What Hib infection is
Hib is Haemophilus influenzae type b, a bacterium that causes serious infections in young children. Despite the name, it has nothing to do with influenza, which is caused by viruses, and a flu shot does not protect against Hib (see influenza). The bacterium spreads through the air when a person coughs or sneezes. Many people, including healthy children and adults, carry it in the nose and throat without symptoms, and it can reach someone who is not protected.
Hib is most dangerous for children under 5, especially babies who have not had all their vaccinations. Before the vaccine, Hib was one of the leading causes of bacterial meningitis in children.
What illnesses Hib causes and how they show up
- Meningitis, inflammation of the brain lining: high fever, severe headache, neck stiffness, drowsiness, vomiting and refusal to eat; in babies, irritability, a high-pitched cry and a bulging soft spot;
- Epiglottitis, swelling of the flap over the windpipe, sudden and dangerous: severe sore throat, drooling, noisy breathing, a child sitting leaning forward; the airway can close off;
- Pneumonia: cough, fever and fast breathing;
- Sepsis, bloodstream infection: high fever, chills and listlessness;
- Bone, joint and soft tissue infections: pain, swelling, redness, refusal to bear weight or move a limb.
Early on, symptoms are easily mistaken for a cold or a routine virus. The signs that should not wait: a child who is unusually limp, hard to wake, struggling to breathe, or who has a stiff neck or seizures.
Why Hib infection is dangerous
Hib meningitis and epiglottitis are emergencies. Even with treatment, complications can include hearing loss, developmental delay, seizures and other neurological effects. Epiglottitis can quickly block the airway completely. That is why prevention matters more than treatment.
Diagnosis and treatment
Diagnosis is made in a hospital: examination, blood tests, a spinal fluid test if meningitis is suspected, and cultures and imaging as needed. Treatment is with intravenous antibiotics, and in epiglottitis or severe illness with breathing support in intensive care. A doctor chooses the drugs and the duration. Close contacts of a severely ill child, especially children under 4 or 5 in the household, may be offered preventive treatment.
Hib vaccine in Georgia
Vaccination works: after Hib vaccines were introduced, serious cases fell by more than 99% in countries with high coverage. In Georgia, the Hib component is part of the six-in-one (hexavalent) vaccine in the national preventive vaccination calendar (Minister's Order No. 01-60/n, current version of July 13, 2023):
- at 2, 3 and 4 months: three doses of the hexavalent vaccine, at least 4 weeks apart;
- the hexavalent vaccine covers diphtheria, pertussis, tetanus, Hib, polio and hepatitis B in one product.
Use of the hexavalent vaccine is recommended up to 24 months of age. The national calendar has no separate Hib booster. For children under 18, calendar vaccines are free under the state program. For children who missed the schedule and in other situations, clinics list Hexaxim, Infanrix hexa and Hiberix, and a pediatrician will choose the plan. Vaccination prices at clinics in Georgia are shown further down this page.
If a child missed doses, the series is not restarted. It is continued, and the doctor determines the age and number of doses, which can differ for toddlers over one year and for children over 5. The same combined vaccines also protect against diphtheria and polio. Other causes of bacterial meningitis, meningococcus and pneumococcus, are covered by separate vaccines: see meningococcal and pneumococcal infections.
When to see a doctor urgently
- fever with severe headache, a stiff neck, drowsiness or trouble waking a child;
- seizures or loss of consciousness;
- sudden sore throat with drooling and labored breathing, especially if the child sits leaning forward;
- in a baby, a high-pitched cry, refusing feeds or a bulging soft spot.
Do not wait until morning or try medicines "to see if it helps." Call an ambulance at 112.
