Læknablaðið - 15.01.1996, Blaðsíða 44

32
LÆKNABLAÐIÐ 1996; 82
Ungbarnabólusetning á íslandi gegn
Haemophilus influenzae af hjúpgerð b
Árangur eftir sex ára notkun PRP-D
(ProHIBiT®)
Kristín E. Jónsdóttir11, Halldór Hansen2>, Víkingur H. Arnórsson31, Þröstur Laxdal4>,
Magnús Stefánsson5)
Jónsdóttir KE, Hansen H, Arnórsson VH, Laxdal Þ,
Stefánsson M
Immunization against Haemophilus influenzae type b
in Iceland.
Results after six years use of PRP-D (ProHIBiT®)
Læknablaðið 1996; 82: 32-8
Haemophilus influenzae type b (Hib) causes menin-
gitis bacteremia and epiglottitis, dangerous infec-
tions, which occur mainly in children under five
years of age. Incidence of Hib meningitis in that age
group in Iceland was 43/100.000 1974-1988.
In the fall of 1988 Icelandic health authorities decid-
ed to offer infant immunisation against Hib with
PRP-D (ProHIBiT®) vaccine, product of Con-
naught Ltd, Canada.
Results are presented of this immunisation pro-
gramme which has been running since spring 1989.
The vaccine is administered at the age of three, four,
six and 14 months. During the first year of the immu-
nisation programme one dose was offered to chil-
dren aged 15 months up to end of third year.
During the 10 years 1980-1989, 92 children had Hib
meningitis, 61 Hib bacteremia or arthritis and 21
acute epiglottitis.
During the five years 1990-1994 no child had Hib
Frá 1,sýklafræðideild Landspítalans, 2|ungbarnadeild
Heilsuverndarstöðvar Reykjavíkur, 3,Barnaspítala Hrings-
ins, 4,barnadeild Landakotsspítala, 5,barnadeild Fjórðungs-
sjúkrahússinsáAkureyri. Fyrirspurnir, bréfaskipti: Kristín E.
Jónsdóttir, sýklafræðideild Landspítalans v/Barónsstíg, 101
Reykjavík.
Lykilorð: Haemophilus influenzae b, bóluefni.
meningitis or epiglottitis but three had Hib bactere-
mia. Hib strains were 10-16% of Haemophilus influ-
enzae strains isolated from surface swabs from 0-5
years old children at different periods until spring
1991 but became very scarse after that.
Anti-PRP antibodies in blood measured <0.15 pg/
rnl in 20% of children after three doses of vaccine
but >1.0ug/ml in 95% after four doses.
No fully immunized child has had invasive Hib dis-
ease, but one had meningitis and two bacteremia
after one dose of vaccine and one bacteremia after
three doses. In 1993 21 fully immunized three to four
years old children received a booster dose of
PRP-D. Geometric Mean Titer of anti-PRP was
l.llpg/ml before and 137.11ug/ml after the dose.
Mean antibodies against diphtheria were 0.37 IU
before and 11.69 IU after the dose.
It remains uncertain how long anti-PRP will last in
vaccinees when Hib strains disappear.
Correspondence: Kristín E. Jónsdóttir, Department
of Clinical Microbiology, the National University
Hospital, 101 Reykjavík, Iceland.
Ágrip
Haemophilus influenzae af hjúpgerð b (Hib)
veldur hættulegum sýkingum í heilahimnum,
blóði og barkaloki einkum hjá börnum innan
fimm ára. Tíðni Hib heilahimnubólgu í þeim
aldurshópi á íslandi var 43 á 100.000 árin 1974-
1988 (1). Síðla árs 1988 ákváðu íslensk heil-
brigðisyfirvöld að bjóða upp á bólusetningu
ungbarna gegn Hib með PRP- D (ProHIBiT®)
bóluefni frá Connaught Ltd, Kanada.
Skýrt er frá árangri af notkun þessa bóluefn-
is, sem hófst vorið 1989 og er gefið börnum