Antibody response to polyribosyl-ribitol phosphate antigen of Haemophilus influenzae in Ecuadorian and German children.

Serum samples from 1,221 Ecuadorian children 0 to 5 years of age and from 236 German subjects were tested by enzyme-linked immunosorbent assay for class-specific antibodies to the capsular polysaccharide of Haemophilus influenzae type b (PRP antigen). A gradual prevalence increase of and mean titer increase in immunoglobulin M (IgM) antibody was seen in Ecuadorian but not in German children older than 6 months. At the end of the first year of life, about 50% of the Ecuadorian children showed IgM and IgG antibody to PRP. Seroepidemiological analysis revealed that living at a low altitude and lower calorie intake (a proxy measure of breast-feeding) were factors associated with earlier acquisition of PRP antibody. Children from low-altitude areas of Ecuador also experienced significantly more episodes of significant respiratory infections. The acquisition of PRP-reactive antibodies in Ecuadorian children might thus reflect exposure to encapsulated H. influenzae type b in lower respiratory tract infections.