Invasive Haemophilus influenzae type b disease

Abstract

After four decades of increase in the incidence of invasive Haemophilus influenzae type b (Hib) disease in the United States, the last two decades have seen more than a 99% decrease in incidence associated with universal use of conjugate Hib vaccine in infants. Recently we have had reminders from the United Kingdom and in Native American and Alaska Native populations that Hib, the pathogen, has not disappeared and that the protection from invasive disease depends every day on availability of immunogenic vaccines and implementation of optimal strategies for their use. We take for granted that these contingencies will be met. This month in The Journal, Saha et al prove that Hib currently is a major cause of bacterial meningitis in infants in Bangladesh, dismissing a prior notion of its rarity as due to inadequate culture techniques. Showing increasing resistance to ampicillin and choloramphenicol, the authors additionally make an immediate case for bringing the more costly third-generation cephalosporins within “reach of the people of Bangladesh” and lay the responsibility of universal immunization on the table of policy makers. After four decades of increase in the incidence of invasive Haemophilus influenzae type b (Hib) disease in the United States, the last two decades have seen more than a 99% decrease in incidence associated with universal use of conjugate Hib vaccine in infants. Recently we have had reminders from the United Kingdom and in Native American and Alaska Native populations that Hib, the pathogen, has not disappeared and that the protection from invasive disease depends every day on availability of immunogenic vaccines and implementation of optimal strategies for their use. We take for granted that these contingencies will be met. This month in The Journal, Saha et al prove that Hib currently is a major cause of bacterial meningitis in infants in Bangladesh, dismissing a prior notion of its rarity as due to inadequate culture techniques. Showing increasing resistance to ampicillin and choloramphenicol, the authors additionally make an immediate case for bringing the more costly third-generation cephalosporins within “reach of the people of Bangladesh” and lay the responsibility of universal immunization on the table of policy makers. Invasive Haemophilus influenzae type b diseases in Bangladesh, with increased resistance to antibioticsThe Journal of PediatricsVol. 146Issue 2PreviewTo determine the prevalence, age-group distribution, serotype, and antibiotic susceptibility patterns of invasive Haemophilus influenzae type b (Hib) isolates in Bangladeshi children because data regarding Hib diseases in developing countries are scarce, which has led to delay of the introduction of Hib vaccine in these countries. Full-Text PDF