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Mortality from meningitis caused by Haemophilus influenzae type b(Hib),a disease that affects mainly infants and young children,can reach 5%in industrialized countries and ten times that in non-industrialised countries.To determine the efficacy of vaccination against Hib,we carried out a retrospective survey of the incidence of Hib meningitis over five decades in the Greater Helsinki area of Finland,where all children with bacterial meningitis are treated in one of three centres.Except for meningococcal epidemic in the early 1970's,Hib was the leading cause of childhood bacterial meningitis until the Hib conjugate vaccines changed the picture profoundly.In 1986-87 the polysaccharide-diphtheria toxoid conjugate(PRP-D)was given experimentally to 50%of infants.In 1988-89 all infants were vaccinated,50%with PRP-D,50%with another conjugate vaccine, the oliosaccharide-CRM197 protein conjugate(HbOC).Since 1990 a third conjugate vaccine,the polysaccharide-tetanus toxoid(PRP-T),has been administered routinely to all infants.The vaccines were administered at age 3-6 months,with a booster dose at 14-18 months.In the first five years of the Hib vaccination programme the number of cases of Hib meningitis in children aged 0-4 fell sharply,from 30 in 1986(the first year of the programme)to none in 1991.The decline contrasts sharply with the rising trend up to the mid 1980's.Vaccination seems to be the only explanation for the observed change in the epidemiology of Hib meningitis. |
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hemophilus influenza
hemophilus influenza vaccine
meningitis
meningitis,bacterial
meningitis,children
meningitis,hemophilus influenza
meningitis,prevention
vaccine
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