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Invasive H. influenzae Infection in Children in Minnesota

H. influenzae is on the rise in Minnesota.

The Minnesota Department of Health reported five unrelated cases of serious Haemophilus influenzae type B (Hib) infection in children younger than 5 years in 2008: three cases of meningitis, one case of pneumonia with bacteremia, and one case of epiglottitis. One child with meningitis died. This is the highest annual number of cases reported in children younger than 5 years in Minnesota since 1992. Three children had not received any doses of Hib vaccine because of parental refusal. The other two children had received two doses of Hib vaccine, but one child was too young (5 months) to have completed the primary series, and the other child was diagnosed with an immunodeficiency (hypogammaglobulinemia). To date, no increases in Hib cases have been noted in other states.

Comment: Although all these cases occurred during a Hib vaccine recall and shortage, none of the children were inadequately immunized because of the shortage. Nonetheless, the increase in invasive Hib disease could reflect decreased herd immunity statewide, owing to deferment of the Hib booster dose during the shortage as recommended by the CDC. The report underscores the need for timely immunizations and for discussions with parents about the very real risks that result from refusing or deferring vaccination.

— Peggy Sue Weintrub, MD

Published in Journal Watch Pediatrics and Adolescent Medicine February 4, 2009

Citation(s):

Centers for Disease Control and Prevention (CDC). Invasive Haemophilus influenzae type B disease in five young children — Minnesota, 2008. MMWR Morb Mortal Wkly Rep 2009 Jan 30; 58:58.

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