what would you respond with? hib - Mothering Forums

Forum Jump: 
 
Thread Tools
Old 03-22-2009, 01:23 PM - Thread Starter
 
yd66's Avatar
 
Join Date: Mar 2009
Posts: 13
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
i am curious about what i read right here, after discussing sanitation/hygine in relation to diseases this is a response i got:

Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis and a major cause of other serious invasive diseases among children aged <5 years in the United States before Hib conjugate vaccines became available in 1988 (1,2). In 1991, all infants starting at age 2 months were recommended to receive Hib conjugate vaccines; by 1996, incidence of Hib invasive disease (i.e., illness clinically compatible with invasive disease, such as meningitis or sepsis, with isolation of the bacterium from a normally sterile site) among children aged <5 years had declined by >99%

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5111a4.htm

So between 1988 and 1996, there was such a massive improvement in sanitation and hygiene in the USA that incidence of this disease went down by 99%?
You guys must have been filthy in the eighties, no?

seems like i should be able to pinpoint the flaws there but i just cant
yd66 is offline  
Sponsored Links
Advertisement
 
Old 03-22-2009, 01:34 PM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 42,826
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Different diseases, different stories. Hib isn't a case for sanitation, obviously.

The story here is serotype replacement. While Hib went down, other things filled the void.

-Angela
alegna is offline  
Old 03-22-2009, 02:11 PM
 
ema-adama's Avatar
 
Join Date: Dec 2007
Posts: 2,333
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by yd66 View Post
So between 1988 and 1996, there was such a massive improvement in sanitation and hygiene in the USA that incidence of this disease went down by 99%?
You guys must have been filthy in the eighties, no?

seems like i should be able to pinpoint the flaws there but i just cant
It depends on what you have understood about the transmission of the disease and what you know protects against complications of the disease.

It also depends on who you are talking to.

I have never understood Hib to be a disease related to sanitation. What is interesting is that when Hib becomes invasive, it is more likely to be pneumonia in developing nations and more like to be meningitis in developed nations. I haven't found a reason why.

ETA: and that does not look at serotype replacement - tons of threads about it here on MDC and lots to read on google scholar

Megan, mama to her little boy (Feb2008) and introducing our little girl (Dec 2010)
ema-adama is offline  
Old 03-23-2009, 12:18 AM
 
luminesce's Avatar
 
Join Date: Aug 2006
Location: In a perpetual 2WW
Posts: 2,207
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by yd66 View Post
i am curious about what i read right here, after discussing sanitation/hygine in relation to diseases this is a response i got:

Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis and a major cause of other serious invasive diseases among children aged <5 years in the United States before Hib conjugate vaccines became available in 1988 (1,2). In 1991, all infants starting at age 2 months were recommended to receive Hib conjugate vaccines; by 1996, incidence of Hib invasive disease (i.e., illness clinically compatible with invasive disease, such as meningitis or sepsis, with isolation of the bacterium from a normally sterile site) among children aged <5 years had declined by >99%

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5111a4.htm

So between 1988 and 1996, there was such a massive improvement in sanitation and hygiene in the USA that incidence of this disease went down by 99%?
You guys must have been filthy in the eighties, no?

seems like i should be able to pinpoint the flaws there but i just cant
Sanitation is in no way connected to the decline of Hib invasive disease. The vaccine works. Better than they thought, in fact - it reduced carriage, which they didn't even anticipate. The long term repercussions of that aren't clear.

Me (37) ~ DH (39) ~ DS (3) ~ TTC #2 since 4/10
luminesce is offline  
Old 03-23-2009, 12:35 AM
 
taterbug1999's Avatar
 
Join Date: May 2006
Location: Kentucky
Posts: 498
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
http://www.who.int/mediacentre/factsheets/fs294/en/

Here is an article I found from WHO, it estimates that pre vax there ranged from 20-60 cases of hiB meng. per 100,000 children. That's .02%-.06%, right? It does not mention mortality or long term complications from these cases. It also mentions that babes are most at risk from 4-18 mos. which I find personally interesting because that is the time period we are bombarding them with vaccines. Just an interesting note, KWIM? hiB generally lives in the back of our throats, and can cause infections of the ears, nose, eyes i.e. pinkeye, and lungs, i.e. pnuemonia when it does enter the body. If it enters the blood this is when you may encounter the hiB meningitis or some other rarer complications.

Cases of true hiB back in the day were probably not diagnosed as such because when they began keeping track was when they were counting hiB meningitis incidence. I had pnuemonia 2x as a kid, but noone checked for hiB I am assuming (I grew up in the eighties, dob 1977). Nobody was checking each case of pink eye or each ear infection or sinus infection for hiB. Point being there were probably lots of cases, but nobody was counting THOSE.

All this to say that the CDC picks and chooses the data they advertise. Compare theirs to the WHO. They talk about rates dropping, etc. but they don't advertise that many of us have had hiB and never even knew it.

As for cleanliness this is not a disease I ever considered being swept away by public sewers or water supplies. But it did occur to me while typing this that during the eighties and nineties we saw a lot of kids going into daycare centers where they were at that prime age and in close contact. But it is again important to note that there are/were many many more cases of hiB that were asymptomatic or surface cases, yet we have been sensationalized into thinking it only causes brain damage and death.

I hope that helps... I am not exactly sure what your specific ? meant.... I know I probably didn't asnwer it exactly,but I just think hiB has been put out there unclearly. Does that make sense? (That by no means undermines parents who have dealt with the evil side of it, but my ds and I both had pink eye last year and I imagine that was hiB too)
taterbug1999 is offline  
Old 03-23-2009, 02:42 AM
 
Emmeline II's Avatar
 
Join Date: Feb 2006
Posts: 8,558
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Hib

"It should be a rule in all prophylactic work that no harm should ever be unnecessarily inflicted on a healthy person (Sir Graham Wilson, The Hazards of Immunization, 1967)."
Emmeline II is offline  
Old 03-23-2009, 06:27 PM
 
Emmeline II's Avatar
 
Join Date: Feb 2006
Posts: 8,558
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Also, it is important to note that HIB was NOT a reportable disease prior to 1991.

The prevaccine Hib estimates
http://www.mothering.com/discussions...=503552&page=3

The first Hib vaccine was licensed in 1985. Hib was put on the childhood recommended schedule of immunizations in 1993. Prior to 1991, Hib was not a notifiable disease.

Here are the number of reported Hib cases:

1991 (2,764)
1992 (1,412)
1993 (1,419) Hib placed on childhood schedule, resulting in universal immunization and state-by-state mandates for entry to daycare/school

1994 (1,174)
1995 (1,180)
1996 (1,170)
1997 (1,162)
1998 (1,194)
1999 (1,309)
2000 (1,398)
2001 (1,597)
2002 (1,743)
2003 (2,013)

From the CDC Pink Book: The incidence of invasive Hib disease began to decline dramatically in the late 1980s, coincident with licensure of conjugate Hib vaccines. In other words, the vaccine had nothing to do with the initial dramatic decline. The incidence of hib dramatically declined around the same time a vaccine was licensed, not introduced.

Bacterial meningitis in the United States, 1978 through 1981. The National Bacterial Meningitis Surveillance Study
W. F. Schlech 3rd, J. I. Ward, J. D. Band, A. Hightower, D. W. Fraser and C. V. Broome

From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control.

We analyzed data from 27 states with full participation from 1978 through 1981. Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), [**ALL*** SEROTYPES] followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%).


http://jama.ama-assn.org/cgi/content...ct/253/12/1749

"I have notes taken of the rat trials presented by the FDA of the Hib trials which showed that the early Hib vaccine, licenced in 1985, which was the early polysaccharide one, not the later conjugated Hib vaccine, not only provoked Hib in rats (by causing transient immune suppression for 7 - 14 days) but also in humans. That is why the polysaccharide vaccine was kept very very quiet. It continued to be used after 1987, but was rapidly replaced with the conjugate vaccine, and the CDC prefer not to talk about this. I've scanned and posted at photobucket the memorandum sent to all paediatricians."

http://i45.photobucket.com/albums/f7...rion/upeB6.jpg

http://i45.photobucket.com/albums/f7...rion/upeBD.jpg

http://i45.photobucket.com/albums/f7...rion/upeC9.jpg

"It should be a rule in all prophylactic work that no harm should ever be unnecessarily inflicted on a healthy person (Sir Graham Wilson, The Hazards of Immunization, 1967)."
Emmeline II is offline  
Old 03-24-2009, 03:38 PM
 
kriket's Avatar
 
Join Date: Nov 2007
Location: SW Ohio
Posts: 4,609
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)

you mamas are excellent. So well put!

I'm crunchy... Like a Dorito.
Mama to Sprout jog.gif 4.09 and Bruises babyboy.gif 7.11 handfasted to superhero.gif 9.07

kriket is offline  
Old 03-25-2009, 07:53 PM
 
anewmama's Avatar
 
Join Date: Feb 2007
Posts: 1,485
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So, in 2003 there were 2,013 but in 2004, there were 19 under 5? Table 1.

http://www.cdc.gov/mmwr/PDF/wk/mm5809.pdf

Are your figures for all age ranges? Can you point me to the source? Cause 2,013 to 19....? What am I missing?
anewmama is offline  
 
User Tag List

Thread Tools


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off