Passive Immunization for Infection With Haemophilus influenzae Type b

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 662-666
Author(s):  
Mathuram Santosham ◽  
Ray Reid ◽  
G. William Letson ◽  
Mark C. Wolff ◽  
George Siber
Keyword(s):  
Haemophilus Influenzae ◽  
Capsular Polysaccharide ◽  
Passive Immunization ◽  
The United States ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Meningitis In Children ◽  
High Risk Infants ◽  
First Year Of Life

Haemophilus influenzae type b is the leading cause of meningitis in children younger than 5 years of age in the United States.1 The incidence of infection with H influenzae type b in certain populations, such as Apache and Navajo Indians and Alaskan Eskimos, is 10 to 20 times higher than in the general US population.2-4 Another important feature of H influenzae type b infections in these populations is that more than 80% of the cases occur during the first year of life, with 35% to 45% occurring during the first 6 months. One of the currently licensed vaccines that contains the capsular polysaccharide of the H influenzae type b organism is not reliably immunogenic in infants younger than 18 months of age.5,6 A number of new H influenzae type b vaccines prepared by covalently coupling the H influenzae type b capsular polysaccharide with a protein carrier antigen are undergoing clinical evaluation.7-13 One of these conjugate vaccines was shown to be efficacious in preventing disease caused by H influenzae type b in Finnish infants when they were immunized at 3, 4, and 6 months of age.14 Unfortunately, in a recently concluded trial, the same vaccine was not found to be efficacious in preventing such disease in infants younger than 1 year of age among the Alaskan Eskimo population.15 We have evaluated an alternative approach for protecting high-risk infants. A human hyperimmune globulin called bacterial polysaccharide immune globulin (BPIG) was prepared from the pooled plasma of adult blood donors immunized with H influenzae type b, pneumococcal, and meningococcal capsular polysaccharide.16

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.

Opsonophagocidal Activity in Sera From Infants and Children Immunized With Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate)

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 694-697
Author(s):  
Barry M. Gray
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Capsular Polysaccharide ◽  
Good Health ◽  
The United States ◽  
Infants And Children ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Group B

Immunization with Haemophilus influenzae type b capsular polysaccharide (polyribosylribitol-phosphate [PRP]) has resulted in limited and variable antibody radioimmunoassay in infants younger than 2 years of age. Although an H influenzae type B vaccine has been in use for several years, it is not used now for the age group at greatest risk for disease. In an effort to enhance immunogenicity, PRP has been coupled to various carrier proteins and to an outer membrane protein complex (OMPC) from Neisseria meningitidis group B.1,2 The latter approach has yielded a vaccine that elicits a good antibody response after a single 15-µg dose of vaccine in infants as young as 2 months of age, as measured by radioimmunoassay and immune bacteriolysis.3,4 In this report we describe the results of a pilot study using this H influenzae type B conjugate vaccine, PedvaxHIB, in children from 2 months to 4 years of age. Three different vaccine lots were examined for consistency of response. Sera were measured for antibody levels by radioimmunoassay and for functional activity using an opsonophagocytic assay using human adult neutrophils. These assays correlated well and demonstrated the excellent immune response and biologic activity of sera from infants vaccinated with this unique H influenzae type B conjugate vaccine. MATERIALS AND METHODS Subjects Infants and children were part of a multicenter study to assess the safety and immunogenicity of PedvaxHIB.3 They ranged in age from 2 to 51 months and were from various socioeconomic backgrounds and geographic areas of the United States. All were in good health, and informed consent was obtained from the parents of all participants.

Immunogenicity of a New Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate) (PedvaxHIBTM)

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 668-675
Author(s):  
Philip P. Vella ◽  
Joan M. Staub ◽  
Jack Armstrong ◽  
Kathleen T. Dolan ◽  
Cynthia M. Rusk ◽  
...  
Keyword(s):  
United States ◽  
Native Americans ◽  
Haemophilus Influenzae ◽  
Capsular Polysaccharide ◽  
The United States ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Older Children ◽  
Neurologic Sequelae

Haemophilus influenzae type b is responsible for an estimated 15 000 to 20 000 cases of meningitis per year in the United States, mainly in children 2 months to 5 years old.1-4 The mortality rate from meningitis due to H influenzae type b infections ranges from 5% to 10%. Despite antibiotic treatment, up to 35% of survivors have permanent neurologic sequelae. In addition to meningitis, H influenzae type b is responsible for other invasive infections, including epiglottitis, septicemia, cellulitis, septic arthritis, osteomyelitis, pneumonia, pericarditis, and otitis media; approximately 30 000 cases H influenzae diseases occur annually in the United States. The diseases peak in incidence between 6 and 12 months of age, with almost one half of the cases occurring before 1 year of age. About 75% of disease caused by H influenzae type b occurs in children younger than 24 months old. The incidence of disease is higher in children of certain groups, including blacks, Hispanics, Eskimos and Native Americans, young children attending day-care facilities, patients with asplenia or antibody-deficiency syndromes, and children of lower socioeconomic status.5 There is considerable evidence that antibody to the capsular polysaccharide (polyribosylribitol-phosphate [PRP]) of H influenzae type b is protective.6-8 These antibodies activate complement for bactericidal antibody,9,10 induce opsonophagocytic activity,11,12 and protect infant rats from bacteremia due to challenge with H influenzae type b.13,14 It has been demonstrated clinically that antibodies induced by vaccination of older children with PRP are protective.7,15 The level of antibodies correlated with protection has been estimated to be 0.05 to 0.15 µg/mL after natural infection16 or after passive acquisition via immunoglobulin17 and 1.0 µg/mL for vaccine-induced protection.18

Safety, Tolerability, and Immunogenicity of Concurrent Administration of Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate) With Either Measles-Mumps-Rubella Vaccine or Diphtheria-Tetanus-Pertussis and Oral Poliovirus Vaccines in 14-to 23-Month-Old Infants

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 682-689 ◽  
Author(s):  
Barry Dashefsky ◽  
Ellen Wald ◽  
Nancy Guerra ◽  
Carol Byers
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Capsular Polysaccharide ◽  
Age Groups ◽  
The United States ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Concurrent Administration

In 1985, the first capsular polysaccharide (polyribosylribitol-phosphate [PRP]) vaccine for Haemophilus influenzae type b was licensed and recommended for routine use in children between 24 and 60 months of age.1,2 In the United States, approximately 75% to 90% of invasive disease due to H influenzae type b occurs in infants younger than 24 months,1,3 a population for whom H influenzae type b polysaccharide vaccine is inadequately immunogenic and protective. In an effort to enhance the immunogenicity of H influenzae type b polysaccharide vaccine for children in the most susceptible age groups, conjugate vaccines have been developed in which the capsular PRP of H influenzae type b has been bound to a variety of carrier proteins, thereby conferring the vaccines with thymic-dependent attributes.4,5 One such conjugate vaccine, in which the carrier protein is diphtheria toxoid (PRP-D), was licensed in 1987 and has been recommended since 1988 for routine use in children 18 months of age and older.6,7 A second conjugate vaccine, in which an oligosaccharide derivative of H influenzae type b capsular PRP is coupled to CRM197, a nontoxic mutant diphtheria toxin (oligo-CRM), was licensed in 1988 and is a sanctioned alternative to PRP-D.8 Another investigational conjugate vaccine, in which the polysaccharide is linked to the outer membrane protein of Neisseria meningitidis group B (PRP-OMPC), has been demonstrated to be both safe and immunogenic when administered in a two-dose schedule to 2- to 6-month-old infants.9 However, anti-PRP antibody levels decline significantly during the ensuing 10 to 15 months10,11; they rise significantly in response to booster doses of either PRP or PRP-OMPC administered 10 to 15 months after the initial priming doses of PRP-OMPC.11,12

scholarly journals Studies of Treatment for Haemophilus influenzae Type b Meningitis in Children

2007 ◽  
Vol 81 (1) ◽  
pp. 51-58
Author(s):  
Tadashi HOSHINO ◽  
Naruhiko ISHIWADA ◽  
Katsuaki ABE ◽  
Junko OGITA ◽  
Chie FUKASAWA ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Meningitis In Children
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