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Prevention Vaccination (See also Chap. 116) The development of conjugate vaccines that prevent invasive infections with Hib in infants and children has been a dramatic success. Three such vaccines are licensed in the United States. In addition to eliciting protective antibody, these vaccines prevent disease by reducing rates of pharyngeal colonization with Hib. The widespread use of conjugate vaccines has dramatically reduced the incidence of Hib disease in developed countries. Even though the manufacture of Hib vaccines is costly, vaccination is cost-effective. The Global Alliance for Vaccines and Immunizations has recognized the underuse of Hib conjugate vaccines. The disease burden has. | Chapter 139. Haemophilus Infections Kỳ 4 Prevention Vaccination See also Chap. 116 The development of conjugate vaccines that prevent invasive infections with Hib in infants and children has been a dramatic success. Three such vaccines are licensed in the United States. In addition to eliciting protective antibody these vaccines prevent disease by reducing rates of pharyngeal colonization with Hib. The widespread use of conjugate vaccines has dramatically reduced the incidence of Hib disease in developed countries. Even though the manufacture of Hib vaccines is costly vaccination is cost-effective. The Global Alliance for Vaccines and Immunizations has recognized the underuse of Hib conjugate vaccines. The disease burden has been reduced in developing countries that have implemented routine vaccination e.g. The Gambia Chile . An important obstacle to more widespread vaccination is the lack of data on the epidemiology and burden of Hib disease in many developing countries. All children should be immunized with an Hib conjugate vaccine receiving the first dose at 2 months of age the rest of the primary series at 2-6 months of age and a booster dose at 12-15 months of age. Specific recommendations vary for the different conjugate vaccines. The reader is referred to the recommendations of the American Academy of Pediatrics Chap. 116 and www. cispimmunize .org . Currently no vaccines are available for the prevention of disease caused by nontypable H. influenzae. Chemoprophylaxis The risk of secondary disease is greater than normal among household contacts of patients with Hib disease. Therefore all children and adults except pregnant women in households with at least one incompletely immunized contact 4 years of age should receive prophylaxis with oral rifampin. When two or more cases of invasive Hib disease have occurred within 60 days at a child-care facility attended by incompletely vaccinated children administration of rifampin to all attendees and personnel is .
