HAEMOPHILUS-INFLUENZAE TYPE-B EPIGLOTTITIS AFTER IMMUNIZATION WITH HBOC CONJUGATE VACCINE

Introduction: US Food and Drug Administration (USFDA) has licensed fou r Haemophilus influenzae type B (Rib) vaccines for use in children. Ha emophilus influenzae type B is by far the most common pathogen in chil dhood epiglottitis and it is hoped that with the introduction of the H ib Vaccine that a corresponding decrease in epiglottitis cases will be appreciated. Materials and Methods: A retrospective study of all chil dren admitted with the diagnosis of epiglottitis for the Ii-year perio d of 1982 to 1992 was conducted in order to determine the incidence of epiglottitis and Hib Vaccine failure. Fifty-nine cases were included in the study by documentation of an inflamed epiglottis. The case of H ib epiglottitis in a 4-year-old child immunized with HbOC conjugate va ccine at 18 months of age is detailed. Results: A statistically signif icant decrease was found in the incidence of epiglottitis since introd uction of the vaccines; however, the overall trend in decrease for the Ii-year period was not statistically significant. Vaccination status was difficult to accurately document with only two cases of vaccine fa ilure identified. Conclusion: The incidence of Haemophilus influenzae type B epiglottitis at our regional Children's hospital has decreased since the introduction of the Hib vaccine. Reasons for vaccine failure are postulated. (C) 1994 by W.B. Saunders Company