The CDC reported this week that five cases of H. flu invasive disease have appeared in children in Minnesota. There have been no reports of similar disease in Massachusetts thus far.
One of the five children reported to the Minnesota Department of Health with invasive Haemophilus influenzae type b (Hib) disease died. Only one of the children had completed the primary Hib immunization series; three had received no doses of Hib-containing vaccine, according to the CDC. “The five Hib cases are the largest number among children aged <5 years reported from Minnesota since 1992. The cases occurred during a Hib vaccine recall and continuing nationwide shortage that began in December 2007," said the CDC.
An American Academy of Pediatrics (AAP) alert on the same date reminds pediatricians and family practitioners that it is “critically important” for all infants to complete the primary three dose series of a Hib-containing vaccine on schedule.
“Given the vaccine shortage, prolonged booster deferral, and reduced compliance with the primary series coverage, the increase in the number of Hib cases in Minnesota likely reflects a weakening of herd immunity -- that is, the percentage of immunized children in the population has dropped below a certain critical level,” said the AAP.
The AAP said, “The recent cases of Hib invasive disease serve as a reminder that serious vaccine-preventable diseases do occur if infants and children are not vaccinated. Physicians also should remember to review immunization status when evaluating a child with fever since evaluation of unimmunized children with fever and/or lethargy may differ.”
Prior to widespread Hib vaccination, H. Influenzae b was a frequent cause of bacterial meningitis and epiglottitis in infants and young children.
The Massachusetts Department of Public Health has also distributed an alert, reminding practitioners to vaccinate infants against H. influenza. Providers who do not have adequate supplies of Hib containing vaccine to support a 3-dose series for healthy children (or 4 doses for high risk children) should contact the Mass. DPH vaccine unit immediately at 
617-983-6828
.
Carole Allen, MD
President, Massachusetts Chapter, American Academy of Pediatrics
Vice President, Middlesex District, MMS
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