Læknablaðið - 15.01.1996, Page 48

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LÆKNABLAÐIÐ 1996; 82
Table I. Four cases ofinvasive Hib disease in Icelandic children vaccinated with PRP-D.
CaseYear/M Sex/Age Number of doses received Time from last dose to illness Diagnosis Anti-PRP in convalescent serum
1. 1989/Oct M 3 months 1 12 days Meningitis ND
2. 1989/Nov F 12 months 1 5 months Bacteremia Epiglottitis 2.09 pg/ml
3. 1991/Apr M 3 '/2 years 1 15 months Bacteremia Leukemia ND
4. 1991/Dec M 9 months 3 3 months Bacteremia Arthritis 1.59 pg/ml
ND = Not done
Table II. Seven cases ofinvasive Hib disease in non-immunized Icelandic individuals 1990-1994.
Case Year Sex & age Diagnosis
1 1990 M 4 years Bacteremia. Pneumonia
2“ F 38 years Bacteremia in pregnancy
3“ M 1 day, son of case 2 Bacteremia
4“ F 27 years Bacteremia in pregnancy Delivery, 37 weeks. Child healthy
5 1991 M 1 day Bacteremia Mother febrile, blood not cultured Hib isolated from placenta
6 1992 F 22 years Bacteremia in pregnancy Abortion, 22 weeks
7 1993 M 26 years Meningitis. Pneumonia. Narcotic addict
Table III. Number ofHaemophilus influenzae /Hib (%) isola-
tesfrom swabs sent in for diagnostic purposes from 0-5 years
old children at different timeperiods before and after launch of
infant PRP-D vaccination May 1989 (swabs from pharynx
65%, ear25%, eyelO%).
Year/Months H. infl./Hib (%)
1984/Jan-Apr 144/15(10)
1986/Aug-Nov 117/12 (10)
1990/Sept-Dec 116/18 (16)
1991/Jan-Mar 89/9 (10)
/Apr-June 131/4 (3)
/July-Sept 89/2 (2)
/Oct-Dec 172/0
1992/Jan-May 243/1
1994/Jan-Mar 282/1
Blóðsýnum til mótefnamælinga var safnað á
barnadeild Heilsuverndarstöðvar Reykjavík-
ur.
Ræktun og greining á H. influenzae var gerð
á sýkladeild Landspítala með hefðbundnum
hætti og hjúpgerð greind með Difco antisera
eða Wellcogen latex prófi.
Mótefnamælingar voru gerðar á vegum
Connaught Ltd, Kanada með RIA tækni.
Niðurstöður
1. Fjöldi sjúklinga með Hib heilahimnu-
bólgu, Hib blóðsýkingu og bráða barkaloks-
bólgu. Heilahimnubólga af völdum Hib
greindist hjá 92 börnum fimm vikna til sjö ára á
árunum 1980-1989, eitt dó.
Átta börn veiktust árið 1989, sjö þeirra voru
óbólusett, en eitt hafði fengið einn PRP-D
skammt (tafla I).