Hib infection makes deadly return as some parents decide against vaccination

[Momtezuma Tuatara]

http://www.ksdk.com/news/health/story.aspx?storyid=167518&catid=9

Hib infection makes deadly return as some parents decide against vaccination

17 February 2009


By Anita Manning, special for USA TODAY
When a very sick toddler was brought into a Minneapolis-area hospital last winter, doctors immediately suspected meningitis. The baby, 15 months old, was lethargic, had a fever of 104 degrees and was increasingly unresponsive.

Within days, test results were in. William Pomputius, an infectious-disease specialist at Children's of Minnesota, was shocked to learn that the girl had Haemophilis influenzae type B, or Hib infection, a disease that has been nearly wiped out by routine vaccination.

That was the first of what would be five cases of Hib in Minnesota in 2008, the most since 1992. Normally, the state sees no more than one or two cases a year, often none. Three of the babies, including a 7-month-old who died, had not been immunized. Of the remaining two, one was too young to be fully immunized and one had an immune deficiency, so vaccination was not effective.

The cases, along with scattered measles outbreaks last year that infected about 140 children and adults, most of them not immunized, have health officials concerned that a growing trend among some parents to delay or forgo infant vaccinations could create a large enough population of unprotected children to allow outbreaks of diseases that haven't been seen by most doctors for a generation.

The Centers for Disease Control and Prevention reports national immunization rates are still high, and in most areas there are enough vaccinated children to create a "herd immunity," a wall of immunized people that prevents spread of disease, so children who are vulnerable - those too young to be vaccinated or who can't be because of immune disorders or other medical problems - are protected.

But health officials are concerned that herd immunity is not holding in the face of a rise in the number of parents who, believing that vaccines are unsafe, unnatural or unnecessary, are not allowing their babies to be vaccinated.

"Some parents wonder if these diseases are a risk," says Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. "With something like Hib, many people have never heard of it because we haven't seen it.

"But it was a killer disease, and we want parents to know it is very dangerous."

The vaccine for Hib, which became routinely used in 1991, "was like an overnight miracle," says Kristen Ehresmann, immunization program manager for the Minnesota Department of Health. Rates of severe Hib disease dropped 99%, to less than one in 100,000 children, nationally, the CDC says. "For anyone who has experienced that, to see this increase in the disease is really quite distressing," she says.

In Minnesota, the number of parents who choose not to vaccinate their children has increased from fewer than 1% a few years ago to "3, maybe 4%," she says. But "those individuals are extremely vocal, and they're drowning out the majority of parents who want their children to be in an environment where they're not exposed unnecessarily. By vaccinating your child, you're doing good not only for that child, but for the community."

A shortage of Hib vaccine that began in late 2007 because of manufacturing problems at Merck could have contributed to the increase in cases, says Patsy Stinchfield, nurse practitioner and director of immunology at Children's Hospitals and Clinics of Minnesota.

Merck's problems left only one supplier, Sanofi Pasteur, whose Hib vaccine is given at 2, 4, and 6 months, with a booster dose at 15 months. The CDC says there is enough vaccine for babies to get the first three doses, but because of the shortage, which may continue until summer, it advises holding off on the booster dose for healthy children.

But doctors say the missing booster dose could allow an increase of Hib bacteria in the community. More children may be carrying it without symptoms, and with a cough or a sneeze they could spread it to unimmunized babies.

"Pediatric physicians have collectively been holding our breath to see if this would happen, and indeed it did," Stinchfield says. "We don't know if this is the tip of the iceberg or not."

The CDC and Minnesota health department have begun to interview 2,000 parents and take swabs of children's throats to get a clearer picture of how many children are carriers.

What is already clear, Stinchfield says, is that "to not vaccinate could potentially cause the death of a child, and that has happened here in Minnesota. And to not follow the schedule that has been scientifically documented and proven has its consequences."

USA TODAY

[Momtezuma Tuatara]

Okay, now what is interesting about Hib, is that if you look at the literature, while serious HIb disease has fallen, Hib infections of other kinds have NOT decreased at all. In fact, they have increased, in terms of ear infections etc.

There is an ASSUMPTION here that the Hib B vaccine provides community immunity, but I don't accept that argument, because if it did, then there would not be a rise in Hib B infections in the elderly in USA; there would be no Hib B detected in ear infections.

My personal belief is that yes, the vaccine may well provide personal protection for those vaccinated, who might otherwise have got serious haemophilus disease in the past, but that the vaccinated pass Haemophilus Influenza B around, just as much as they ever did before.

But it's also my personal belief, that the people who would be been susceptible to serious Hib infections in the past, are now the ones getting all the other kinds of serious bacterial infections which cause meningitis type issues and deaths.

I believe that, because there has not been an overall decrease in meningitis-type infections at all, and we've seen enough with regard to serotype swapping to know that when you create a "hole" in an individual's carriage flora, you just open up a space for something else to take preferential status.

The whole business of the host being the determinant of infection outcome, has been lost in the discussion.

[cartersmom]

The fear mongering is so effective though. I agree with everything you've said. I have learned about serotype replacement and understand from a logical standpoint that overall cases of menengitis have not decreased...they are just being caused by something else. I KNOW this, yet the HIB vax is the only one I still grapple with in my head. I suppose because I know it is an effective vaccine and then I could say well at least DS won't get HIB and if he gets something else there is nothing I could have done. So far he has had no vaccines....but the HIB one keeps bugging me...all the others I have been able to put my fears to rest.....for some reason this one won't let go.
I go back and read Classen's studies about this vaccine and the increase in diabetes. I remind myself that I am breastfeeding and that offers some protection. I also chose to do a homeopathic nosode for HIB. My son is in daycare however....I just don't know how to put this one to rest. I feel it's gnawing at my brain and exhausting me. At least daily I "consider" this vaccine...the ONLY one I would consider and then I of course do not act on this and do it all again the next day. Ive been doing this since he started daycare at 3 months old..he's 10 months now :(

[Momtezuma Tuatara]

Most of the meningitis vaccines have some "effectivity" in terms of protection against individual clinical disease. What most people don't realise though, is that in a person with "that" predisposition, they just swap one problem for another. The only "plus" is that that reduces it down to likelihood of contact, so vaccine manufacturers always have to plat cat and mouse...

[cartersmom]

So then if one is just swapping problems...what's the point right?? The illness will just be caused by something different if a person is predisposed to that type of illness??
Do you have any advice on how I can stop driving myself bonkers about this? I have no way of knowing if my son is "predisposed", I check the MMWR weekly and know there are no cases og HIB around my area....If there were a case mear me would it be worth it??

This is making me :eek::bangshead::shrug::confused:

[Momtezuma Tuatara]

Why do you think that your son is predisposed? Don't say you don't, ... because if you didn't think that, then you wouldn't be going round the bend.

[cartersmom]

Why do you think that your son is predisposed? Don't say you don't, ... because if you didn't think that, then you wouldn't be going round the bend.

I'm saying I have no way of knowing if he is or if he isn't not that I think he is. How can we know?? we can't so I guess the possibility is what makes me nuts. I know it's all a risk vs benefit analysis. If my son wasn't in daycare I wouldn't think twice about it probably. Everything Ive read says daycare put kids at a significantly higher risk for HIB.

[MinorityView]

But breastfeeding significantly lowers the risk. http://insidevaccines.com/wordpress/vaccine-efficacy-how-often-do-vaccines-work/other-stuff/invasive-bacterial-infections-and-breastfeeding/

You can calculate how long you exclusively bf your kid, and also look at the effects of continuing bm, if you are still nursing.

Hope this cheers you up.

[cartersmom]

But breastfeeding significantly lowers the risk. http://insidevaccines.com/wordpress/vaccine-efficacy-how-often-do-vaccines-work/other-stuff/invasive-bacterial-infections-and-breastfeeding/

You can calculate how long you exclusively bf your kid, and also look at the effects of continuing bm, if you are still nursing.

Hope this cheers you up.

I plan on nursing as long as I can (well if he still wants to at 5 we may have a problem) ;) but yes that does make me feel better. It is a small home daycare as well so I don't think his risk is increased significanmtly like it may be in a large overcrowded daycare. Some of the choices to pass on the vaccines are so easy I don't bat an eyelash....others are harder because the vaccine is actually quite effective, but I still have a problem with what is in them and the effect it has on the immune system overall.....Oh lord, my eye is twitching :rolleyes:

[Lexie]

According to my mother, the only vaccines available when I was a child were for tuberculosis, pertussis, diphtheria, tetanus, and yellow fever. None of these today are considered 'life or death' important. I went to school like everyone else, was in daycare after school while my mother went to university, and apart from not being allowed to play with my cousins when they had their childhood diseases, I didn't avoid sick people. I've never had any of the diseases I didn't get vaccinated against. I was always sick, always taking some prescription drug, and had absolutely no resistance. I'm amazed I didn't get any childhood diseases.

My baby is just about 9 months old now, and while I had some fears in the beginning, I don't now. I know it's because she's already been sick once before. I was always afraid to experience that. Afraid, most of all, that I wouldn't know what to do. Worst case scenario is pretty bad in my mind. But when her illness came and went and proved to be extremely uneventful, I began to have a lot more faith in both of us. Her body knew what to do and I was able to help without losing my head. Also, she got sick from my husband and handled it so much better than he did. I always imagined a baby as being so fragile and unable to handle pretty much anything. She proved me wrong. Of course, she was getting vitamin C from me and my husband was being stubborn/lazy about taking any himself. When she got better before he did, I started giving it to him every few hours. I was getting tired of listening to the grumbling. :D

[Momtezuma Tuatara]

Normally I wouldn't ramble like this on a public board, and I may remove this post at some point.

But yesterday was a special day for me....

And what follows before, is mostly how I feel about my life so far, and not a commentary on anyone else's feelings.



I'm saying I have no way of knowing if he is or if he isn't not that I think he is. How can we know?? we can't so I guess the possibility is what makes me nuts. I know it's all a risk vs benefit analysis. If my son wasn't in daycare I wouldn't think twice about it probably. Everything Ive read says daycare put kids at a significantly higher risk for HIB.

The reality of that is that none of us know what the "risks" are, for anything, from day to day.

To illustrate that, three things happened yesterday, and a fourth came to mind....

1) A man brought me the score book of a cricket game played almost 10 years ago, (30/1/1999), which I had scored myself. The game is etched in my mind, because my "mother" radar told me that my son was seriously struggling, and while I scored, that other part of my brain was trying to analyse what was wrong with my son. I knew it was serious. Yet, that day, he became the first player in this area to take four wickets in four consecutive balls. The local policemen, who was standing at second slip, caught the third ball, which came through so fast that he fractured his hand. Yet, twice before that ball, I'd been down to long leg and asked Ian what was wrong. He had a white streak down his face. His shoulders were up, and he was pulling breath on the in breath. My brain was in over-drive.

I remember his batting that day vividly, because normally he's like a rabbit and runs every possible run wearing the fielding team down, but this time, he stood still and smeared the ball all over the park until he was got out.

I had made a mistake in the score book, calling the four wickets in four balls,a hattrick, when it was a four-in-four, and the man wanted me to change the record, so that the honours board could be changed.

Five days later, our son was in hospital fighting for his life, having lost 2/3rds of his blood supply. Yet I know he started that bleeding at 11.00 a.m. that morning. They never found the "cause".

2) Yesterday our son rang, to talk for about an hour, and sounded like a frog. He had a sore throat, felt lousy, and had been having abdominal problems.

He'd seen the doc, who had pointed out to him that voltaren causes gastro bleeding, and wanted to do a blood test to differentiate between an abdominal muscle pull and gastro bleeding. (I pointed out that I had told him that, way back, when they first gave it to him.!) So he's not using that any more... The doc had said he would prefer it to be a gastro issue, as that is easier to fix.

Ha.

My son said, "no way, been there, done that, took months to get right, not want to go there again...."

(Tests today, came back clear, so it's just too much hard work.)

3) In true family style, where not much keeps a tuatara's son down, I sat down last night, and watched this son of my play against India in a 20/20 game, even though he felt appalling that morning.

He has a track record of doing this. Played an under 17 cricket tournament with a semi-healed 5th metatarsal which had fractured three weeks before. Sometimes, not even a ball and chain is any use :giggle:

I couldn't help thinking that just about 10 years ago, I watched him have one of the most successful game of his teenage life, while he started to extensively bleed inside himself.

You just never know, do you.

4) And I also remembered sitting down, to listen to the third test in Pakistan on May 10th, 2002... settling myself nicely, only to turn the radio on and hear Brian Waddle desribing the Al Queda bomb the NZ team had just been amongst, and that my son was unaccounted for at that time. Then came a strange phone call with this kid saying in a high pitched voice... "mummmm...." and the line went dead. Three hours later, he rang again on Brian Waddle's phone, after he'd recovered from shock...

Those three hours were the longest three hours of my life.

You just never know, do you.

There's a film I love, called "Strictly ballroom" which talks about "a life lived in fear, is a life half lived."

I know that feeling. But I've never been prepared to let fear rule my life.

And should something happen to my son --- either son --- today, and their life might finish, I know that both of them would have lived a life to the full, living their dreams, and doing their very best.

I'm not going to worry whether tomorrow, I might get hit by a bus, or cancer or anything else. Today is for living, and living to the full.

Life is for participating in, not being fearful of, or abdicating from.

All fear does is trash my head. While those memories bring tears to my eyes, remembering the stress at the time, they don't make me afraid of the future. Because all the time, even back then, there was one thing that was uppermost in my mind. That God is in control, and whatever would happen, would be for the best. Some would argue that pain and suffering is never for the best. I would disagree with that, because both are very much part of building the character, and preparing you for the future.

I'm not going to let ifs and buts determin my decisions and emotions. Even though the medical profession tries so often to scare me into exactly that corner.

[magical1]

Hey Cartersmom,

1.Trust your gut as a Mother.

2. Go and get a Magnesium supplement for that twitching eye of yours. :)

[MinorityView]

Life gets really tough sometimes. You do the best you can to take care of what you can...and then you trust in whatever higher power you trust in.

So you do all you can to keep your baby healthy (within reason) and then relax and trust.

[cartersmom]

Normally I wouldn't ramble like this on a public board, and I may remove this post at some point.

But yesterday was a special day for me....

And what follows before, is mostly how I feel about my life so far, and not a commentary on anyone else's feelings.




The reality of that is that none of us know what the "risks" are, for anything, from day to day.

To illustrate that, three things happened yesterday, and a fourth came to mind....

1) A man brought me the score book of a cricket game played almost 10 years ago, (30/1/1999), which I had scored myself. The game is etched in my mind, because my "mother" radar told me that my son was seriously struggling, and while I scored, that other part of my brain was trying to analyse what was wrong with my son. I knew it was serious. Yet, that day, he became the first player in this area to take four wickets in four consecutive balls. The local policemen, who was standing at second slip, caught the third ball, which came through so fast that he fractured his hand. Yet, twice before that ball, I'd been down to long leg and asked Ian what was wrong. He had a white streak down his face. His shoulders were up, and he was pulling breath on the in breath. My brain was in over-drive.

I remember his batting that day vividly, because normally he's like a rabbit and runs every possible run wearing the fielding team down, but this time, he stood still and smeared the ball all over the park until he was got out.

I had made a mistake in the score book, calling the four wickets in four balls,a hattrick, when it was a four-in-four, and the man wanted me to change the record, so that the honours board could be changed.

Five days later, our son was in hospital fighting for his life, having lost 2/3rds of his blood supply. Yet I know he started that bleeding at 11.00 a.m. that morning. They never found the "cause".

2) Yesterday our son rang, to talk for about an hour, and sounded like a frog. He had a sore throat, felt lousy, and had been having abdominal problems.

He'd seen the doc, who had pointed out to him that voltaren causes gastro bleeding, and wanted to do a blood test to differentiate between an abdominal muscle pull and gastro bleeding. (I pointed out that I had told him that, way back, when they first gave it to him.!) So he's not using that any more... The doc had said he would prefer it to be a gastro issue, as that is easier to fix.

Ha.

My son said, "no way, been there, done that, took months to get right, not want to go there again...."

(Tests today, came back clear, so it's just too much hard work.)

3) In true family style, where not much keeps a tuatara's son down, I sat down last night, and watched this son of my play against India in a 20/20 game, even though he felt appalling that morning.

He has a track record of doing this. Played an under 17 cricket tournament with a semi-healed 5th metatarsal which had fractured three weeks before. Sometimes, not even a ball and chain is any use :giggle:

I couldn't help thinking that just about 10 years ago, I watched him have one of the most successful game of his teenage life, while he started to extensively bleed inside himself.

You just never know, do you.

4) And I also remembered sitting down, to listen to the third test in Pakistan on May 10th, 2002... settling myself nicely, only to turn the radio on and hear Brian Waddle desribing the Al Queda bomb the NZ team had just been amongst, and that my son was unaccounted for at that time. Then came a strange phone call with this kid saying in a high pitched voice... "mummmm...." and the line went dead. Three hours later, he rang again on Brian Waddle's phone, after he'd recovered from shock...

Those three hours were the longest three hours of my life.

You just never know, do you.

There's a film I love, called "Strictly ballroom" which talks about "a life lived in fear, is a life half lived."

I know that feeling. But I've never been prepared to let fear rule my life.

And should something happen to my son --- either son --- today, and their life might finish, I know that both of them would have lived a life to the full, living their dreams, and doing their very best.

I'm not going to worry whether tomorrow, I might get hit by a bus, or cancer or anything else. Today is for living, and living to the full.

Life is for participating in, not being fearful of, or abdicating from.

All fear does is trash my head. While those memories bring tears to my eyes, remembering the stress at the time, they don't make me afraid of the future. Because all the time, even back then, there was one thing that was uppermost in my mind. That God is in control, and whatever would happen, would be for the best. Some would argue that pain and suffering is never for the best. I would disagree with that, because both are very much part of building the character, and preparing you for the future.

I'm not going to let ifs and buts determin my decisions and emotions. Even though the medical profession tries so often to scare me into exactly that corner.


Thank you for posting that.. It really resonated with me :o. I know you're right...all of you are right. Ive always had trouble with fear and the feeling I have when I look at my son is so overwhelming sometimes. He is my first (maybe will be my only) and I never knew you could love another human being so much. I have to work on my trust. I certainly have my mommy instincts. I need to learn to trust them :D

[MinorityView]

And give yourself some understanding. Motherhood is terrifying and has an irrational side. I kept expecting my very fat baby to starve. Seriously. I was always worrying whether she was getting enough milk. She was so fat she could hardly move.

I also remember how frightened I was the first time she got sick, at age 8 months.

The only thing I can recommend is to let yourself be frightened and then look at it from a step back position. And don't ever let your fear govern your decision-making process.