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Originally Posted by MissRubyandKen
 Following this thread has left me with the question, is HiB only freakishly rare because they no longer test for it, except in certain circumstances. Or has it really decreased to a rarity and they are on the up and up? I have to wonder because I know they have done this with other diseases so they could play up or down the numbers. Does anyone have any info on this? Did less testing coincide closely with the HiB vaccine's addition to the schedule? Where have all the HiB numbers come from over the years, who was routinely tested under what circumstances?
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I think something that confuses the issue is that not all Hib infections are reportable - only "invasive" disease is reportable. So that's why I mentioned earlier that cultures are not often sent for serotyping unless the patient presents with invasive disease. And even then, serotyping isn't always done for numerous reasons. One is that you rely on hospitals & labs to cooperate but it takes time, costs money & requires people to function outside of their normal routines. So when you say "they" aren't serotyping you're really talking about a lot of people for a lot of reasons. Also, a lot of places aren't going to do serotyping if the patient isn't a little kid.
Most states have things like case criteria guides that tell investigators what makes a case a case & condition lists that tell everyone when things have to be reported. But things do not always happen like they are supposed to because people aren't perfect.
Regarding vaccine failure as you quoted, there are several studies you might look up exploring the role of IgG2 deficiency.
