Abstract
Strategies for management of children attending DC facilities after occurrence of a case of HIB disease are controversial. The success of chemoprophylaxis has been variable. Failure of rifampin prophylaxis as currently recommended, may result from usage limited to direct contacts of the index case. This prospective study was designed to ascertain the extent of colonization in household contacts of colonized children attending DC facilities with an index case of HIB disease. Outer membrane protein (OMP) analysis was used to determine similarity between strains isolated from contacts and index cases. In DC children from 6 facilities, 15% were colonized with identical subtypes of HIB. In addition, 7% of children in the larger DC centers carried non-identical subtypes. Colonization with identical subtypes in children from DC homes was greater than in the larger DC centers (91% vs 8%, p<0.00001). Within families of children with identical OMP subtypes, 25% (17% of parents and 44% of siblings) were colonized despite lack of direct contact with the index case. This colonization rate was comparable to that of household contacts of index cases. Of household contacts of DC children with non-identical subtypes of HIB, 13% were colonized. We conclude that colonized household contacts are a potential source of HIB infection for susceptible DC children and may also warrant prophylaxis.
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Li, K., Dashefsky, B. & Wald, E. 559 PHARYNGEAL COLONIZATION WITH HAEMOPHILUS INFLUENZAE TYPE B (HIB) IN HOUSEHOLD CONTACTS OF COLONIZED CHILDREN ENROLLED IN DAY CARE (DC) FACILITIES ATTENDED BY A CHILD WITH INVASIVE HIB DISEASE. Pediatr Res 19, 204 (1985). https://doi.org/10.1203/00006450-198504000-00589
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DOI: https://doi.org/10.1203/00006450-198504000-00589