H. influenzae infections
Haemophilus influenzae type b (Hib) was initially thought to be the cause of influenza illness because Hib was found in a group of patients during an influenza outbreak in 1892. This lasted until scientists discovered that the flu was caused by a virus. The name of the bacterium did not change after this discovery however.
Hib bacteria stained on a microscope slide
Young child with one of the invasive illnesses caused by Hib ~ epiglottitis which is a life threatening illness characterized by high fever, difficulty breathing with noisy inhalation, sitting forward and excessive drooling. Hib causes swelling around the epiglottis in the throat and impedes airflow.
Hib bacteria is of two types - typeable due to the particular capsule surrounding the bacteria and nontypeable. The typeable strains are named a -f and type b (Hib) causes 95% of invasive illness. Hib bacteria is commonly found in the nose and throat of healthy individuals and the bacteria is spread by respiratory droplets even from people who are not ill.
Prior to the vaccine for Hib, about 5-10% of children under the age of 5y were colonized with this bacteria in their nose and throats and these children were the major source of spread. The vaccine prevents colonization in young children. Young children cannot fight off this encapsulated bacteria similar to strep pneumonia bacteria (another encapsulated bacteria) that poses a threat to younger children. Children remain at risk for illness until about age 5y if unimmunized with two thirds of cases occuring under the age of 2 years with a peak incidence around 10-12 months of age. Older children and adults are likely to become colonized but do not become ill from this bacteria but can spread the germ.
Similar to Strep pneumonia bacteria, Hib bacteria can cause mild illnesses such as ear infections, sinus infections and pneumonia, which can become serious. Invasive illness caused by Hib bacteria include meningitis (infection of the covering of the brain/spinal cord), epiglottis (see above), pericarditis (infection around the heart), septic arthritis (infection of joints) and bacteremia (blood infections). Up to 10% of chidren who contract invasive Hib illness will die. Around 20-30% of children who recover from meningitis will be left with neurological deficits such as hearing loss, learning difficulties and cerebral palsy.
Most invasive Hib illness will be characterized by high fever.
Meningitis: high fever, headache, vomiting, stiff neck; babies with poor feeding, extreme irritability, vomiting and/or fever
Pericarditis: fever, chest pain, difficulty breathing
Septic Arthritis: fever, painful joint(s), redness of joint
Blood infection: fever, poor circulation, pain, confusion/irritability
Like S. pneumonia infections, Hib infections can be prevented. Breastfeeding will provide some protection up to the age of six months with Hib antibody transfer to babies. The most effective method to prevent Hib illness is the vaccine. The vaccine was introduced for routine immunization in 1990 in the US and in many countries worldwide. The incidence of Hib invasive illness has decreased by almost 95% in countries with routine Hib vaccination.
Hib can cause serious illness, leave behind neurological problems and is preventable.
(S. pneumoniae blog: http://www.wholekidspediatrics.com/blog/article/streptococcus-pneumonia-s.-pneumonia)
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