Nasty Infectious Diseases You Want To Avoid - Haemophilus influenzae type b
This is a type of rod-shaped bacterium that can cause serious diseases. It is the leading cause of bacterial meningitis in children. H. flu meningitis is a serious infection characterized by inflammation of the brain and spinal cord that may be fatal. More than two thirds of all bacterial meningitis victims are children younger than age five, most of them are infected with Haemophilus influenzae type b (usually shortened to H. flu or "Hib"). It's serious because nearly 1 child in every 20 who gets meningitis dies, and up to 35 percent develop permanent brain damage.
According to the Centers for Disease Control, from the 1980s more than half of the estimated 20,000 Americans aged 5 years or younger who became infected with the Hib bacterium each year developed bacterial meningitis. This disorder was the leading cause of acquired mental retardation in the United States, leaving many youngsters blind, deaf, or paralyzed. However, widespread use of a Hib vaccine licensed for infants in 1990 has dramatically reduced the incidence of a deadly disease that only 10 years earlier killed 800 infants each year in the United States. According to the Centers for Disease Control and Prevention, the incidence of invasive Hib infection has dropped by almost 98 percent among infants and children since the introduction of the vaccine. Although Hib meningitis is not yet completely eradicated, the vaccine has been stunningly effective.
Cause - The Haemophilus influenzae type B bacterium has several different strains, each with a different capsule around the bacterium. Type b was the most common cause of meningitis in children before the vaccine; the other types are rare. However, the bacteria causes other diseases besides meningitis; one strain (nontypeable) is a common cause of ear infections in children. Other illnesses caused by H. influenzae type B bacteria include epiglottitis, septic arthritis, cellulitis, bacteremia, and pneumonia. The bacteria enter a person's body through the nose; meningitis results if the bacteria travel through the blood into the membrane covering the brain (the meninges). Healthy children can carry the bacteria in their nose and throat secretions; the infection is spread by kissing or sharing possessions, drinks, food, etc. Child care workers can also spread the bacteria.
Symptoms - If a child is going to develop symptoms, they will appear within two weeks after exposure. All types of meningitis may appear in children either gradually or suddenly. The gradual type is harder to diagnose because the symptoms (at least at first) are vague. Much more common is the abrupt onset variety of meningitis, in which symptoms appear in less than 24 hours, with a sudden high fever (100 degrees F to 106 degrees F) chills, vomiting, stiff neck, intense headache in the front of the head, or a seizure. The neck with acetaminophen and sponge baths. hurts when the child tries to touch his chin to the chest. There may be muscle spasms and photophobia (eye pain from light). Some children exhibit unusual behavior as the infection begins, including aggressiveness, irritability, agitation, delirium, or screaming, followed by lethargy or coma. Some may few weeks to a few months. experience a cold or an ear infection before the onset of meningitis. A baby from age three months to two years may exhibit fever, vomiting, irritability, seizures, and a high-pitched cry. The baby may suddenly become rigid, and the soft spot on the front of the head may become hard or bulging.
Diagnosis - A lumbar puncture (spinal tap) is necessary to sample the fluid around the spinal cord and check for bacteria, white cells, sugar, and protein. This will help determine what sort of virus or bacteria is causing the meningitis. Bacterial meningitis causes cloudy fluid, with a high amount of certain types of white blood cells, low sugar, and high protein. Bacteria will grow in blood culture or spinal fluid culture in 24 to 48 hours; rapid tests on fluid or blood give results in just a few hours and are often helpful in identifying the type of bacteria. Recent antibiotic treatment prior to getting meningitis may make diagnosis more difficult. Lumbar puncture is a safe procedure when done in a large emergency room or in an experienced pediatrician's office and is imperative in correctly diagnosing meningitis.
Treatment - Without treatment, a child can die from Hib meningitis; with antibiotics, of the shot and quickly pass. about 95 percent of children recover. Any child with possible H. flu meningitis will be admitted to the hospital for IV antibiotics. A baby or child would also receive dexamethasone with become carriers. the antibiotic and continue to take it for two to four days to prevent swelling of the brain and subsequent hearing problems. Children should rest in a darkened, quiet room; any fever higher than 101 degrees F should be treated with acetaminophen and sponge baths. A child with H. flu meningitis is considered to be infectious until after receiving 24 hours of antibiotics; however, even after recovery some children will carry bacteria in nose and mouth. Rifampin is given to eliminate this bacteria. Healthy carriers are infectious for a few weeks to a few months. Children who recover from this type of meningitis, as well as those who are vaccinated, are immune.
Complications - Increased pressure on the brain from fluid buildup is a serious complication; signs of this include changes in head measurement, activity, vision, breathing, pupils' response to light, or decrease in urine. The most common long-lasting complication is hearing impairment. Recent studies suggest that children over six weeks of age who received dexamethasone immediately had less hearing loss than those who did not receive the steroid. Other, less common, complications include blindness, hydrocephalus, arthritis, seizures, and permanent developmental delays.
Prevention - The best prevention for Hib is vaccination for all infants. The Hib vaccine is one of the safest of all vaccine products and cannot cause meningitis. About one in every eight children who receive the vaccine may have some slight redness, swelling, or tenderness at the injection site. About 1 in every 140 children will develop a fever higher than 102 degrees F. The reactions begin within 24 hours of the shot and quickly pass. Before the vaccine, as many as 5 percent of healthy preschoolers carried H. flu type b but did not get sick. Vaccinated children cannot An antibiotic called rifampin is used to prevent cases of Hib after exposure; if all babies and young children in a home or child care group are vaccinated, preventive medicine after an exposure is not necessary. Rifampin will temporarily get rid of H. flu from the noses and throats of healthy carriers about 95 percent of the time. It helps prevent any exposed child in a day care center or a family from getting H. flu meningitis.
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