Symptoms
Hib bacteria get into the body through the nose and mouth, where it can linger for a while without causing any symptoms. In some cases, however, the bacteria spread to the bloodstream and to other parts of the body. This is called invasive Hib disease.
Meningitis
The most common mark of invasive Hib disease is bacterial meningitis, or inflammation around the brain and spine. Prior to widespread vaccination, Hib meningitis occurred in 50 to 65% of cases and was the most common cause of bacterial meningitis in kids under five years old.
Symptoms of Hib meningitis include:
- Fever
- Headache
- Confusion, irritability, or otherwise altered mental status
- Stiff neck
- Sensitivity to light
- Nausea and/or vomiting
- Altered reflexes (in young babies)
Epiglottitis
Hib epiglottitis is when the bacteria infect the epiglottis (the throat tissue that keeps food and liquids from getting into the respiratory tract), sometimes causing swelling so severe it blocks the airway. Epiglottitis occurred in about 17% of Hib cases prior to widespread vaccination.
Some symptoms of epiglottitis include:
Sore throat that comes on quickly
Fever
Drooling (especially in children)
Change in voice
Bluish skin color
Stridor, or a high-pitched sound when someone breathes in or out
Pneumonia
Pneumonia (an infection of the lungs) is another common complication of invasive Hib disease, occurring in about 15% of cases in the prevaccine era.
Signs and symptoms of pneumonia can vary, but they generally include flu-like symptoms like chills, fever, and nasal congestion, productive cough, chest pain, fast breathing (in children), body aches, fatigue, vomiting (in children), and bluish skin color.
Septic Arthritis
Septic arthritis is a joint infection that happened in roughly 8% of Hib cases prior to the introduction of the vaccine.1 This happens when Hib bacteria infect the joint (typically a large one like a knee or hip), causing significant discomfort.
Symptoms of septic arthritis caused by invasive Hib disease include severe joint pain, difficulty moving affected joint, and redness or swelling around the affected joint.
Cellulitis
Skin infections (or cellulitis) are another common complication of invasive Hib disease. This occurred in roughly 6% of pre-vaccination era cases—most often in young children—and typically affected the face, head, or neck.1 The most common symptom of cellulitis is red, tender, and/or swollen skin.
Bacteremia
Infections that spread to the bloodstream are called bacteremia (also called sepsis). Symptoms of Hib bacteremia include flu-like symptoms, like fever, chills, and fatigue, abdominal pain, nausea and/or vomiting, anxiety, difficulty breathing, and confusion.
Causes
Unlike the similarly-named influenza, Haemophilus influenzae is caused by a bacterium (not a virus).
There are multiple types of Haemophilus influenzae, but type b (commonly referred to as Hib), has historically been the most severe.Before the development of an effective vaccine, Hib caused the overwhelming majority—roughly 95%—of serious Haemophilus influenzae infections.
It’s uncertain exactly how Hib bacteria spread, but scientists think it passes from one person to the next through respiratory droplets (through coughing or sneezing).1 As a result, people are generally exposed to Hib after being in close contact with someone who is infected, such as at home or in a childcare setting.
New infections start in the nose and throat, where they can be quickly fought off by the immune system or hang out for months without causing any symptoms. Invasive diseases happen when the bacteria get into the bloodstream and go on to infect other parts of the body.
At-Risk Populations
Certain individuals are more like to get invasive Hib disease than others. Like many vaccine-preventable diseases, Hib mainly affects young children. Prior to widespread vaccination, Hib accounted for 50 to 65% of cases of meningitis in kids under five years old and was the most common cause of bacterial meningitis in these kids.
Those most likely to get Hib include unvaccinated children and people close to them, as well as individuals with weakened immune systems, including those with certain medical conditions like:
- Sickle cell disease
- HIV infection
- Cancer requiring treatment, such as chemotherapy, radiation, or bone marrow stem cell transplants
Because Hib can look like a lot of other bacterial infections, healthcare providers often rely on lab tests, in addition to a person’s medical history and physical exam, to diagnose the disease and recommend treatment. If positive for Haemophilus influenzae, local health officials might also want to run tests to figure out if the infection is due to type b or some other subtype.
Treatment
Hib disease can be treated effectively with antibiotics, but additional care might be needed to help manage symptoms related to complications. People with invasive Hib disease (especially young children) are often hospitalized as a result of the infection.
Antibiotics
The most common medication used to treat Hib is a 10-day course of a third-generation cephalosporin (such as cefotaxime or ceftriaxone) or a combination of chloramphenicol and ampicillin.
Additional Support
Depending on the severity of the infection, individuals with Hib disease might also need treatment to help with symptoms or subsequent complications. These can include breathing support, blood pressure medication, wound care (due to skin infections), amputations (due to bacteremia), or long-term rehabilitation for brain damage or hearing loss (due to meningitis).
Prevention
While Hib can often be effectively treated using antibiotics, the best protection against the disease and its potential complications is by preventing it all together through vaccination. The vaccine is typically administered during early childhood in three or four doses, depending on the brand.
The Centers for Disease Control and Prevention recommends the following groups receive the Hib vaccine:2
- Children ages 2 to 15 months (or up to 5 years old if unvaccinated, for catch-up doses).
- Unvaccinated children under age 18 years who have an HIV infection.
- Anyone (kids or adults) who is unvaccinated and doesn’t have a functional spleen or who has sickle cell disease.
- Anyone (kids or adults) who has received a hematopoietic stem cell transplant, even if they’ve been vaccinated against Hib before.
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