Haemophilus influenzae B (HIB)

Haemophilus influenzae (H. influenzae) is a bacteria that has six serotypes, a-f. Serotype b is responsible for most cases of serious illness due H. influenzae. The bacteria colonize the nasopharynx however, hosts can remain asymptomatic for several months. 

Passive immunity is provided in utero by transplacentally acquired maternal IgG antibodies and breastfeeding further protects by provides IgA antibodies.  In the prevaccine era, most children acquired immunity by 5-6 years of age through asymptomatic infection by Hib bacteria. (1)

In 2017 South Africa had 313 cases of invasive H. influenzae. Of that twenty-two percent of cases, 41 cases, were serotype b (Hib) (2)

Transmission

It is assumed that respiratory droplet spread is the mode of transmission, but there is little evidence on the precise mechanism. Invasive HIB is not highly communicable (contagious) and if a case has been identified in your community there is no need to panic.  Risk of direct secondary transmission may increase with people living in the same household.  Breastfeeding has numerous benefits, and in this case it is protective against Hib, breast milk has been shown to contain secretory antibodies, this protection extends beyond the breastfeeding period (1)

Carriers of Hib are infectious as long as organisms are present in the nasopharynx, which may be for a prolonged period even without nasal discharge. The hosts immune system, if well balanced, will not allow for invasive infection.

Symptoms

The most common types of invasive disease are pneumonia, meningitis, epiglottitis, , arthritis, and cellulitis. Symptoms and signs of Hib meningitis maybe similar to other causes of bacterial meningitis and may include fever, headache, photophobia, stiff neck, vomiting and confusion. Severe cases may present with convulsions and coma. Infants often present with less characteristic symptoms such as, vomiting, refusal to feed and irritability. Severe cases may develop a tense or bulging fontanelle, a high-pitched scream and convulsions, symptoms that are similar to the brain inflammation caused by vaccination. 

Diagnosis

Depending on the site of infection, cerebrospinal fluid, blood, pleural fluid, joint fluid, and middle ear aspirates can be sent for laboratory analysis. 

 

Treatment

Antibiotic therapy is used. It is important to note that diphtheria antitoxin does not neutralize toxin that is already bound to tissues, but it will neutralize circulating toxin and "prevent" progression of disease. 

Homeopathic Treatment

Due to the severity of diphtheria allopathic intervention is required in severe cases 

Discussion

In 2017 South Africa had 313 cases of invasive H. influenzae. Of that twenty-two percent of cases, 41 cases, were serotype b (Hib) (2)

“Exposure to Hib immunization is associated with an increased risk of insulin dependent diabetes (IDDM).” (3)

“Vaccinations have been discussed as one among many environmental candidates contributing to the immune process that later may lead to type 1 diabetes.When studying the induction of autoantibodies using the autoantibody of 90th percentile as cutoff level, hemophilus influenza B (HIB) vaccination appeared to be a risk factor 1A-2A and for GADA in logistic regression analyses.” (4)

Citations

1- CDC Pink book HIB

2- GERMS-SA Annual surveillanceL report 2017

3- Autoimmunity, 2002 Vol. 35 (4), pp. 247–253 Clustering of Cases of Insulin Dependent Diabetes (IDDM) Occurring Three Years After Hemophilus              Influenza B (HiB)

4- https://www.ncbi.nlm.nih.gov/pubmed/14679101 Vaccinations may induce diabetes-related autoantibodies in one-year-old children.