By NewsDesk @bactiman63
Officials with Island Health are reporting a sharp increase in Haemophilus influenza type B (Hib) disease on Vancouver Island in the last two months. This outbreak is affecting people experiencing homelessness, unstable housing, or supportive housing and those using substances including drugs that are inhaled.
Hib has infected at least eight people on the island and led to at least one death. Prior to this year, rates of Hib have been extremely low for the past decade (between 0-1 cases per year) due to excellent control through the universal childhood vaccination program.
Chief medical health officer for Island Health, Dr. Réka Gustafson said, “We expect to see one or no such infections in Island Health in a calendar year. We tend to see less than three in the entire province in a calendar year — so eight in less than a calendar year, and more importantly, six in the last few weeks is really a significant change.”
Hib disease can take many forms, including meningitis, bacteremia, periorbital or other cellulitis, septic arthritis, osteomyelitis, pericarditis, epiglottitis, or pneumonia. Onset of symptoms is usually abrupt, and may include fever, headache, lethargy, anorexia, nausea, vomiting, and irritability. Progressive stupor or coma is common with meningitis. Case fatality can be as high as 5% for meningitis presentations and neurologic sequelae, including deafness in 15-20% of survivors. Coinfection or preceding infection with other respiratory pathogens can also occur.
Individuals may transfer the organism to close contacts though droplet spread by coughing and sneezing. Sharing of droplet or saliva containing items including food, drink and equipment for substance use is also a risk for transmission.
Unimmunized and under-immunized people are most susceptible to Hib disease. Given decreased circulation of Hib since the introduction of vaccine, natural immunity in the adult population has likely reduced and many adults will not have received Hib vaccination as children. Hib vaccine was introduced in BC in 1986 and has been part of the childhood immunization schedule since that time. The vaccine is very effective in preventing disease as well as reducing community transmission.
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