Haemophilus influenzae type b (Hib)

Hib is a disease caused by the bacteria Haemophilus influenzae type b. This bacterium was the most common cause of meningitis (infection of membranes around the brain and spinal cord) in children under five. Hib can also cause epiglotitis (severe swelling of the epiglottis at the back of the throat), pneumonia (infection of the lungs), osteomyelitis (infection of the bones and joints) and cellulitis (infection of the tissue under the skin, usually on the face). 

These conditions can develop quickly; meningitis and epiglotitis can sometimes be fatal. After the introduction of the Hib vaccine the disease is now quite rare in Canada.

Hib is diagnosed by a history of exposure to the disease, symptoms and laboratory testing. Tests can include taking a sample from the blood, spinal fluid, lung fluid or joint fluid. 

The onset of symptoms is usually sudden. Symptoms depend on which part of the body is infected. 

• Meningitis – fever, headache, stiff neck, nausea, vomiting and drowsiness
• Pneumonia – shortness of breath, fever, lack of energy, loss of appetite, headache, chest pain and cough
• Epiglotitis – difficulty breathing and swallowing, pale colour and fever
• Osteomyelitis – swelling, inflammation and pain over the affected bone

The time period between when someone is exposed to Hib and when symptoms develop is unknown but may be as short as two to four days.

It is spread by direct contact with the saliva or droplets of an infected person or carrier who sneezes or coughs. It is possible for people who are not ill to carry Hib and spread it to others (“carriers”). It is then spread to the next person through contact with discharge or droplets from the nose or mouth. 

Hib is very rare in Canada, but there are still outbreaks in other parts of the world. Anyone at any age who has not had the disease or been immunized is at risk. 

Antibiotics are used to treat and prevent Hib infection. Supportive care and treatment in hospital is often needed. Medication can be given to control the fever and pain and fluids to prevent dehydration. Antibiotics may be recommended for household and childcare contacts.

Health-care providers, hospitals and laboratories, schools and childcare centres are required to report cases of Hib to Public Health. Public Health staff will interview the health-care provider and patient (or caregivers) to find out how the infection occurred, identify other people at risk of infection, implement control measures (such as immunization and restrictions on attending school or work) and provide other advice.

The best protection is immunization. The New Brunswick Immunization Schedule provides Haemophilus influenzae type b vaccine combined with diphtheria, tetanus, acellular pertussis, polio and Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) as part of the routine childhood immunization at two, four and six months of age. Although routine immunization has contributed enormously to the prevention of serious Hib disease in young children and infants, it is very important that all doses be given on time.

For additional information, contact your health-care provider, local Public Health office or Tele-Care 811.