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Acute epiglottitis in children: results of a large-scale anti-Haemophilus type B immunization program
1Centre hospitalier Honoré Mercier, Saint-Hyacinthe, Québec.
Insights
The Haemophilus influenzae type b (Hib) vaccine significantly reduced acute epiglottitis in Quebec children. This immunization program achieved an 84.6% efficacy, drastically lowering cases in preschoolers.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Acute epiglottitis incidence was high in children before widespread vaccination.
- The introduction of conjugate vaccines against Haemophilus influenzae type b (Hib) aimed to reduce disease burden.
Purpose of the Study:
- To evaluate the impact of the Hib immunization program on acute epiglottitis incidence in Quebec children.
- To quantify the effectiveness of Hib vaccination in preventing acute epiglottitis.
Main Methods:
- Utilized the provincial healthcare database (Med-Echo) for case ascertainment.
- Compared acute epiglottitis incidence in preschoolers (0-6 years) before and after vaccine introduction.
- Calculated the reduction in incidence and estimated program efficacy.
Main Results:
- Acute epiglottitis cases in preschoolers dropped from an average of 97 cases/year (1984-1987) to 15 cases in 1993.
- The incidence of acute epiglottitis was reduced to 15.4% of its pre-vaccine level.
- The overall efficacy of the immunization program was estimated at 84.6%.
Conclusions:
- The Hib immunization program has been highly effective in preventing acute epiglottitis in children.
- Vaccination strategies, including updated conjugate vaccines, have substantially decreased the incidence of this serious childhood infection.
Abstract:
The incidence of acute epiglottitis in children is declining in the province of Quebec, Canada. In 1988, a PRP-D anti-Haemophilus type B vaccine was introduced into the routine vaccination schedule of 18-month-old children. A substantial reduction in the occurrence of acute epiglottitis was perceived by clinicians. Since 1992, improved new vaccines (PRP-T, HbOC, PRP-OMPC), given to 2-month-old infants, have been expected to increase the efficacy of the immunization program. The impact of the immunization program on preventing acute epiglottitis was verified using a provincial database system called Med-Echo. In the presumably vaccinated target population (0 to 6 years old), 15 children suffered acute epiglottitis in 1993, whereas 97 cases were reported on the average for each yearly period from 1984 to 1987, just before the program's inception. Thus, the incidence of acute epiglottitis in preschoolers was reduced to 15.4% of its former level. The overall efficacy of the immunization program in preventing acute epiglottitis, therefore, is estimated to be 84.6%.