Hib Disease (Haemophilus Influenzae Type b)

If you're the parent of a child or teen, chances are your child received a vaccination for an illness called Hib, or Hib disease, when he or she was a baby. But what is Hib disease, and why do kids need to be vaccinated against it?

About Hib Disease

Hib is short for Haemophilus influenzae type b, a type of bacteria. Despite its name, Hib doesn't cause influenza, but it can cause a number of serious illnesses, some of which can be life threatening.

Hib can cause ear infections, pneumonia, blood infections, cellulitis (a skin infection), arthritis, epiglottitis (a severe infection of the throat), and meningitis (an infection of the membranes covering the brain and spinal cord).

Hib disease can occur at any age, but is most common in unvaccinated kids younger than 5 years old and those who haven't completed the full series of Hib vaccines during infancy. Hib disease also can be a concern for the elderly and people with weakened immune systems.

Before the Hib vaccine was developed, Hib disease was the leading cause of bacterial meningitis in the United States. Each year, about 12,000 children got meningitis as a result of Hib, and about 1 in 20 died. Among those who survived, about 1 in 4 had permanent brain damage. Epiglottitis, too, can be life threatening and used to cause a number of deaths each year.

Since the Hib vaccine was introduced in the late 1980s, the U.S. rate of Hib infection has decreased by 99%. In developing nations where use of the vaccine is less common, though, Hib disease continues to be a major health concern.

Causes

Hib is spread from person to person, either from a healthy carrier of the infection (someone who has the bacteria in his or her body but who doesn't have symptoms of an illness) or someone who is sick with Hib.

Hib spreads through direct contact with mucus or respiratory droplets (saliva) from someone carrying the bacteria. This usually happens when a healthy Hib carrier sneezes or coughs near an unvaccinated person. Even carriers who aren't sick can pass the disease to others for as long as the bacteria remain in their body.

Symptoms

All children with Hib disease have a fever. Other symptoms will depend on the type of illness that results from the Hib disease:

• Meningitis symptoms include a headache, stiff neck, and vomiting.
• Pneumonia symptoms include coughing and breathing difficulty.
• Epiglottitis symptoms include sore throat, drooling, and breathing difficulty.
• Cellulitis symptoms include red, tender skin.
• Arthritis symptoms include severe pain, swelling, and redness in a joint.
• Ear infections cause ear pain.

Each illness caused by Hib also has its own specific complications. Meningitis can cause permanent brain damage and death. Epiglottitis can quickly lead to life-threatening breathing difficulties. The other infections, like pneumonia, cellulitis, and arthritis, can cause organ failure if not promptly treated.

When to Call a Doctor

If your child has not received the full course of Hib vaccines and he or she shows any signs of the conditions above, call a doctor right away. You also should call a doctor if your child has a fever and you think he or she might have been exposed to someone with Hib disease.

Some of the illnesses that result from Hib disease can lead to emergency situations. If your child has trouble breathing or other severe symptoms, dial 911 or get your child to a hospital ER right away.

To diagnose a case of Hib disease, the doctor will examine your child and ask you about the symptoms. The doctor may take a small sample of your child's blood, spinal fluid, or another body fluid for testing.

Treatment

Hib disease is treated with antibiotic medicines to kill the bacteria. Other treatments will depend on the illness that results from the Hib infection and any complications that develop.

For 1 to 2 days after antibiotic treatment has begun, keep your child home from school and away from anyone who hasn't received the Hib vaccine. Ask the doctor for advice on keeping your child comfortable at home until the infection has gone away.

Prevention

The main way prevent Hib disease is to make sure that kids receive the Hib vaccine as infants. The vaccinations approved to protect against Hib infection are highly effective and routinely administered throughout the United States.

The series of vaccinations usually involves injections at 2 months, 4 months, and 6 months, although some brands of vaccine do not require a 6-month shot. A booster dose is given at 12 to 15 months.

If your young child has not received the Hib vaccine or has not completed the full series of injections, keep him or her away from anyone who might have Hib disease until the vaccinations are complete. If your child never received the Hib vaccine as a baby, talk to your doctor about whether your child should be vaccinated. The vaccine is not routinely recommended for kids older than 5 who haven't been vaccinated, unless they have problems with their immune system (such as asplenia, sickle cell disease, immunoglobulin deficiency, HIV, or cancer).