Some Hib stuff...

Interesting Hib reads:

Prevnar leading to other infections:
http://cat.inist.fr/?aModele=afficheN&cpsidt=15841788
http://jac.oxfordjournals.org/cgi/reprint/50/suppl_3/59.pdf
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1112059

Slight decrease in incident of disease we have a vaccine for, but increase incident of disease we don't have a vaccine for (vaccine creating problems):
http://jcm.asm.org/cgi/content/full/42/2/807
“We show that the introduction of the vaccine in Portugal led to changes in H. influenzae, particularly the decline in strains of serotype b (from 81 to 16%), which was accompanied by a relative increase of NC strains (from 19 to 80%). We also report for the first time a Portuguese serotype f invasive strain that was isolated during the vaccination period. The efficacy of the Hib conjugate vaccine (10) has been extensively studied, and it significantly reduces the incidence of carriage in immunized children, which may have several consequences, e.g., the isolation of other serotypes in cases of invasive disease, especially serotypes a and f (18, 19); an increase in virulence of non-b serotypes (15, 16); and a concomitant increase in NC strains (9).”

http://www.medscape.com/viewarticle/413130_8

CDC's Pink Book:
http://www.cdc.gov/nip/publications/pink/hib.pdf

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm
“Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.”

http://www.adis.com/files/journals/RES/res_0102.pdf

http://www.pidj.com/pt/re/pidj/abstract.00006454-199909000-00014.htm;jsessionid=FKLYy5PcpQ2n3ZQqh2gyppLrlcL2tL27DwRRfMzJKy5NVl5Xqt6D!1005135326!-949856144!8091!-1

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1112059

http://www.medscape.com/viewarticle/413130_19

http://www.pnas.org/cgi/content/full/94/12/6571

http://www.who.int/immunization/topics/hib/en/index.html

Clonal relationship of recent invasive Haemophilus influenzae serotype f isolates from Denmark and the United States
http://jmm.sgmjournals.org/cgi/content/full/53/11/1161

Antibiotic resistance and clinical significance of Haemophilus influenzae type f
http://jac.oxfordjournals.org/cgi/content/abstract/52/6/961?ijkey=2b85954155fe71ba94bfeda678188103ffafdc38&keytype2=tf_ipsecsha

Bacterial Vaccines and Serotype Replacement: Lessons from Haemophilus influenzae and Prospects for Streptococcus pneumoniae
http://www.cdc.gov/ncidod/EID/vol5no3/lipsitch.htm

Outbreak of Haemophilus influenzae type b disease among fully vaccinated children in a day-care center.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14743044&dopt=Abstract

Confronting the pneumococcus: a target shift or bullet change?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11137259&dopt=Abstract

Immunogenicity and impact on nasopharyngeal carriage of a nonavalent pneumococcal conjugate vaccine.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10479145&dopt=Abstract

It seems to me that Hib vaccines caused the pneumococcal bacteria to thrive—creating a shift in what causes bacterial meningitis. Because of the Hib vaccine we need the pneumococcal vaccine. What will we need for the pneumococcal vaccine?