovalent vaccines are limited. Whenever feasible, the same combination vaccine should be used for the subsequent doses. Unvaccinated children age 7 months or older may not require a full series of 3 or 4 doses. Unvaccinated infants age 2 through 6 months should receive 3 doses of vaccine, administered 2 months apart.
The primary series should be followed by a booster dose at age 12 through 15 months, administered at least 8 weeks after the last dose. A booster dose is only needed if 2 or 3 primary doses were administered before age 12 months.
Unvaccinated children age 7 through 11 months should receive 2 doses of vaccine, 4 weeks apart. Those 2 doses should be followed by a booster dose at age 12 through 15 months, administered at least 8 weeks after the last dose. Unvaccinated children age 12 through 14 months should receive 1 dose of vaccine, followed by a booster dose at least 8 weeks later. Any previously unvaccinated child age 15 through 59 months should receive a single dose of vaccine.
Unvaccinated infants age 2 through 6 months should receive 2 doses of vaccine, administered 2 months apart. Unvaccinated children age 7 through 11 months should receive 2 doses of vaccine, 4 weeks apart, followed by a booster dose at age 12 through 15 months.
The booster should be administered at least 8 weeks after the last dose. Unvaccinated children age 12 through 14 months should receive 1 dose of vaccine, followed by a booster at least 8 weeks later. It is administered to infants at age 2, 4, 6, and 15 through 18 months. Haemophilus influenzae type b is an encapsulated, immotile and non-spore forming Gram-negative coccobacillus. Note: The information contained in this fact sheet is intended for the purpose of general information and should not be used as a substitute for the individual expertise and judgement of healthcare professionals.
Invasive Haemophilus influenzae disease. Facts Surveillance and disease data Microbiology Prevention and control. Factsheet about Invasive Haemophilus influenzae disease Factsheet. Twitter Facebook Linked In Mail. Factsheet Haemophilus influenzae type b Hib is an obligate human pathogen and an important cause of invasive bacterial infections in both children and adults, with the highest incidence among young children.
The pathogen Haemophilus influenzae type b is an encapsulated, immotile and non-spore forming Gram-negative coccobacillus. Encapsulated strains express six antigenically distinct capsular polysaccharides which are classified as serotype a through f. Serotype b Hib has a polyribosyl ribitol phosphate PRP polysaccharide capsule that is a major virulence factor. The PRP capsule protects the organism from phagocytosis in the absence of anticapsular antibodies and facilitates penetration to the blood stream and the cerebrospinal fluid.
Humans are the only known reservoir for Hib. Clinical features and sequelae Haemophilus influenzae type b causes pneumonia, septicaemia, meningitis, epiglottitis, septic arthritis, cellulitis, otitis media, and purulent pericarditis, as well as less common invasive infections such as endocarditis, osteomyelitis, and peritonitis. Haemophilus influenzae type b infections are clinically indistinguishable from infections caused by other bacteria.
Prior to widespread immunisation, Hib was the most common cause of bacterial meningitis in children in Europe, and remains the leading cause of meningitis morbidity and mortality in unimmunised populations around the world. The highest incidence of invasive Hib in unimmunised populations is in the 6—24 months age group. This is explained by the passive protection from maternal antibodies during the first months of life and the improving natural immunity after two years of age.
Symptoms and signs of Hib meningitis are indistinguishable from other causes of bacterial meningitis and include fever, headache, photophobia, stiff neck, vomiting and altered mental status.
Severe cases may present with convulsions and coma. Infants often present with less characteristic symptoms such as, vomiting, refusal to feed and irritability. Severe cases may develop hypotonia, a tense or bulging fontanelle, a high-pitched or moaning cry and convulsions. Septicaemia is the second most common presentation, accounting for around a quarter of all confirmed cases of invasive Hib disease, and can affect all ages.
There are large variations across populations in the recorded incidence of both Hib pneumonia and meningitis, and one large study from the island of Lombok in Indonesia failed to show any protection against pneumonia from the conjugate Hib vaccine. Epiglottitis is a life-threatening medical emergency; the result of an infection of the epiglottis and surrounding tissues that interferes with airflow.
The peak incidence is in the 5—10 year age group. Patients typically present acutely with a short history of high fever, tachypnoea, inspiratory stridor and excessive drooling. Intubation and sometimes an emergency tracheotomy may be required to prevent airway obstruction and death. Other, less common, clinical manifestations of invasive Hib disease include cellulitis, septic arthritis, osteomyelitis, and pericarditis.
Routine immunisation has resulted in a remarkable decline in serious Hib disease and has practically eliminated Hib meningitis among vaccinated infants and young children. The World Health Organization estimates that Hib causes three million episodes of serious disease and deaths annually worldwide. Most cases are among unimmunised children and in economically developing countries. Age is an important risk factor for invasive Hib infections, and children younger than five years of age are at highest risk of Hib disease in unimmunised populations.
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