New Vaccine Development Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986) / Chapter Skim
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Appendix D-3: The Prospects for Immunizing Against Hemophilus influenzae Type b
Appendix D-3: The Prospects for Immunizing Against Hemophilus influenzae Type b
Pages 186-196
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From page 186... ...
influenzas type b in the developing world. Much of the following discussion is based on information from the United States and presumes that the disease process is similar throughout the world.
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Passive protection studies in animals, primarily the infant rat, provide further evidence for the protective effects of antibodies against type b polysaccharide (Myerowitz and Norden, 1977~.There is strong evidence from the Finnish studies of the capsular polysaccharide (polyribophosphate) vaccine for the protective role of
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From page 188... ...
The second is that the mortality rate for H influenzae type b meningitis can reach 40 percent even with treatment, in contrast to 5 percent for treated cases in the United States (Cadoz et al., 1983; Cochi, personal communication, 1983; Griffiss, personal communication, 1985; Hill, 1983; Norden, 19821.
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TABLE D-3.2 Morbidity and Mortality Associated with Nonmeningitic Hemophilus influenzas Type b Invasive Disease . Number of cases pneumonia, bacteremia, and epiglottitis (morbidity category C)
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{An obvious potential source of error in this estimate is the greater relative frequency of invasive lower respiratory tract disease in the developing world as compared to the United States.) The case fatality rate of these conditions (pneumonia, bacteremia, epiglottitis)
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are possible post-exposure means of controlling secondary spread of disease; however, secondary disease probably represents a small proportion of the total disease burden, and these agents are not as practical as prevention in developing countries. Success in vaccine prevention of invasive disease, particularly meningitis, will depend on the development of a vaccine capable of inducing immunity in infants.
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The vaccine currently licensed in the United States apparently produces such reactions less frequently (Broome, personal communication, 19851. The vaccine proved to be effective in preventing H
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These results have been confirmed in clinical studies conducted with the PRP-D vaccine in over 2,000 children between 2 and 24 months of age (Gordon, personal communication, 1985~. The National Institutes of Health-National Institute of Allergy and Infectious Diseases initiated an efficacy study with this vaccine in Alaska in 1984.
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1983. Personal communication, Centers for Disease Control, Atlanta, Ga.
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1977. Haemophilus influenzae type b capsular polysaccharide vaccine in children: A double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland.
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