LONG-TERM FOLLOW-UP OF THE RATE OF PHARYNGEAL COLONIZATION WITH HAEMOPHILUS INFLUENZAE TYPE B (Hib) AT A CHRONIC-CARE FACILITY FOLLOWING PROPHYLAXIS WITH RIFAMPIN

The objective of this study was to investigate the epidemiology of invasive disease due to Haemophilus influenzae type b in childhood in Glasgow. A retrospective study has been made on the hospital records of 252 children aged 0 to 12 years admitted to Glasgow hospitals during 1981–1990. The annual incidence of invasive Haemophilus influenzae type b disease in Glasgow was estimated at 39 per 100,000 children less than five years of age per year. The figure for Haemophilus meningitis was 23.8 per 100,000 children less than five years of age per year. Ninety-five per cent of all cases occurred in children less than five years of age and 72.1% of meningitis cases occurred before two years of age. There was a mortality of 2.77%. Long-term neurological sequelae were found in 15.3% of the survivors. The annual incidence of Haemophilus influenzae type b disease is slightly higher in Glasgow than previously reported for the United Kingdom. The study provides baseline data to help assess efficacy of proposed early childhood vaccination.

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Efficacy of Rifampin in Eliminating Pharyngeal Carriage of Haemophilus influenzae Type b

PEDIATRICS ◽

10.1542/peds.66.1.5 ◽

1980 ◽

Vol 66 (1) ◽

pp. 5-8

Author(s):

Eugene D. Shapiro ◽

Ellen R. Wald

Keyword(s):

Haemophilus Influenzae ◽

Care Facility ◽

Carrier State ◽

Haemophilus Influenzae Type ◽

Haemophilus Influenzae Type B ◽

Type B ◽

Exact Test ◽

Staff Members ◽

Control Subjects ◽

Increased Risk

Household contacts less than 6 years of age of children with Haemophilus influenzae type b meningitis are at increased risk of developing systemic H influenzae type b disease. Positive oropharyngeal cultures for H influenzae type b were found in 17/97 patients (18%) and 7/62 staff members (11%) at a chronic care facility at which two patients had developed ampicillin-resistant H influenzae type b meningitis. H influenzae type b colonization was eliminated in 8/9 carriers treated with a single daily oral dose of rifampin, 20 mg/kg/day (maximum 600 mg) for four days; colonization persisted in 9/10 control subjects (Fisher's exact test P < .001; corrected X2 P < .005). After treatment of additional H influenzae type b-positive individuals and the remaining control subjects, rifampin was found to have eradicated H influenzae type b in a total of 24/25 carriers (96%). All isolates of H influenzae type b were sensitive to rifampin at either 0.5 or 1.0 µg/ml. Rifampin is effective in eliminating the H influenzae type b carrier state and may be useful in preventing associated H influenzae type b disease in close contacts of children with H influenzae type b meningitis.

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Follow-up of prospective randomized trial of ampicillin or chloramphenicol versus moxalactam treatment of Haemophilus influenzae type b meningitis

The Journal of Pediatrics ◽

10.1016/s0022-3476(88)80707-8 ◽

1988 ◽

Vol 112 (5) ◽

pp. 795-798 ◽

Cited By ~ 8

Author(s):

Sheldon L. Kaplan ◽

Sally K. Mason ◽

Edward O. Mason ◽

Mary Murphy ◽

E. O'Brian Smith

Keyword(s):

Haemophilus Influenzae ◽

Randomized Trial ◽

Prospective Randomized Trial ◽

Haemophilus Influenzae Type ◽

Haemophilus Influenzae Type B ◽

Type B

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Antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b in a population of splenectomized individuals with varying vaccination status

Epidemiology and Infection ◽

10.1017/s0950268897007978 ◽

1997 ◽

Vol 119 (2) ◽

pp. 167-174 ◽

Cited By ~ 27

Author(s):

H. B. KONRADSEN ◽

C. RASMUSSEN ◽

P. EJSTRUD ◽

J. B. HANSEN

Keyword(s):

Streptococcus Pneumoniae ◽

Haemophilus Influenzae ◽

Vaccine Coverage ◽

Pneumococcal Vaccination ◽

Haemophilus Influenzae Type ◽

Type B ◽

Serious Infections ◽

Antibody Levels

In order to determine antibody levels against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) in a population of splenectomized subjects, 561 persons in a Danish county, splenectomized between 1984 and 1993 were identified. Two hundred and thirty-five were alive and 149 participated in the study. Each person donated a blood sample for antibody determination by ELISA. Though vaccine coverage among the 149 persons was 91% only 52% had ‘protective’ levels of pneumococcal antibodies. Despite recommendations for regular follow-up on pneumococcal antibody levels this had only been carried out in 4% of the subjects. Splenectomized subjects who needed pneumococcal revaccination were significantly more likely to have received their initial vaccination less than 14 days before or after splenectomy, as recommended, than those not requiring revaccination. Therefore, the timing of initial pneumococcal vaccination in relation to splenectomy seems to be important. All persons had Hib antibody levels higher than 0·15 μg/ml and 60% had levels higher than 1 μg/ml, which are the levels thought to provide short term and long term protection, respectively. In total, 37% of the 149 persons tested had pneumococcal and Hib antibody levels thought to correlate with protection from serious infections.

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Comparison of Rifampin and Ampicillin in Day Care Center Contacts of Haemophilus influenzae Type b Disease

PEDIATRICS ◽

10.1542/peds.66.1.1 ◽

1980 ◽

Vol 66 (1) ◽

pp. 1-4

Author(s):

Charles Gessert ◽

Dan M. Granoff ◽

Janet Gilsdorf

Keyword(s):

Haemophilus Influenzae ◽

Day Care ◽

Care Center ◽

Haemophilus Influenzae Type ◽

Haemophilus Influenzae Type B ◽

Type B ◽

Day Care Center ◽

Randomized Crossover Trial ◽

Culture Positive

A prospective, randomized, crossover trial was conducted comparing therapy with rifampin to therapy with ampicillin in eradicating Haemophilus influenzae type b carriage. Twenty-eight carriers were identified in a day care center following exposure to a patient with H influenzae type b meningitis; 26 children were randomly assigned to treatment with either ampicillin (100 mg/kg for five days) or rifampin (20 mg/kg for four days). Cultures were repeated two and four days after discontinuing therapy. In the initial trial, 6/17 children (35%) remained culture positive after treatment with ampicillin compared to 0/9 children treated with rifampin (P = .106). The six children who were ampicillin treatment failures had H influenzae type b isolates sensitive to that drug. These children were subsequently treated with rifampin and their cultures became negative. (For both trials, P = .027.) Repeat cultures 30 days after therapy in 20 treated children revealed one culture positive for H influenzae type b. No further cases developed in the day care center (four months of follow-up). These data suggest that rifampin may be more effective than ampicillin in chemoprophylaxis of contacts of H influenzae type b disease.

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