Some techniques of detection of Hib were compared, including classic techniques such as bacterial culture and modern techniques such as PCR method. The results were as follows: 21% (+) culture with Hib compared to the total of clinically diagnosed cases, Hib-latex agglutination with 95% sensitivity and 99.6% specificity, counter immunophoresis assay to detect Hib by 97% sensitivity and 100% specificity. PCR increased the number of positive cases of Hib meningitis by 42.8% compared to culture alone. Blood culture gave a highly significant value to diagnose (51% Hib-possitive culture)
Haemophilus influenza type b ; Meningitis ; methods ; diagnosis

Haemophilus influenzae type b(Hib) is one of the most common cause of invasive bacterial disease in children. In Korea, However, the proportion occupied by Hib as a cause of pediatric pathogen is less compared to those of western countries. Natural immunity to Haemophilus influenzae type b was determined on 308 Korean children. The titration of antibody to capsular polysaccharide (PRP) was performed by the radioantigen binding assay. Forty percent of the total subjects and 31% of children under 5 years had an antibody level considered to be protective( 0.15 g/ml).Seropositivity was 13.6% in 12~17 month age group, and increased progressively to 19% in 5~10 year age group. In the age groups under 36 months of age, the geometric mean titers of anti-PRP antibody were below the protective level. These data indicate that a lot of Korean children under 5 years of age do not have antibody levels considered to be protective against H. influenzae type b, and do not explain the apparent low risk of Korean children to Hib Further studies including comparative antibody response to polysa-charide and protein antigens with other racial groups are needed.
Antibody Formation ; Child* ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Immunity, Innate ; Influenza, Human ; Korea

Among the fifty-three clinical isolates of Haemophilus influenzae, nineteen isolates including eight isolates of each biotype I-VIII, six of serotype b (Hib) strains and five of nontypeable strains were characterized by SDS-PAGE about outer membrane protein (OMP), restriction enzyme analysis (REA) and rRNA gene restriction pattems. OMP patterns showed to common band patterns in each H. influenzae isolate. Based on the two major proteins, 31KDa-38KDa, isolated strains were classified into 7 subtypes. In the OMP patterns about biotype and serotype, the specific pattern of each biotype was not distinguishable, but all of the serotype b strains were shown identical unique pattern, therefore it made distinctive difference with nontypeable strains. The digested genomic DNAs with EcoRI were identical result with rRNA gene restriction. It was more subdivided into 10 ribotypes. The most common ribotype I and serotype 1 accounted for 6 strains (31.6%) and 7 strains (36.8%) of the 19 clinical isolates, respectively. Hib isolates that were both OMP subtype 1 and ribotype I accounted for 2 strains (10.5%). In the epidemiologically unrelated strains, the putative association between the subtypes could not be confirmed. According to these results, the three methods were discriminatory and appropriate techniques for epidemiological studies of H. influenzae.
DNA ; Electrophoresis, Polyacrylamide Gel* ; Genes, rRNA* ; Haemophilus influenzae type b ; Haemophilus influenzae* ; Haemophilus* ; Influenza, Human ; Membrane Proteins ; Restriction Mapping* ; Ribotyping

Since the implementation of conjugate Haemophilus influenzae serotype b (Hib) vaccine, the rate of infections caused by Hib has dramatically decreased, and the proportion of infections caused by non-type b H. influenzae has increased. Cerebral venous sinus thrombosis (CVST) is rare; however, it should be considered as a potential complication of bacterial meningitis. Herein, we report about a child who developed CVST after being diagnosed with H. influenzae serotype f meningitis.
Bacteremia ; Central Nervous System Infections ; Cerebrospinal Fluid ; Child ; Haemophilus influenzae type b ; Haemophilus influenzae ; Haemophilus ; Humans ; Influenza, Human ; Meningitis ; Meningitis, Bacterial ; Meningitis, Haemophilus ; Sepsis ; Serogroup ; Sinus Thrombosis, Intracranial

Diphtheria-Tetanus-acellular Pertussis Vaccines ; Haemophilus influenzae type b ; immunology ; Influenza Vaccines ; Vaccination ; methods ; Vaccines, Combined

<b>OBJECTIVEb>To analyze the occurrence feature of adverse events following immunization (AEFI) of Hib conjugate vaccine (HibCV) and to evaluate the safety of HibCV in postmarketing.

<b>METHODSb>2008-2013 HibCV AEFI data were collected through national AEFI information management system, which were downloaded in March 18, 2014.The demographic information and inoculation quantity of HibCV were from Immunization information management system in Jiangsu province. The incidence rate and 95% CI value of AEFI, common vaccine reaction and rare vaccine reaction following immunization of HibCV were calculated. The differences in the incidence rate of common vaccine reaction and rare vaccine reaction among sex, months of age, and number of injections were compared by means of (χ² tests.

<b>RESULTSb>A total of 6.16 million doses of vaccine were administered in Jiangsu province during 2008-2013, and 4 718 vaccinees reported having adverse event, for a rate of 76.60/100 000 (95% CI: 74.42/100 000-78.79/100 000). The incidence rate of common vaccine reaction and rare vaccine reaction was 71.10/100 000 (95% CI: 68.99/100 000-73.20/100 000) and 5.16/100 000 (95% CI: 4.60/100 000-5.73/100 000), respectively. The main symptoms of common vaccine reactions were fever, swelling, indurations and gastrointestinal reactions. The incidence rates of them were 40.54/100 000, 35.09/100 000, 12.94/100 000 and 0.36/100 000 in turn. The main symptoms of rare vaccine reactions were anaphylactic rashes and angioedema, the incidence rates of which were 4.77/100 000 and 0.15/100 000 respectively. 91.39% (4 002/4 379) of common vaccine reactions and 88.36% (281/318) of rare vaccine reactions happened within 1 d after vaccination. Anaphylactic shock (3 cases) and laryngeal edema (1 case) all happened within 1 d after vaccination. The incidence rate of common vaccine reactions among boys (79.72/100 000, 2 641/3 313 071) was higher than that of girls (61.07/100 000, 1 738/2 846 001) (χ² = 74.92, P < 0.001). The incidence rate of common vaccine reactions among children aged ≥ 12 month-old (86.82/100 000, 2 200/2 533 949) was higher than that among children aged 2-11 month-old (60.11/100 000, 2 179/3 625 123) (χ² = 149.79, P < 0.001). The incidence rate of common vaccine reactions in children vaccinated the first dose (78.93/100 000, 2 666/3 377 614) was higher than that in children vaccinated the second or third or fourth dose (61.59/100 000, 1 713/2 781 458) (χ² = 64.59, P < 0.001). The incidence rate of rare vaccine reactions in children vaccinated the first dose (6.69/100 000, 226/3 377 614) was higher than that in children vaccinated the second or third or fourth dose (3.31/100 000, 92/2 781 458) (χ² = 33.82, P < 0.001).

<b>CONCLUSIONb>The safety of HibCV among children was relative good. However, the surveillance should still focus on the anaphylactoid reactions of anaphylactic shock and laryngeal edema after HibCV immunization.

Angioedema ; Bacterial Capsules ; Child ; Female ; Fever ; Haemophilus Infections ; Haemophilus Vaccines ; adverse effects ; Haemophilus influenzae type b ; Humans ; Hypersensitivity ; Immunization ; Influenza, Human ; Male ; Safety ; Vaccination ; Vaccines, Conjugate

Acute otitis media (AOM) and pneumonia are among the most common infectious diseases of children. Both are mucosal infections and share many common features such as etiological agents, pathogenesis and immunity. Influenza plays an important role in the pathogenesis of AOM and pneumonia. A vaccine against influenza may have substantial impact on these diseases during the influenza season. In clinical trials, influenza vaccine has reduced the incidence of AOM and pneumonia complicating influenza in children. However, the efficacy of vaccines has been controversial in children less than 2 years of age. Similarly, vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both common causes of AOM and pneumonia, have the potential to reduce the impact of disease. Clinical trials showed that the currently licensed 7-valent pneumococcal conjugate vaccine (PCV), administered during infancy, had an efficacy of 6-7% for the prevention of AOM, however, visits to the clinic for AOM were reduced by up to 20-30% after routine use in the U.S. Both Hib and PCVs have a proven effectiveness of >20% for prevention of radiologically confirmed pneumonia in children. The recently introduced pnuemococcal vaccine conjugated with protein D is expected to reduce AOM and pneumonia caused by non-typable H. influenzae, in addition to its effects on pneumococcal diseases. Considering their high incidence in children, recent achievements in the prevention of AOM and pneumonia with vaccines may have a significant economic and social impact.
Achievement ; Child ; Communicable Diseases ; Haemophilus influenzae type b ; Humans ; Incidence ; Influenza Vaccines ; Influenza, Human ; Otitis ; Otitis Media ; Pneumonia ; Seasons ; Social Change ; Streptococcus pneumoniae ; Vaccines

Haemophilus influenzae type b (Hib) has been one of the most common causes of invasive bacterial infections in the young children during the pre-vaccine era. The polysaccharide vaccine developed in the 1970s was composed of the capsular polysaccharide of Hib. The polysaccharide vaccine was not not effective in children younger than 2 years old those who are the highest risk group. In the 1980s, the protein conjugate vaccine was developed employing diphtheria toxoid, tetanus taxoid or outer membrane protein of Neisseria meningitidis as carrier proteins. The protein conjugate protein is highly effective in young infants. In countries where Hib conjugate vaccine is included in routine immunization, Hib disease is almost eradicated. The incidence and spectrum of Hib disease vary among different countries. The incidence of Hib diseases among Korean infants and young children is lower compared to those of western countries; the incidence of Hib meningitis in children under 5 years of age is around 10 per 100,000 per year, compared to around 50 in the United States and 20-30 in the European countries. Immunogenicity of Hib vaccine in Korean infants is very good and the responsiveness of Korean infants to Hib vaccine vaccine is better than that of the U.S. infants, which may has implication for the apparently lower incidence of Hib disease in Korean children. Hib vaccine was introduced in the early 1990s, and has been recommended for high risk children and used as an optional vaccine among healthy infants. Hib vaccine is not included in the National Immunization Program yet, but the Committee on Infectious Disease, Korean Pediatric Society, have decided to include the Hib vaccine in the routine immunization program in 2008. Hib vaccine should be included in the National Immunization Program in the near future and a surveillance system for Hib disease should be established.
Bacterial Infections ; Carrier Proteins ; Child ; Communicable Diseases ; Diphtheria Toxoid ; Haemophilus ; Haemophilus influenzae ; Haemophilus influenzae type b ; Humans ; Immunization ; Immunization Programs ; Incidence ; Infant ; Influenza, Human ; Membrane Proteins ; Meningitis ; Neisseria meningitidis ; Tetanus ; United States

Epiglottitis is an uncommon but potentially life threatening infectious disease in young children. And it is rapidly progressing cellulitis of the epiglottis and adjacent structures that has the potential for causing abrupt, complete airway obstruction. The most common cause of acute epiglottitis is Haemophilius influenzae type b(Hib), therefore in USA, the acute epiglottitis is seen less commonly since the wide spread use of immunization against Hib. In Korea, there has been no report of acute epiglottitis caused by known bacterial organism, and a little investigation of the effects of the immunization against Hib, or Hib related respiratory diseases. In this report, we describe two cases of acute epiglottitis caused by Hib, occurred in non-immunized young-male children admitted to Ajou University Hospital. They had visited to the emergency center of Ajou University hospital with the complaints of acute fever, drooling, dysphagia and severe respiratory difficulties. In both cases, we observed the cherry-red colored, severely swollen epiglottis by the direct laryngoscopic examination. Hib was cultured in blood samples from both two cases, and the patients treated successfully by the 3 days of endotracheal intubation and proper antibiotics therapy without any complications such as pneumonia, meningitis, osteomyelitis, or pericarditis.
Airway Obstruction ; Anti-Bacterial Agents ; Cellulitis ; Child ; Communicable Diseases ; Deglutition Disorders ; Emergencies ; Epiglottis ; Epiglottitis* ; Fever ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus* ; Humans ; Immunization ; Influenza, Human ; Intubation, Intratracheal ; Korea ; Meningitis ; Osteomyelitis ; Pericarditis ; Pneumonia ; Sialorrhea

PURPOSE: This study was performed to assess the difference of organisms causing bacterial meningitis according to time. METHODS: We analyzed retrospectively 40 medical records of bacteriologically proven meningitis from 1992 to 2002. We divided them into two groups; neonate's group(14 cases), and children's group(26 cases). The results of the neonate's group were compared with those of previously reported articles in Korea, in 1970s-1980s. The causative agents of the children's group were analyzed according to the stage before and after the introduction of H. influenza type b(Hib) vaccine. RESULTS: In neonates, Group B streptococci(GBS) was the most common cause of bacterial meningitis. There was a trend in Korea that major causative agents of neonatal bacterial meningitis have changed from gram negative bacteria including E. coli to gram positive bacteria including GBS. In children, H. influenzae was isolated in six out of 11 cases(55%) in 1992-95, before the introduction of Hib vaccine, while two out of seven(29%) were isolated in 1999-2002, after the introduction of the Hib vaccine. CONCLUSION: Our study showed that the most common agent of neonatal bacterial meningitis was GBS. There was a trend that after the introduction of Hib vaccine, the incidence of H. influenza meningitis decreased in children.
Child* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Haemophilus influenzae type b ; Humans ; Incidence ; Infant, Newborn ; Influenza, Human ; Korea ; Medical Records ; Meningitis ; Meningitis, Bacterial ; Retrospective Studies