Epiglottitis and Haemophilus influenzae Immunization: The Pittsburgh Experience–A Five-Year Review

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 424-427
Author(s):  
Hugo González Valdepeña ◽  
Ellen R. Wald ◽  
Elizabeth Rose ◽  
Kitirat Ungkanont ◽  
Margaretha L. Casselbrant

Objective. Current trends in the clinical presentation and management of children with epiglottitis at Children's Hospital of Pittsburgh were reviewed for the years 1988 to 1993. Methodology. The medical records of all patients diagnosed as having epiglottitis between July 1988 and June 1993 at the Children's Hospital of Pittsburgh were reviewed. An additional telephone survey was conducted among the primary care physicians of those patients to collect information regarding administration of Haemophilus influenzae type b (HIB) vaccines. Results. During the study period 28 children (age range, 11 months to 11 years, 10 months) were admitted with the diagnosis of epiglottitis. Cases declined remarkably in 1991. Fever, sore throat, and stridor were the usual symptoms. HIB was the most common cause of epiglottitis accounting for 21 cases. Candida albicans was recovered from the surface culture of the epiglottis in two patients. At least 11 children experienced vaccine failure: nine with polysaccharide vaccine and two with the conjugate vaccine for HIB. Conclusion. Cases of epiglottitis have declined dramatically since licensure of HIB conjugate vaccines for use in early infancy. At least 52% of the reported cases represent vaccine failures with the purified polysaccharide vaccine.

2019 ◽  
Author(s):  
Martin Greta

BACKGROUND Tuberculosis is a widespread and in many cases a fatal, infectious disease caused by many strains of mycobacterium complex usually mycobacterium tuberculosis. It can affect any part of the body but mainly the lungs hence called pulmonary tuberculosis. Tuberculosis in children has been less of a public health priority in the recent years despite the fact that TB has been a major cause of childhood morbidity and mortality worldwide with difficulties in diagnosis. Data on trends of childhood TB is rarely in published literature hence need for this research which will help in publishing OBJECTIVE To establish the trends in TB among children aged 1-12 years and its management over a period of five years from 2011- 2015 at Arthur Davison children’s hospital in Ndola and also to determine the proportion of TB in these children and to establish the age group most affected by TB over the period of five years and lastly to assess the proportion of TB and HIV as a co-morbidity METHODS The study reviewed all records that were registered in the MOH TB register at ADH from 2011 to 2015 coming up with a total number of 483 TB records and these records had satisfied the inclusion and exclusion criteria. The data capturing tool was used to collect the data. RESULTS : This study determined the trends of TB in children aged 1 to 12 over the five years period from a total of 483 reviewed paediatric TB cases , its proportion in these children, the age range most affected by TB and lastly assessed TB and HIV as a co-morbidity at Arthur Davison Children’s hospital. It revealed that the trends were decreasing and that out of 483 TB patient, the majority 157(32.5%) of the TB patients were seen in the year 2011, followed by 129(26.7%), 84(17.4%), 57(11.8%) and 56(11.6%) representing the year 2012, 2013, 2014 and 2015 respectively. Findings on the age range most affected are that the majority 282(58.4%) of the TB patients were aged (5-12) years old while 201(41.6%) were aged between (1-5) years old. Therefore, the age range most affected by TB was between (5-12) years. The TB proportion results showed that Out of 483, the majority 467(96.7%) of the TB patient type were newly diagnosed, followed by 13(2.7%), 2(.4%) and the rest 1(.2%) that were Relapse, Trans-in and Treatment resumed respectively. And that many 467(96.7%) of TB condition types were PTB while 16(3.3%) were EPTB. Furthermore, the majority of 463(95.9%) were diagnosed by X-ray while 20(4.1%) were diagnosed by smear microscopy. And lastly In terms of HIV as a co-morbidity, the majority 175(36.2%) of the TB patients were HIV positive, followed by 173(35.8%) that were HIV negative while the rest 135(28%) of the TB patients were not tested for HIV CONCLUSIONS This study reports that the trends of TB in children aged 1-12 years have been decreasing from 2015 to 2011 .And the age range most affected was found to have been 5-12 years and the proportion of TB cases were mostly newly diagnosed and the diagnosis was made by use x-ray and lastly the large proportion of TB patients had tested positive for HIV as a co-morbidity. Therefore efforts should be made to sustain this decreasing trend of childhood TB.


PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 321-325
Author(s):  
Steven B. Black ◽  
Henry R. Shinefield ◽  

The b-CAPSA I capsular polysaccharide vaccine for Haemophilus influenzae type b was given to 87,541 children 2 through 5 years of age in the Kaiser Permanente Medical Care Program, and the children were then followed using a multiple modality surveillance. Phase 1 consisted of 24-hour recall of immediate side effects which were recorded on questionnaires given to families of 13,500 children. Local side effects were found to be uncommon: 2.3% had a temperature of ≥38.3°C (≥101°F); 4.8% had local erythema, 2.9% local swelling, and 12.6% local tenderness; two children had wheezing shortly after immunization. In Phase 2, 30 days after immunization, questionnaires were mailed to parents of all 87,541 children, who were asked to respond to questions about illnesses and health care. Phase 3 consisted of active surveillance of patient health care use by physicians and nurses during the 30 days after immunization. During the 30-day reporting periods, there were 40 hospitalizations, including one for wheezing and one for febrile seizure. Of the 40 hospitalizations, only the one for wheezing was believed by the admitting physician to be probably associated with vaccine administration. Three children had seizures within 30 days of immunization. None of the seizures was believed by the reporting physician to be associated with immunization. Adverse effects of the vaccine were mild, limited to local reactions and occasional temperature elevation; bronchospasm after immunization occurred rarely.


PEDIATRICS ◽  
1988 ◽  
Vol 81 (6) ◽  
pp. 886-893
Author(s):  
JOEL I. WARD ◽  
CLAIRE V. BROOME ◽  
LEE H. HARRISON ◽  
HENRY SHINEFIELD ◽  
STEVEN BLACK

In recent months much controversy has focused on interpretations of new data concerning the safety and efficacy of Haemophilus influenzae type b vaccines.1-3 These controversies led the Infectious Disease Committee (Redbook Committee) of the Academy of Pediatrics (AAP) on Nov 13, 1987, to issue by telegram a change in recommendations for the H influenzae type b polysac-charide vaccine. Then, on Dec 22, 1987, the US Food and Drug Administration (FDA) licensed a new, more immunogenic, H influenzae type b conjugate vaccine (Prohibit-Connaught). The aim of this commentary is (1) to provide some background to these events, (2) to elucidate some of the difficulties involved in evaluating vaccines after licensure, (3) to present an alternative interpretation of available data regarding the polysaccharide vaccine, and (4) to comment on the new H influenza type b conjugate vaccine.


Sign in / Sign up

Export Citation Format

Share Document