Haemophilus influenzae type B epiglottitis after immunization with HbOC conjugate vaccine.
BACKGROUND
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.


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.


CONCLUSIONS
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.
Keyser
J S
JS
Portsmouth Naval Hospital, VA.
Derkay
C S
CS
D001426:Bacterial Proteins; D002675:Child, Preschool; D004826:Epiglottitis / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D017211:Treatment Failure; D014611:Vaccination; D014768:Virginia / Q000453:epidemiology
D001426:Bacterial Proteins; D018073:Haemophilus Vaccines; C061963:HibTITER protein, Haemophilus influenzae