Overview of Haemophilus influenzae and related bacteria

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Overview of Haemophilus influenzae and related
bacteria

• Leonard Mayer, Ph. D.
• Chief, Meningitis Laboratory
• MVPDB/DBD/CDC

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Haemophilus influenzae (Hi)

• gram negative coccobacillus
• Serotypes a-f, and HiNT
• Meningitis, pneumonia, sepsis, otitis media,
  among others
• Vaccine for serotype b (Hib)
• Non-b Hi cases are more visible after Hib vaccine
  implementation

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Haemophilus influenzae (Hi)

• Severe bacterial infection, particularly among
  infants
• Before the introduction of effective vaccines, Hi
  type b (Hib) was a leading cause of bacterial
  meningitis in children lt5 years
• Introduction of conjugate vaccines in 1991 in
  U.S. led to rapid decline in Hi type b disease
• Most disease in the United States and other
  developed countries is now due to non-b serotypes
  and nontypeable (NT) strains
• Now in U.S., NT currently most common serotypes
  a-f less common

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Decline of Hib Meningitis Related to Vaccine
Distribution
Incidence (per 100,000)

• 1980

Year
Polysaccharide Vaccine
Conjugate Vaccine
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H. influenzae (Hi) Serotypes
Encapsulated
Unencapsulated
Type b (Hib)
Type non - b (a, c, d, e, f)
Nontypeable (NT)
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Encapsulated vs. Unencapsulated

• Capsule related to virulence
• NT genetically diverse
• NT viewed as colonizers

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H. aegypitus

• 1st described by Robert Koch while investigating
  cholera in Egypt in 1883
• Causes conjuntivitis (pink eye) purulent with
  no permanent damage
• lt1986 never isolated from sterile site
• Now called Haemophilus influenzae biogroup
  aegyptius

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Brasilian Purpuric Fever (BPF)
Harrison ClinMicroRev 21594 08
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• He got more purple . . . . I was in a room with
  him and the doctor asked me to leave so I
  wouldnt see. And right after the doctor came
  out and said he had died. It was really fast. The
  disease didnt even last 24 hours. It was really
  fast.
• Mother of a child with BPF
• Whats Killing the Children?,
• NOVA documentary, WGBHTV,
• Boston, MA, 18 December 1990.

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Same unique clone by

• Plasmid restriction profile
• SDS-PAGE protein profile
• rRNA ribotyping
• MLEE
• Seroagglutination
• Antibiotic susceptibility testing

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HiNT
BPF
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H. haemolyticus

• H. haemolyticus is nonpathogenic, in contrast to
  the pathogenic H. influenzae.
  Wikipedia
• Common in carriage isolates
• Biochemically similar to H. influenzae
• Require hemin (factor X) and NAD (factor V)
• Lose hemolytic activity by yet un known mechanism

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Active Bacterial Core Surveillance (ABCs) Sites,
2004
(pop. 38.6 million)
OR
MN
NY
CT
CA
CO
MD
TN
NM
GA
Participating counties or states
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• 2010 5 / 392
• 19992000 4 / 234
• Blood, knee fluid, peritoneal fluid. no CSF

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