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Haemophilus influenzae type B epiglottitis after immunization with HbOC conjugate vaccine
1Portsmouth Naval Hospital, VA.
Insights
The Haemophilus influenzae type B (Hib) vaccine has decreased epiglottitis cases in children. Further study is needed to understand the reasons for the observed Hib vaccine failures.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
Background:
- Haemophilus influenzae type B (Hib) is a primary cause of childhood epiglottitis.
- The USFDA has approved four Hib vaccines for pediatric use.
- Introduction of the Hib vaccine aimed to reduce epiglottitis incidence.
Observation:
- A retrospective study analyzed 59 epiglottitis cases from 1982 to 1992.
- The study investigated the incidence of epiglottitis and Hib vaccine failure.
- One case of Hib epiglottitis in a vaccinated child is detailed.
Findings:
- A statistically significant decrease in epiglottitis incidence was observed post-Hib vaccine introduction.
- The overall 11-year trend for epiglottitis reduction was not statistically significant.
- Accurate documentation of vaccination status was challenging, with only two identified vaccine failures.
Implications:
- The Hib vaccine has successfully reduced the incidence of Haemophilus influenzae type B epiglottitis.
- Postulated reasons for vaccine failure warrant further investigation.
- Continued surveillance is crucial for monitoring vaccine effectiveness.
Introduction:
US Food and Drug Administration (USFDA) has licensed four Haemophilus influenzae type B (Hib) vaccines for use in children. Haemophilus influenzae type B is by far the most common pathogen in childhood epiglottitis and it is hoped that with the introduction of the Hib vaccine that a corresponding decrease in epiglottitis cases will be appreciated.
Materials And Methods:
A retrospective study of all children admitted with the diagnosis of epiglottitis for the 11-year period of 1982 to 1992 was conducted in order to determine the incidence of epiglottitis and Hib vaccine failure. Fifty-nine cases were included in the study by documentation of an inflamed epiglottis. The case of Hib epiglottitis in a 4-year-old child immunized with HbOC conjugate vaccine at 18 months of age is detailed.
Results:
A statistically significant decrease was found in the incidence of epiglottitis since introduction of the vaccines; however, the overall trend in decrease for the 11-year period was not statistically significant. Vaccination status was difficult to accurately document with only two cases of vaccine failure identified.
Conclusion:
The incidence of Haemophilus influenzae type B epiglottitis at our regional Children's hospital has decreased since the introduction of the Hib vaccine. Reasons for vaccine failure are postulated.