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Traveler Summary

Key Points

  • Hib disease is a serious bacterial infection acquired through the inhalation of aerosolized respiratory droplets facilitated by contact with infected persons. Hib disease occurs primarily in developing countries worldwide and has been nearly eradicated in the U.S.
  • Risk of serious illness is high for young children, certain immunocompromised persons, and certain ethnicities.
  • Symptoms vary depending on what part of the body is affected.
  • Consequences of severe Hib disease include infection of the brain, lungs, throat, ears, joints, and skin.
  • Prevention includes observing good respiratory hygiene (cough and sneeze etiquette) and frequent, thorough handwashing.
  • Hib vaccine is routinely given to children younger than 5 years, but it is not indicated for healthy, older individuals not vaccinated as children.
  • Vaccine side effects are uncommon but can include injection-site reactions and fever.
  • Duration of vaccine protection following completion of a full vaccine series during infancy lasts until at least the age of 5 years, the age at which natural immunity becomes prevalent; no booster dose is recommended for child travelers.

Introduction

Hib disease is a serious bacterial illness caused by Haemophilus influenzae bacteria, resulting in meningitis (infection of the brain and spinal cord coverings), pneumonia (infection of the lungs), epiglottitis (swelling in the throat), otitis media (middle ear infection), and other infections.

Hib disease usually affects children younger than 5 years. By age 5-6 years, most children have acquired natural immunity from exposure, usually without showing symptoms of the disease.

Risk Areas

Hib disease has been nearly eradicated in the U.S. since the introduction of routine Hib vaccination in 1987. Worldwide occurrence is between 4 to 8 million cases of serious disease (mostly in developing countries where Hib vaccination is not routine), with hundreds of thousands of deaths annually.

Transmission

Hib disease is transmitted person to person via aerosolized respiratory droplets (e.g., by coughing or sneezing) facilitated by contact with an infected person.

Risk Factors

Risk is highest for unvaccinated children younger than 5 years, persons with certain immunocompromising conditions (e.g., missing or nonfunctional spleen, blood stem cell transplant, HIV infection in children, chemotherapy, or radiation therapy), and certain ethnicities (African American, Hispanic, Native American, and Alaskan Native).

Symptoms

Symptoms and time of onset following exposure vary depending on what part of the body is affected.

Consequences of Infection

In countries where serious Hib disease does occur, the most common disease types are meningitis, epiglottitis, pneumonia, arthritis, and skin infection.

Need for Medical Assistance

Persons with severe disease (e.g., trouble breathing, loss of alertness, or stiff neck) should seek immediate medical attention because hospitalization is usually required; antibiotic therapy must be started immediately.

Prevention

Non-vaccine

Observe good respiratory hygiene (cough and sneeze etiquette) and frequent, thorough handwashing.

Vaccine

Hib vaccine is given routinely as a childhood vaccination and to persons at increased risk of disease. Combination vaccines are also available.

Side Effects

Side effects are rare but can include mild injection-site reactions and fever lasting less than 24 hours. Irritability, runny nose, tiredness, and hives can also occur.

Persons with underlying medical conditions or who have concerns about the vaccine should speak to their health care provider before vaccine administration.

Timing

Hib vaccine and Hib-combination vaccine are given as follows:

  • Routine, regardless of travel, for children younger than 5 years: 3 or 4 doses, 1 dose each at ages 2, 4, 6, and 12-15 months (depending on the brand of Hib vaccine used, a child might not need the dose at age 6 months). Catch-up schedules are available if the first dose is delayed by more than a month.
  • Unvaccinated persons 5 years and older (when indicated): 1 dose of Hib-only vaccine.

Duration of vaccine protection following completion of a full vaccine series during infancy lasts until at least the age of 5 years, the age at which natural immunity becomes prevalent; no booster dose is recommended for child travelers.