Effectiveness of vaccination for Haemophilus influenzae type b

doi:10.1016/S0140-6736(03)12385-9

The Lancet

Volume 361, Issue 9355, 1 February 2003, Pages 395-396

https://doi.org/10.1016/S0140-6736(03)12385-9 Get rights and content

Summary

Several cases of invasive Haemophilus influenzae type b (Hib) infection have been identified in children previously vaccinated against this disease. We have reviewed all cases of Hib in Nottingham, UK, since the conjugated vaccine was introduced into the primary course of childhood immunisations in 1992. Our results show a worrying increase in the frequency of Hib in Nottingham, which is much the same as the national trends. We believe that the medical profession should be aware of the return of Hib, and that we now need to review the need for a booster vaccination for what was thought to be a disease of the past.

References (4)

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Surveillance of invasive Haemophilus influenzae infections in children
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(Jan 24; 2002)

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Cited by (50)

Haemophilus influenzae type b invasive infections in children hospitalized between 2000 and 2017 in a Pediatric Reference Hospital (PRH)
2020, Heliyon
Citation Excerpt :
Between 1999 and 2009, in the PH-HCPR there were between 0 and 2 cases per year of invasive disease due to Hib [17]. However, as of 2010, as observed in other countries [18, 19, 20], an increase in the frequency of infections by this agent was observed. As of 2010, there is a statistically significant increase in these infections in the population studied.
Uruguay incorporated the conjugate vaccine against Haemophilus influenzae b (Hib) in 1994. In 2008, the vaccine was changed from one with natural conjugated capsular polysaccharide to one with a synthetic polysaccharide component. We describe the frequency and characteristics of invasive Hib infections in children hospitalized in a Pediatric Reference Hospital (PRH) between January 1st, 2000 and December 31st, 2017.
Sterile site Hib isolations from hospitalized children were included. Clinical and microbiological characteristics were analyzed. Favorable conditions for the infection were considered: incomplete immunization, immunodeficiencies and associated pathologies. Two periods are described: 1, prior to vaccine change (1/1 st/2000- 12/31/08) and 2, post-change (1/1 st/09- 12/31st/17).
45 children were hospitalized: 5 in the first period and 40 in the second. The hospitalization rate per 10,000 discharges was 0.41 (95% CI 0.05–0.77) and 4.2/10,000 (95% CI 2.89–5.48), respectively (p < 0.01). The diagnoses at discharge were: meningitis/ventriculitis (20), pneumonia (16), bacteremia (3), epiglottitis (1), arthritis (1), cellulitis (3) and obstruction of the upper airway (1). Four children presented comorbidities. Twenty seven received less than 3 doses of anti-Hib vaccination and 18 were properly vaccinated (2 were immunodeficient). The median hospitalization was 14 days, 18 children required intensive therapy.
Observed change may be due to: incomplete primary series, inhomogeneous vaccine coverage and immunogenicity of the synthetic polysaccharide. To reduce this public health problem, epidemiological surveillance.
Imaging in Otolaryngology
2018, Imaging in Otolaryngology
Diagnostic Imaging: Head and Neck
2017, Diagnostic Imaging: Head and Neck
Diagnostic Imaging: Pediatrics
2017, Diagnostic Imaging: Pediatrics
Acute Meningitis
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases
Haemophilus influenzae type b pneumonia in Egyptian children under five years: A step toward the identification of the real burden in our community by the use of real-time polymerase chain reaction
2012, Egyptian Journal of Medical Human Genetics
Citation Excerpt :
More-detailed analysis has shown that strain Eagan possesses gene regions not found in Rd, including the cap region genes, encoding the type b capsular polysaccharide; the hif gene cluster, encoding the pilus adhesion; the hmw1 and hmw2 gene clusters, encoding the high-molecular-weight adhesions; and the tryptophanase gene cluster; all related to the virulence factors of Hib strains [2]. It is estimated that the bacillus causes more than 3 million cases of serious disease, mainly meningitis and pneumonia in children less than 5 years old with approximately 386,000 deaths each year worldwide [3]. Invasive Hi diseases in children were almost exclusively caused by serotype b prior to the introduction of H. influenzae serotype b conjugate vaccine which had been replaced by nontypeable strains in several countries [4].
Haemophilus influenzae (Hi) causes more than 3 million cases of serious disease, mainly meningitis and pneumonia in children less than 5 years old with approximately 386,000 deaths each year worldwide. The presence or absence of a polysaccharide capsule is an important distinguishing characteristic of H. influenzae species. The polysaccharide capsule can be serologically classified into six serotypes (a to f). Invasive Hi diseases in children were almost exclusively caused by serotype b (Hib). To the best of our knowledge, the real burden of Hib pneumonia in Egypt is not clarified. Yet, few studies are published and concerned with Hib sepsis among neonates or Hib meningitis in children. We aimed in this study to identify the frequency of Hib pneumonia among Egyptian children below five years by the use of real-time polymerase chain reaction (PCR) technique, with insight on antimicrobial resistance of Hib strains in the Egyptian community. One hundred patients with community-acquired pneumonia were investigated for Hib by both real-time PCR and bacterial culture. Haemophilus influenzae type b was diagnosed in 31% of the examined population by PCR, with sensitivity of 100% (95% CI: 0.86–1), specificity 100% (65% CI: 0.93–1), positive predictive value (PPV) 100% (95% CI: 0.83–1), and negative predictive value (NPV) 100% (95% CI: 0.93–1). Blood culture was positive in 12 patients only, with a sensitivity of 38% (95% CI: 0.22–0.57), a specificity of 100% (65% CI: 0.93–1), PPV 100% (95% CI: 0.69–1), and NPV 77% (95% CI: 0.68–0.86). Isolated Hib strains were sensitive to ceftriaxon in 91% of cases, followed by ampicillins in 31% and cotrimoxazole in 17%. Three patients had multidrug resistant strains of Hib.
Haemophilus influenzae type b infection is still an important and frequent pathogen causing community-acquired pneumonia in Egypt with changeable antibiotic sensitivity pattern. PCR represented a sensitive and rapid tool for the diagnosis of Hib pneumonia. Governmental plans to eradicate Hib in our community with the introduction of Hib conjugate vaccine in the national immunization program became indispensable.

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The Lancet

Summary

References (4)

Combined vaccination of Haemophilus influenzae type b conjugate and diphtheria-tetanus-pertussis containing acellular pertussis

Lancet

Surveillance of invasive Haemophilus influenzae infections in children

CDR weekly

Cited by (50)

Haemophilus influenzae type b invasive infections in children hospitalized between 2000 and 2017 in a Pediatric Reference Hospital (PRH)

Imaging in Otolaryngology

Diagnostic Imaging: Head and Neck

Diagnostic Imaging: Pediatrics

Acute Meningitis

Haemophilus influenzae type b pneumonia in Egyptian children under five years: A step toward the identification of the real burden in our community by the use of real-time polymerase chain reaction

Research LettersEffectiveness of vaccination for Haemophilus influenzae type b

Summary

Lancet

Surveillance of invasive Haemophilus influenzae infections in children

CDR weekly

Research Letters
Effectiveness of vaccination for Haemophilus influenzae type b