What is included in long-term monitoring following an outbreak of Haemophilus influenzae infections?

Updated: Jul 02, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

If the close contact group includes a fully vaccinated child who is immunocompromised, then make an exception because the vaccination may have been ineffective. A close contact group is defined as persons who reside with the patient or a nonresident who has spent 4 hours or more with the index patient for at least 7 days preceding the day of hospitalization of the patient based on the revised guidelines. [94, 106] Administer rifampin within 7 days after hospitalization of the index patient to ensure effectiveness. The need for chemoprophylaxis has decreased dramatically because the Hib conjugate vaccine now protects many children.

The need for all daycare center contacts to be treated is debatable when a single case has occurred because of uncertainty about the actual risk of secondary Hib disease in this setting. [94]

If 2 or more cases of Hib disease have occurred in a childcare center within 120 days, the consensus is to institute prophylaxis to all attendees and staff members based on the revised guidelines. [106]

Pharyngeal cultures do not need to be obtained to determine prophylaxis, as this delays administration of rifampin.

Administer H influenzae conjugate vaccine to patients younger than 24 months with invasive Hib disease during convalescence regardless of prior immunization. Patients aged 24 months or older with invasive Hib disease do not need immunization.

Patients with recurrent invasive Hib disease despite receiving Hib immunization should undergo immunologic evaluation.


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