Management of Contacts of Children in Day Care With Invasive Haemophilus influenzae Type b Disease

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 939-941
Author(s):  
BARRY DASHEFSKY ◽  
ELLEN WALD ◽  
KARL LI
Keyword(s):  
Haemophilus Influenzae ◽  
Day Care ◽  
Care Setting ◽  
The United States ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
American Academy Of Pediatrics ◽  
Increased Risk

Haemophilus influenzae type b (HIB) is the most common cause of serious bacterial disease in children in the United States with 20,000 cases occurring annually. In 1979, it was convincingly reported that this pathogen could spread in households, resuiting in a significantly increased risk of subsequent disease in household contacts.1 Confusion resulting from changing recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics regarding rifampin prophylaxis for HIB disease2,3 and the recent advent of the HIB vaccine4 prompt this commentary on the management of contacts of children with invasive HIB disease with special emphasis on the day-care setting.

Protective Efficacy of Haemophilus influenzae Type b Polysaccharide Vaccine

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 643-647
Author(s):  
Eugene D. Shapiro ◽  
Anne T. Berg
Keyword(s):  
United States ◽  
Haemophilus Influenzae ◽  
Protective Efficacy ◽  
The United States ◽  
Invasive Disease ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Increased Risk

There has been uncertainty and controversy about the protective efficacy of Haemophilus influenzae type b polysaccharide vaccine almost since it first was licensed in the United States. This article will briefly review the available epidemiologic data about the protective efficacy of this vaccine in children with no recognized underlying illnesses. H influenzae type b polysaccharide vaccine was licensed in the United States in April 1985, based on the results of a randomized clinical trial that was conducted in Finland.1 That study indicated that the vaccine's protective efficacy was 90% against invasive disease caused by H influenzae type b in children 18 to 71 months of age. Authorities recommended that all children receive the vaccine at 2 years of age and that it be administered to children up to the age of 60 months.2,3 The Immunization Practices Advisory Committee also recommended that children at increased risk (such as those who attend group day care) receive the vaccine at 18 months and again at 24 months of age because of its inconsistent immunogenicity when administered to 18-month-old children.2 Soon after its licensure, however, reports of vaccine failures began to appear. In some instances the vaccine failure could be attributed to an identifiable immune deficiency.4,5 However, Granoff et al6 reported 54 apparently normal children who had received the H influenzae type b polysaccharide vaccine but subsequently developed invasive disease caused by H influenzae type b. The majority of these children had normal serum concentrations of total immunoglobulins, IgG2, hemolytic complement, and antibody to tetanus toxoid (a T-cell-dependent antigen).

scholarly journals Haemophilus influenzae Type b Polysaccharide Vaccine: An Efficacy Study

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 255-261
Author(s):  
Lee H. Harrison ◽  
Claire V. Broome ◽  
Allen W. Hightower
Keyword(s):  
Haemophilus Influenzae ◽  
Day Care ◽  
Protective Efficacy ◽  
Conditional Logistic Regression ◽  
The United States ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Additional Information

The Haemophilus influenzae type b polysaccharide vaccine was licensed for use in the United States in April 1985. Postlicensure case-control efficacy studies have yielded markedly different estimates of efficacy, leading to contradictory recommendations to practicing physicians. To obtain additional information about the efficacy of the vaccine, we studied cases of invasive Haemophilus influenzae type b disease ascertained through active surveillance in areas with a total population of 34 million. We enrolled children 24 to 59 months of age who did not attend day-care centers. (Data from our day-care study have been published elsewhere.) For each case child, as many as three 24- to 59-month-old control children were chosen from a roster of acquaintances supplied by the child's parent. Conditional logistic regression was used, and vaccine efficacy was estimated to be 62% (95% confidence interval = 0%, 85%), which did not change significantly after adjusting for age and parental smoking, variables that were significantly different for case and control children. Results of this study support our previous finding of a positive protective efficacy, albeit lower than the efficacy of 90% found in children 18 to 71 months of age in the Finnish prelicensure trial.

Patterns of Haemophilus influenzae type b Invasive Disease in New York State, 1987 to 1991: The Role of Vaccination Requirements for Day-Care Attendance

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1014-1016
Author(s):  
Elaine E. Schulte ◽  
Guthrie S. Birkhead ◽  
Stan F. Kondracki ◽  
Dale L. Morse
Keyword(s):  
New York ◽  
Haemophilus Influenzae ◽  
Day Care ◽  
New York State ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Day Care Centers ◽  
York State

Haemophilus influenzae type b (Hib) is the most common cause of bacterial meningitis in young children and is a major cause of other invasive bacterial disease.1 The case fatality rate for Hib meningitis is 1.0% to 3.4%.2,3 Also, 14% of meningitis cases result in persisting neurologic sequelae and 10% to 11% result in sensorineural hearing loss.4,5 With the introduction of Hib vaccines in 1985, what was once a potentially devastating disease is now preventable by vaccination.6 The risk of Hib in day-care centers (DCCs) is highest for younger children (≤23 months of age), during the first month of enrollment in day care, and for those children who attend larger day-care centers as opposed to home day-care settings.7 The incidence of Hib disease is higher for blacks, Hispanics, native Alaskans, American Indians, and children of lower socioeconomic status.8 Increasing enrollment in licensed DCCs throughout the country has provided an opportunity, through entrance requirements, to ensure that these children receive public health preventive measures such as vaccinations. Most states have laws requiring certain vaccinations before entry into DCCs; however, many states do not have a specific DCC entry requirement for Hib vaccination.9 The purposes of this article are to examine patterns of Hib incidence in New York State by gender, race, and age and to evaluate Hib disease within the DCC setting in New York State in relation to changing Hib vaccine requirements for DCCs. METHODS We conducted a retrospective study of invasive Hib disease in New York State outside New York City.

Day Care for Sick Children

PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 445-446
Author(s):  
GEORGE G. STERNE
Keyword(s):  
Haemophilus Influenzae ◽  
Giardia Lamblia ◽  
Day Care ◽  
Hepatitis A ◽  
Care Center ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Day Care Center ◽  
Sick Children

Children in day care, like their home-reared peers, frequently become ill. Whether they are sick more frequently than those not in day care has been a question difficult to resolve because of the problem of appropriate control studies. Many pediatricians are convinced that this is so. There are data that infections due to certain specific agents including hepatitis A, Haemophilus influenzae type B, and Giardia lamblia occur more often in day-care center attendees. Clinical entities such as diarrhea, meningitis, and otitis media have also been shown to be more common in day-care center attendees. A recent review in Pediatrics1 provides a good overview of the problem.

Outbreak of Haemophilus influenzae type b meningitis in a day care center

1990 ◽  
Vol 9 (5) ◽  
pp. 326-332 ◽  
Author(s):  
I. ANDERSSON VON ROSEN ◽  
L. GOTHEFORS ◽  
S. SCHMEISSER ◽  
A. TÄRNVIK ◽  
C. SVANBORG EDÉN
Keyword(s):  
Haemophilus Influenzae ◽  
Day Care ◽  
Care Center ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Day Care Center

Haemophilus influenzae Type b Infections in Day Care Attendees:Implications for Management

1986 ◽  
Vol 8 (4) ◽  
pp. 558-567 ◽  
Author(s):  
R. S. Daum ◽  
D. M. Granoff ◽  
J. Gilsdorf ◽  
T. Murphy ◽  
M. T. Osterholm
Keyword(s):  
Haemophilus Influenzae ◽  
Day Care ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B

Persistent Pharyngeal Colonization with Haemophilus influenzae Type b After Intravenous Chloramphenicol Therapy

PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 435-437
Author(s):  
Eugene D. Shapiro
Keyword(s):  
Haemophilus Influenzae ◽  
Prospective Study ◽  
Index Case ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Household Contacts ◽  
Potential Source ◽  
Increased Risk ◽  
Close Contacts

A recent prospective study has demonstrated that age-susceptible household contacts of children with Haemophilus influenzae type b (HIB) meningitis are at significantly increased risk of developing systemic HIB disease.1 Studies of meningococcal disease have suggested that chemoprophylaxis of close contacts of the index case may decrease this risk by reducing transmission from carriers to noncarriers.2 Chemoprophylaxis of household and day care contacts of children with HIB meningitis has been recommended.3 Three children treated with intravenous chloramphenicol for ampicillin-resistant HIB meningitis were found to harbor HIB in the pharynx prior to hospital discharge. These patients represent a potential source for the reintroduction of HIB into the household.

Disease Caused by Haemophilus influenzae Type b in the Immediate Period After Homologous Immunization: Immunologic Investigation

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 698-704
Author(s):  
Sunil K. Sood ◽  
Robert S. Daum
Keyword(s):  
United States ◽  
Haemophilus Influenzae ◽  
Capsular Polysaccharide ◽  
The United States ◽  
Invasive Disease ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Background Rate ◽  
Protein Conjugate

Several Haemophilus influenzae type b vaccines have been licensed and recommended for administration to children in the United States. These vaccines have consisted of purified polyribosylribitol-phosphate (PRP), the capsular polysaccharide of H influenzae type b,1 alone or covalently bound to one of several carrier proteins. Two of these saccharide-protein conjugate vaccines are now licensed, a polysaccharide-diphtheria toxoid conjugate (PRP-D)2 and an oligosaccharide-mutant diphtheria toxin conjugate (HbOC).3 Two others, a polysaccharide- Neisseria meningitidis outer membrane protein conjugate (PRP-OMPC)4 and a polysaccharide-tetanus toxoid conjugate (PRP-T),5 are currently in clinical trials. One concern with the use of PRP vaccine was the suggestion that the incidence of invasive disease caused by H influenzae type b in the immediate period after immunization might be increased; this idea was supported by evidence from several sources. In a case-control study of the efficacy of PRP vaccine, Black et al6 found that 4 children were hospitalized for invasive disease within 1 week of immunization, a rate of invasive disease 6.4 times greater (95% confidence interval [CI], 2.1 to 19.2) than the background rate in unvaccinated children. In Minnesota, the relative risk for invasive disease in the first week after immunization was 6.2 (95% CI, 0.6 to 45.9),7 and the results of a study conducted by the Centers for Disease Control in six areas of the United States revealed a 1.8-fold (95% CI, 0.3 to 10.2) increase in the occurrence of invasive disease caused by H influenzae type b in the first week after immunization.8 Moreover, among 16 cases of disease caused by H influenzae type b occurring within 14 days of immunization that were passively reported to the FDA,9 10 were clustered within the first 72 hours.

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