학술논문
Haemophilus influenzae Type b Vaccine Failure in Portugal: A Nationwide Multicenter Pediatric Survey
Document Type
Academic Journal
Author
Marques, José Gonçalo; Inácio Cunha, Florbela Maria; Bajanca-Lavado, Maria Paula; Bettencourt, Celia; Jorge, Arminda Maria; Faria, Maria Conceição; Zilhão, Carla; Marques, Laura; Casanova, Conceição; Pereira, Cristiana; Fonseca, Fernando; Monteiro, Cláudia; Bettencourt, Mariana; Moreira, Diana; Rodrigues, Fernanda; Oliveira, Henrique; Sousa, Catarina; Pinheiro, Graciete; Santos, Sara Diogo; Vicente, Adília; Milheiro, Tiago; Pinto, Margarida; Seves, Graça; Bento, Rosa; Virtuoso, M.ª João; Fonseca, Rita; Carvalho, Maria Dinah; Lito, Luís; Cruz, Carla; Coutinho, Adriana; Correia, Paula; Sancho, Luísa; Aliyeva, Elzara; Freitas, Cristina; Canhoto, Nuno; Nunes, Ana Filipa; Queiroz, Ana Maria; Diogo, José; Flores, Maria Manuel; Reis, Paula; Ramalheira, Elmano; Zarcos, Maria Manuel; Lima, Sofia; Castilho, Susana; Lacerda, Catarina; Teixeira, Luísa; Jesus, Ana Maria; Maia Aroso, Sofia; Tavares, Margarida; Vitor, Bonito; Ramos, Angélica; Alves, Manuela Costa; Cunha, Isabel; Faustino, Alberta; Sousa, Álvaro; Rodrigues, Margarida; Maciel, Idalina; Vieira, Sandra; Rodrigues, Jorge; Santos, Elisabete; Costa, Alexandra; Martins, Filomena; Escobar, Carlos; Flores, Pedro; Menezes, Maria Favila; Nunes, João Calado; Neto, Ana; Soares, Marina; Pinto, Rita Mouro; Almeida, Diana; Brito, Isabel; Costa, Hermínia; Silva, Fátima; Cardoso, Joana; Pereira, Magalys; Gonçalves, Luís; Tavares, João; Moniz, Sofia Botelho; Gaspar, Eurico Jorge; Carvalho, Joana; Castro, Ana Paula; Sousa, Álvaro; Francisco, Catarina; Farela Neves, João; Paixão, Paulo
Source
The Pediatric Infectious Disease Journal. Sep 01, 2023 42(9):824-828
Subject
Language
English
ISSN
0891-3668
Abstract
BACKGROUND:: Despite the high effectiveness of the Haemophilus influenzae type b (Hib) vaccine in preventing invasive disease (ID) in children, Hib vaccine failures (VFs) cases may still occur. This study aimed to characterize the Hib-VF cases in Portugal in a 12-year period and trying to identify the possible associated risk factors. METHODS:: Prospective descriptive nationwide surveillance study. Bacteriologic and molecular studies were performed at the same Reference Laboratory. Clinical data were collected by the referring pediatrician. RESULTS:: Hib was identified in 41 children with ID and 26 (63%) were considered VF. Nineteen (73%) cases occurred in children less than 5 years old; 12 (46%) occurred before the Hib vaccine booster dose at 18 months of age. Comparing the first and the last 6-year periods of the study, the incidence rate of Hib, VF and total H. influenzae (Hi) ID significantly raised (P < 0.05). VF cases corresponded, respectively, to 13.5% (7/52) and 22% (19/88) of total Hi-ID cases (P = 0.232). Two children died due to epiglottitis and 1 acquired sensorineural hearing loss. Only 1 child had an inborn error of immunity. The immunologic workup performed in 9 children revealed no significant abnormalities. All 25 Hib-VF strains analyzed belonged to the same clonal complex 6. CONCLUSIONS:: In Portugal, more than 95% of children are vaccinated against Hib, but severe Hib-ID cases still occur. No predisposing factors were clearly identified to justify the increased number of VF in recent years. Along with continued Hi-ID surveillance, Hib colonization and serologic studies should be implemented.