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Related Experiment Videos

Paediatric acute epiglottitis: not a disappearing entity.

John McEwan1, Wijayasingham Giridharan, Raymond W Clarke

  • 1Department of Otolaryngology, Alder Hey Hospital, Eaton Road, West Derby, Liverpool L12 2AP, UK. jamcewan@tiscali.co.uk

International Journal of Pediatric Otorhinolaryngology
|March 29, 2003
PubMed
Summary

Haemophilus influenzae type b (Hib) vaccine failure in epiglottitis is rare but does occur in fully vaccinated children. This study highlights the importance of considering epiglottitis in children with airway obstruction, even post-vaccination.

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Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Bacteriology

Background:

  • Paediatric epiglottitis is a severe, life-threatening condition.
  • Introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine significantly reduced epiglottitis incidence.
  • Vaccine failure is a rare but documented occurrence.

Purpose of the Study:

  • To determine the failure rate of the Hib vaccine by analyzing cases of Haemophilus epiglottitis in fully vaccinated children.
  • To conduct a retrospective review of all epiglottitis cases over a 13-year period.
  • To explore clinical and immunological risk factors associated with Hib vaccine failure.

Main Methods:

  • Retrospective case-note review of 40 epiglottitis cases at Alder Hey Hospital (December 1987-January 2001).

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  • Data collected included patient demographics, clinical presentation, management, complications, and microbiological/serological findings.
  • Haemophilus influenzae antibody titres were measured in acute and convalescent phases.

    • Main Results:

    • Of 40 epiglottitis cases, 8 (20%) occurred after Hib vaccine introduction.
    • Haemophilus influenzae type b was identified in 12 cases; 5 occurred post-vaccine introduction.
    • Four of the five post-vaccine Hib epiglottitis cases were in fully vaccinated children; two had low Hib antibody titres.

    Conclusions:

    • Hib epiglottitis incidence has decreased, but vaccine failures are confirmed.
    • Understanding risk factors for vaccine failure and monitoring Hib antibody titres are crucial.
    • Acute epiglottitis remains important in the differential diagnosis of upper airway obstruction in children, especially as familiarity with the disease wanes.