 Haemophilus Influenzae Infections
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Haemophilus influenzae, or H. influenzae, represents a group of bacteria that may cause different types of infections in infants and children. H. influenzae most commonly causes ear, eye, or sinus infections, and pneumonia.
In rare cases, children may still develop a more serious strain of the bacteria, called H. influenzae type b infections. However, H. influenzae type b has been nearly abolished in the US due to effective vaccine development, which has been available since 1988. It was responsible for causing several types of serious illness, including:
- meningitis - infection of the membranes that surround the spinal cord and brain
- pneumonia - an infection in the lungs
- epiglottitis - a life-threatening infection of the area of the throat that covers and protects the voice box and trachea during swallowing
- infections of the blood, joints, bones, and covering of the heart
H. influenzae type b infections can occur if a child has not completed his or her series of immunizations or in older children who did not receive the vaccine as an infant.Cases of H. influenzae type b (Hib) have decreased dramatically. During the early 1980s, in the US, the estimated incidence of H. influenzae disease was close to 20,000 cases per year. Since the advent of the vaccine, in 1988, there has been a larger than 99 percent decrease in H. influenzae type b cases.
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The H. influenzae bacteria live in the upper respiratory tract and are usually transmitted by close contact with an infected individual. Droplets in the air from a sneeze, cough, or close conversation can be inhaled and may also cause infection.
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The following are the most common symptoms of H. influenzae infections. However, each child may experience symptoms differently. Symptoms may include:
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- otitis media (middle ear infection) - may develop after a child has a common cold caused by a virus. Symptoms may include:
- difficulty sleeping or staying asleep
- tugging or pulling at one or both ears
- fluid draining from ear(s)
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- conjunctivitis - an inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that lines the inside of the eye and also a thin membrane that covers the actual eye. Symptoms may include:
- drainage from one eye or both eyes
- photophobia (eyes sensitive to light)
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- sinusitis - infection in the sinuses. Symptoms may include:
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- younger children:
- runny nose that lasts greater than seven to 10 days. The discharge is usually thick green or yellow, but it can be clear.
- usually do not complain of headaches if less than 5 years of age
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- older children:
- runny nose or cold symptoms that last greater than seven to 10 days
- complaints of drip in his/her throat from his/her nose
- swelling around the eye (tends to be worse in the morning)
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- epiglottitis - due to the H. influenzae type b vaccine, epiglottitis is very rare in children and infants. Epiglottitis is an infection of the area of the throat that covers and protects the voice box and trachea (or windpipe) during swallowing.
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- Some children, about 25 percent, begin with an upper respiratory infection, such as a cold. Symptoms may include:
- quick onset of a very sore throat
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- As the infection worsens, the following symptoms may appear:
- child sits leaning forward
- child keeps his or her mouth open
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- meningitis - due to the H. influenzae type b vaccine, meningitis is very rare in children and infants. Meningitis is an infection of the membranes that surround the brain and spinal cord. Symptoms may include:
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- in children older than 1 year:
- in infants, symptoms are difficult to pinpoint and may include:
- cries when picked up or being held
- bulging fontanelle (or soft spot)
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The symptoms of H. influenzae infection may resemble other medical conditions. Always consult your child's physician for a diagnosis.
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Your child's physician may diagnose the illness based on clinical examination and a medical history. Specific tests will depend on the location of the infection. In some cases, your physician may take a culture of fluid from the eye, ear, throat, or spinal fluid. In other situations, this may be not be possible and a diagnosis will be made based on your child's specific symptoms. Other diagnostic tests may include:
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- chest or neck x-ray - a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- blood tests
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Treatment for H. influenzae greatly depends on which area of the body is infected. Specific treatment for H. influenzae will be determined by your child's physician based on:
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- your child's age, overall health, and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
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Regardless of the location, antibiotics may be used to treat infections caused by H. influenzae. The length of treatment varies depending on the location and severity of the infection. Other therapy will be supportive (aimed at treating the symptoms present).
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H. influenzae type b has been nearly abolished in the US due to effective vaccine development, which has been available since 1988. Immunization with the Hib vaccine can help prevent Haemophilus influenzae type b disease. In rare cases, children may still develop H. influenzae type b infections. This can occur if the child has not completed their series of immunizations or in older children who did not receive the vaccine as an infant.
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Hib is given to babies and children in four doses at the following ages:
- 2 months
- 4 months
- 6 months
- 12 to 15 months
In some situations, children should not receive the vaccine, including:
- Children younger than 6 weeks of age
- Children who are sick or have a fever should wait until they are well to receive the Hib vaccine
- Children who have had a severe reaction to Hib vaccine
- If a child is older than five years and has not received the vaccine, it may not be necessary for them to be immunized
Your child's physician will advise you on the vaccine in these and other situations.
Populations that should be encouraged to receive the vaccine include the following:
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- adults and children with sickle cell disease
- individuals without a spleen
- adults and children with weakened immune systems
- individuals who are HIV positive
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A vaccine, like any medication, is capable of causing serious problems, such as severe allergic reactions. The risk of Hib causing serious harm or death is very small. Most people who get the Hib vaccine do not have any problems with it. Some minor problems may include:
- redness, warmth or swelling in the location where the shot was given
- fever
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- Give your child aspirin-free pain reliever, as directed by your child's physician.
- If your child is allergic to the vaccine, the allergic reaction would most likely occur within a few minutes to a few hours of the shot. Signs of an allergic reaction may include difficulty breathing, wheezing, (squeaking sounds while breathing due to tight airways), weakness, fast heartbeat, hives, and paleness. Report these or any other unusual signs immediately to your child's physician.
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