Beyond the Noise #100: The return of Hib?

[xocetaceans]

This episode discusses a bacterium (Haemophilus influenzae type b (Hib)), and the potential return of diseases caused by it in spite of the fact that there is a Hib vaccine. They also mention that childhood vaccination rates are decreasing.

They discuss the various diseases which this bacterium causes.

A pair of severe cases occurred in Florida in a relatively short time frame: it is noted that the two cases were seemingly not reported by the CDC, but instead were reported by a paper. The question is whether Hib is being well-tracked and whether the CDC has cut the reporting of this disease among other things.

[3catwoman3]

1. This video is an excellent summary of the harm Hib used to do...

…and the terror is caused in pediatricians and peds NP like me. It left out one important scenario.

Epiglottitis presents similarly to croup, with a sore throat and hoarseness. Unlike bacterial Hib, croup is viral and affects the vocal cords, not the epiglottis. The hoarseness of a child with croup sounds terrible, but they are generally not dangerously ill.

Dr. Offit discusses how carefully a child with suspected epiglottitis was handled. The reason for that exquisite caution was that examining a child with an infected epiglottis could cause respiratory obstruction. The routine act of looking in the throat with a tongue blade could result in the infected epiglottis slamming shut, so to speak, over the airway and rendering the child unable to breathe, making intubation impossible, and a tracheotomy necessary.

After the introduction of the Hib vaccine, epiglottitis became pretty much a thing of the past, and it was such a relief to be able to examine a child thoroughly without fearing that using a tongue blade might either kill them or lead to an emergency tracheotomy.