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    Childhood Illnesses Up Close: Hib

    July 7, 2007 by Brandy Vencel

    I was debating about the title. The vaccine I want to highlight is the Hib, but most parents, when their child is sick, don’t walk around saying that their child has Hib. They say, “My child has bacterial meningitis,” or, “My child has pneumonia.” But Childhood Illnesses Up Close: Bacterial Meningitis and Pneumonia and Quite Possibly Other Infections, Too is a very long title. So I’ll stick to Hib.

    What is Hib?
    Hib stands for Haemophilus Influenzae Type B. This is a bacteria that was once the leading cause of bacterial meningitis in children under the age of five.

    Other diseases caused by Hib include:

    Sepsis {bloodstream infection}
    Epiglottitis {severe swelling of the epiglottis, a tissue that closes off the windpipe during swallowing}
    Arthritis {infection of the joints}
    Osteomyelitis {infection of the bones}
    Pneumonia {infection of the lungs}
    (source)

    Is Hib Treatable?

    Hib disease is treated with antibiotics for 10 days. Most cases require hospitalization.

    Even with antibiotic treatment, up to 5% of all children with Hib meningitis [author note: not all forms of Hib, just the mengitis] die from the disease. {source}

    Antibiotics, such as ampicillin or chloramphenicol, are generally used to treat serious infections. Rifampin is used to treat people who might be carrying the bacterium. {source}

    How to I avoid contracting Hib?

    Hib disease can be transmitted through contact with mucus or droplets from the nose and throat of an infected person. Individuals can carry Hib and spread the disease without becoming ill themselves. {source}

    I am sorry to keep repeating myself over and over, but I am constantly struck by how wise our parents really were. How many of you heard these statements growing up?

    • Keep your hands out of your mouth.
    • Don’t pick your nose.
    • Don’t touch your eye. Your hands are probably dirty.
    • Cover your mouth when you cough or sneeze.
    • Use a tissue.
    • Wash your hands.
    • Go wash your hands again. That wasn’t long enough.
    • Go wash your hands. This time use soap.

    This common wisdom was part of basic sanitation principles that helped stop the spread of disease. I once read that the best way to prevent contagious diseases is to wash your hands at least three times a day and not to touch mucous membranes {your own, or someone else’s}.

    Also, Hib is the first illness I have researched where I came upon the idea that putting a child in daycare increases that child’s risk of contracting the disease. This fits, however, with previous discussions of how close living quarters cause disease to spread. Usually, a daycare has more children per square foot, and especially more children under the age of five per square foot. This makes a difference when trying to contain a disease.

    What are the possible side-effects of the vaccine?
    Hib is a vaccine I have trouble finding studies on. This seems to be a trend with newer vaccines. They are, in my opinion, under tested. No long term studies are done. It is hard to know what possible side-effects there are when no one really cares enough to do a study.

    The early versions of the Hib vaccine tended to cause Hib by suppressing the immune system for about a week’s duration after the shot. Basically, children {used as guinea pigs} were given the shot, which weakened their immunity overall, and then these children were sent back into a germ-filled environment of public school or daycare, at which point they actually contracted Hib. {source}

    There is also some evidence that children recently vaccinated with the Hib vaccine may put other, unvaccinated children at risk of contracting the disease, because some children contract Hib from the vaccine, and then pass it on to others. {source}

    Because either no studies or too few studies have ever been conducted to investigate Hib vaccine reactions, the IOM [Institute of Medicine] could not make a determination about whether Hib vaccine causes transverse myelitis, Guillain-Barre syndrome, thrombocytopenia, anaphylaxis and sudden infant death syndrome.

    A manufacturer of HIB vaccine states in the product insert that the vaccine “has not been evaluated for its carcinogenic, mutagenic potential or impairment of fertility” and “it is also not known whether [the vaccine] can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.” {source}

    I don’t know if the Hib vaccine is ever given in isolation. I could only find three vaccines, and all three were conjugates {vaccinating for more than one disease at a time}. I decided to look at Comvax, which vaccinates against Hib as well as Hepatitis B:

    The most frequently cited events were mild, transient signs and symptoms of inflammation at the injection site {i.e., pain/soreness, erythema, and swelling/induration}, somnolence, and irritability, all of which were prompted for on report cards filled out by parents of vaccinated children.

    [snip]

    These adverse experiences are grouped by case: viral infection; febrile seizure; asthma; diarrhea, vomiting, acidosis, dehydration, hypoglycemia, and seizure disorder; bacterial infection; bronchiolitis and reflux esophagitis; dehydration and fever; asthma, respiratory congestion, and tachypnea; asthma and upper respiratory infection; urinary tract infection and vomiting; pneumonia and asthma; apnea and reflux esophagitis; and vitreous hemorrhage. A causal relationship to the vaccine is unknown; however, these serious adverse events were judged not to be related to vaccination with COMVAX by the investigator.

    [snip]

    In addition, a variety of adverse effects have been reported with marketed use of either PedvaxHIB or RECOMBIVAX HB in infants and children through 71 months of age. These adverse effects are listed below.

    PedvaxHIB

    Hematologic/Lymphatic
    Lymphadenopathy

    Nervous System
    Febrile seizures

    Skin
    Sterile injection-site abscess; pain at the injection site

    RECOMBIVAX HB

    Hypersensitivity
    Anaphylaxis and symptoms of hypersensitivity including reports of rash, pruritus, urticaria, edema, arthralgia, dyspnea, hypotension, erythema multiforme, and ecchymoses

    Cardiovascular System
    Tachycardia; syncope

    Digestive System
    Elevation of liver enzymes

    Hematologic
    Increased erythrocyte sedimentation rate; thrombocytopenia

    Musculoskeletal System
    Arthritis

    Nervous System
    Bell’s Palsy; Guillain-Barr© Syndrome

    Psychiatric/Behavioral
    Agitation; somnolence; irritability

    Skin
    Stevens-Johnson Syndrome; alopecia

    Special Senses
    Conjunctivitis; visual disturbances

    Is the trade-off worth it?
    I will tell you that we do not personally vaccinate our children for this disease any longer. I believe our second child received a shot for Hib, but I’m not even sure about that. There is a long list of side-effects and reactions and very little research regarding the vaccine.

    We prefer, instead, to keep our children out of the church nursery until they are at least a year old. We teach our children basic sanitation, as I have mentioned before. We keep a close eye on our thumb suckers, who are at risk because they are constantly putting their hands in their mouths. We keep our children out of Sunday School during cold season. We encourage them to play outside when friends come over, knowing that the sunlight does much to kill bacteria, plus the Vitamin D is a great immune support.

    If you are going to avoid the Hib vaccine for your own children, you need to be careful that you do not schedule playdates with children who have received the vaccine in recent days (within a week’s time). And if you choose to have your children vaccinated, I would suggest keeping your children away from others for about five to seven days. This will benefit your children {who have been given a shot that suppresses immune response}, plus it will prevent any child who actually contracted Hib from the shot from spreading the disease to others who are unvaccinated or are otherwise not immune.

    The Hib vaccine is an ethically acceptable vaccine {as far as I can tell}, for those of you who are wondering.

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