The Pennsylvania Department of Health (DOH) issued a health advisory last week concerning invasive Haemophilus influenzae type b (Hib) infections among unvaccinated children.
As of December 17th, the DOH has received three reports of invasive Hib infections in 3 unvaccinated children. These children reside in Amish communities in southcentral and southeastern Pennsylvania.
Haemophilus influenzae type b, or Hib, can cause a variety of diseases from mild respiratory infections to more severe illness such as meningitis (inflammation of the coverings of the spinal column and brain), blood stream infections, pneumonia, arthritis, and infections of other parts of the body. Hib spreads person-to-person either through exposure to respiratory droplets or direct contact with respiratory secretions from infected or colonized individuals.
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Prior to the availability of the Hib vaccine, Hib disease was the leading cause of bacterial meningitis among children under 5 years old in the United States. In 2019, there were an estimated 7,130 cases of invasive Hib resulting in 1,050 deaths nationwide. Due to widespread Hib vaccination in children, most cases now occur among the elderly and unvaccinated children. In Pennsylvania, there are an average of 5 invasive Hib infections in children each year. In the prevaccination era, hearing impairment or other neurological sequelae occur in 15-30% of survivors. Case fatality ratio is 3%- 6%, despite appropriate antibiotics.
Timely Hib vaccination of young children is important for the prevention of Hib infections. Infants may receive their first dose of Hib vaccine as early as 6 weeks old. All children should receive their primary vaccine doses from 2 through 6 months old and a booster dose at 12-15 months old.
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