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QUOTE
FACTS ABOUT HIB DISEASE
What is Hib Disease?
Hib, which stands for Haemophilus influenzae type b,
is not a disease itself, but is the name of a
bacterial microorganism that causes several serious,
often life-threatening illnesses, one of which --
bacterial meningitis -- may cause mental retardation
in young children. Hib infection is the most common
cause of bacterial meningitis, an inflammation of the
membranes protecting the brain and spinal cord. The
same Hib bacteria also can cause: pneumonia; an
infectious arthritis called septic arthritis;
epiglottitis, which is inflammation of the trachea or
"windpipe"; otitis media, or middle ear infection;
cellulitis, a skin inflammation; and a dangerous heart
disease, pericarditis.
Although the word "influenzae" is part of the
scientific name, Hib is not related to the virus that
causes the respiratory infections generally called
"flu."
Who is most susceptible to Hib?
The Hib bacteria primarily attacks children under age
5. Statistically, prior to the time when a vaccine
was available, one in every 200 children contracted
Hib disease within the first five years of life
(Moxon, 1986).
The risk of contracting Hib disease is greatest in
environments where several children are in close
contact for extended periods. These environments
include group living situations, households with more
than one child less than age 5, day-care centers and
nurseries. Since Hib is present in respiratory
secretions, it can be transmitted from one child to
another by coughing, sneezing or through close facial
contact.
For reasons that are not fully understood, Hib disease
is especially prevalent among certain ethnic groups.
The incidence of Hib among Alaskan Eskimos has been 10
times that of the general United States' population,
while the incidence among American Indians is five
times as great as that in the general population.
How serious can Hib infection be?
If the Hib infection causes bacterial meningitis, it
is very serious. This form of meningitis is nearly
always fatal without treatment. Even with the use of
modern antibiotics, 3 to 5 percent of meningitis
victims die.
Of those who survive, 25-35 percent suffer permanent
brain damage resulting in mental retardation, hearing
loss, partial blindness, speech disorders, paralysis
of one side of the body, behavioral problems or
seizures.
However, some children infected with Hib remain
healthy or become only mildly ill. These children can
still spread the infection to others.
What are the symptoms of Hib Disease?
The illness often starts out mimicking the symptoms of
a cold or earache. Very quickly the child may develop
symptoms of meningitis: irritability, high-pitched
crying, vomiting, loss of appetite and fever. If the
epiglottis is infected, the symptoms include sore
throat, fever and difficulty breathing (Brody, 1990).
How is Hib treated?
Hib infections can be treated with antibiotics.
However, there may be problems that remain after
treatment. One reason for this is that many Hib
diseases do not exhibit symptoms early, so that
therapies often are begun too late. For instance, by
the time severe symptoms signal parents that their
child may have meningitis, brain cells may have
already been permanently damaged or destroyed.
Similarly, a Hib infection that results in
epiglottitis often can block a child's windpipe within
six to 12 hours (or even faster) after symptoms
appear. Since antibiotics do not take effect
immediately, emergency surgery often is required to
save the child's life.
In addition, sometimes antibiotic therapy is
ineffective because certain strains of Hib bacteria
have become resistant and do not respond to the
antibiotics, ampicillin and chloramphenicol, which are
usually used to treat the illness.
How can Hib Disease be prevented?
The primary strategy for preventing Hib disease is
immunization. The first vaccine to protect against
Hib disease was licensed in 1985, but it was only
effective in children 2 years and older. In late
1987, a vaccine using conjugate technology was
approved for children as young as 18 months and later
for children 15 months and older.
Now, there are vaccines that can be used to protect
children 2 months to 5 years of age. By age 6 most
children have developed antibodies to Hib, indicating
that they have been previously exposed to the
infection and are now immune to it.
When should I take my child to be vaccinated?
All children can receive the vaccine at 2 months of
age at the same time they receive other routine
immunizations. The number of doses they receive will
depend on the type of vaccine used. The American
Academy of Pediatrics' Committee on Infectious
Diseases has issued recommendations for immunization
of infants and children 2 months of age and older to
guide physicians in use of the new vaccines (Committee
on Infectious Diseases, 1990-1991).
The immunization regimen differs based on the age the
first dose is administered to the child. By the time
a child is 15 months of age or older (but not yet 6
years), the recommended regimen is a single dose of
any licensed conjugate vaccine. It is important to
complete a recommended regimen to assure immunity to
Hib disease.
Are any other prevention methods being investigated?
Just recently, several researchers reported they could
protect newborns from Haemophilus influenzae type B by
vaccinating mothers late in pregnancy. The strategy
temporarily vaccinates babies before they are born.
It works by passing protective antibodies from the
mother to her child while still in the womb. These
researchers believe this protection may fill the gap
in the first two months of life before babies are old
enough to receive their own shots against Hib disease.
Prenatal vaccination has not been routinely used.
This strategy will continue to be investigated to
determine its effectiveness (The Dallas Morning News,
10/1/91).
References
Brody, Jane. (Oct. 29, 1990). "Vaccine can help
prevent HIB infection." Daily News.
Committee on Infectious Diseases. (1990-1991).
Haemophilus influenzae Type b Conjugate Vaccines:
Recommendations for Immunization of Infants and
Children 2 Months of Age and Older: Update.
Moxon, E.R. (1986). Haemophilus influenzae vaccine.
Pediatrics, 77, 2, 258-260.
"Prenatal vaccination protects newborns, study says."
The Dallas Morning News (October 1, 1991).
Revised October 1991
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