Continued surveillance for this mutation is needed as the most recent Hia strains containing this mutation were isolated in Georgia (20). A critical level of serum antibodies against Hib capsular polysaccharide, mostly immunoglobulin G, confers immunity to Hib by complement-mediated bacteriolysis (34, 35, 37). lab icon. The methods for conjugating the type b capsule to a protein carrier are applicable to Hia. The peak Hia carriage was in children up to 1 year of age (38). Rutherford et al. A retrospective analysis of serotypes, biotypes, and antimicrobial resistance of H. influenzae invasive strains was conducted to document the characteristics of H. influenza isolates during a decade prior the use of the Hib vaccine. The isolated strains showed a 300-bp amplicon by PCR analysis and a different pattern by Southern blotting (20). In a study conducted from March 1980 to September 1985 of 155 highlands children in Papua New Guinea with culture-positive meningitis (Hib vaccination was not implemented), 84% were 12 months of age or younger, and 92% were infected with either H. influenzae, Streptococcus pneumoniae, or both. The apparent increasing numbers of cases of Hia invasive disease suggest that development of a vaccine comparable to the current Hib conjugate is reasonable. Extrapolating from the incidence of 17%, a rate of 43 Hia cases per 100,000 annually would be derived. For example, in a prospective 15-month study (1981 to 1983) of the Apache Indians, 15 Hib and 3 Hia (17%) strains were isolated from children under 5 years of age (24). Structures of H. influenzae capsular polysaccharidea. Extensive clinical experience has validated this approach. Meningitis is an infection of the membrane that covers the brain and spinal cord. The results showed that the changes at the capsulation locus cap alone are sufficient to alter the virulence of H. influenzae. Systemic infections in otherwise healthy children caused by this bacterial species occur throughout the world and are due mostly to H. influenzae type b (Hib). The one that people are most familiar with is H. influenzae type b or Hib.These bacteria live in people’s nose and throat, and usually cause no harm. Signs and Symptoms. Causes, How It Spreads, and People at Increased Risk. lab icon. Haemophilus influenzae was first described by Pfeiffer in 1892 (30). In the United States, following 10 years of Hib conjugate vaccine usage, the annual incidence of Hib meningitis among children less than 5 years of age decreased from >10,000 to <200 cases (4). In 2005 Kapogiannis et al. For example, in Brazil, the incidence of Hib meningitis decreased by 69% during the first year following initiation of Hib conjugate immunization, while the incidence of Hia meningitis increased eightfold (33). The apparent increase in cases in selected populations in the United States, such as the Navajo, White Mountain Apache, and Native Alaskans, has raised concerns about a niche previously filled by Hib that now accommodates Hia strains. Holdaway and Turk studied 106 H. influenzae capsulated strains among 2,171 Haemophilus isolates (recovered from more than 30,000 clinical upper and lower respiratory tract specimens in Newcastle upon Tyne hospitals, May 1962 to April 1966). Diagnosis, Treatment, and Complications. Factsheet The pathogen. From 1999 to 2000, 233,516 doses of Hib conjugate were administered three times to a target population of 117,673 children less than 1 year of age, and 36,949 doses were administered once to a target population of 120,537 children aged 12 to 23 months. These strains have been grouped in a single electrophoretic group (division 1) (22). The mutation of IS1016-bexA has been found in three invasive Hia strains isolated from Utah (10-month period from 1998 to 1999) (1). symptom icon. Hib disease is an invasive bacterial infection that at one time was the most common cause of bacterial meningitis in young children; invasive means that germs spread to parts of the body that are normally germ-free. Haemophilus influenzae disease is a name for any infection caused by bacteria called H. influenzae.. lab icon. We propose that demonstration of the ability of Hia polysaccharide conjugates to elicit bactericidal antibodies will be sufficient to license a vaccine, provided it is safe and standardized (35, 43).
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