Haemophilus influenza type B outbreak reported in Vancouver Island homeless
by NewsDesk Lord, save her
Island Health officials have reported a sharp increase in Haemophilus influenza type B (Hib) disease on Vancouver Island in the past two months. This outbreak affects people with homelessness, precarious or supportive housing and those who use substances including inhaled medications.
Hib infected at least eight people on the island and resulted in at least one death. Prior to this year, Hib rates were very low over the past decade (between 0-1 cases per year) due to excellent control through the universal childhood vaccination programme.
Chief Medical Officer of Island Health, said Dr. Rica GustafssonWe expect to see one or no cases at Island Health in a calendar year. We tend to see less than three in the whole county in a calendar year — so eight in less than a calendar year and, importantly, six in weeks. The last few is a really important change.”
Hib-type disease can take many forms, including meningitis, bacteremia, periorbital or other cellulitis, septic arthritis, osteomyelitis, pericarditis, epiglottitis, or Pneumonia. The onset of symptoms is usually sudden, and may include fever, headache, lethargy, loss of appetite, nausea, vomiting, and irritability. Progressive stupor or coma is common in meningitis. Case fatality can be as high as 5% in cases of meningitis and neurological sequelae, including deafness in 15-20% of survivors. Concomitant infection or previous infection with other respiratory pathogens can also occur.
Individuals can transmit the organism to close contacts through droplet spread through coughing and sneezing. Sharing droplets or saliva containing items including food, drink, and equipment for material use is also a transmission risk.
Unvaccinated and unimmunized people are most likely to get Haemophilus influenzae type b disease. Because the circulation of Haemophilus influenzae type b has decreased since the introduction of the vaccine, it is likely that natural immunity in adults has been reduced and many adults will not receive the Hib vaccine when they were children. The Haemophilus influenzae type b vaccine was introduced in British Columbia in 1986 and has been part of the childhood immunization schedule since that time. The vaccine is highly effective in preventing the disease as well as in reducing community transmission.