Keyser J S, Derkay C S
Portsmouth Naval Hospital, VA.
Am J Otolaryngol. 1994 Nov-Dec;15(6):436-43. doi: 10.1016/0196-0709(94)90085-x.
US Food and Drug Administration (USFDA) has licensed four Haemophilus influenzae type B (Hib) vaccines for use in children. Haemophilus influenzae type B is by far the most common pathogen in childhood epiglottitis and it is hoped that with the introduction of the Hib vaccine that a corresponding decrease in epiglottitis cases will be appreciated.
A retrospective study of all children admitted with the diagnosis of epiglottitis for the 11-year period of 1982 to 1992 was conducted in order to determine the incidence of epiglottitis and Hib vaccine failure. Fifty-nine cases were included in the study by documentation of an inflamed epiglottis. The case of Hib epiglottitis in a 4-year-old child immunized with HbOC conjugate vaccine at 18 months of age is detailed.
A statistically significant decrease was found in the incidence of epiglottitis since introduction of the vaccines; however, the overall trend in decrease for the 11-year period was not statistically significant. Vaccination status was difficult to accurately document with only two cases of vaccine failure identified.
The incidence of Haemophilus influenzae type B epiglottitis at our regional Children's hospital has decreased since the introduction of the Hib vaccine. Reasons for vaccine failure are postulated.
美国食品药品监督管理局（USFDA）已批准四种B型流感嗜血杆菌（Hib）疫苗用于儿童。B型流感嗜血杆菌是儿童会厌炎中迄今为止最常见的病原体，人们希望随着Hib疫苗的引入，会厌炎病例能相应减少。
对1982年至1992年这11年间所有诊断为会厌炎的儿童进行回顾性研究，以确定会厌炎的发病率和Hib疫苗失效情况。通过记录会厌发炎情况，59例病例被纳入研究。详细介绍了一名18个月大时接种HbOC结合疫苗的4岁儿童患Hib会厌炎的病例。
自疫苗引入以来，会厌炎发病率有统计学意义的下降；然而，11年期间总体下降趋势无统计学意义。由于仅发现两例疫苗失效病例，疫苗接种情况难以准确记录。
自引入Hib疫苗以来，我们地区儿童医院B型流感嗜血杆菌会厌炎的发病率有所下降。推测了疫苗失效的原因。
