What are the symptoms of Hib disease?

Almost everyone sometimes has Hib bacteria in their nose and throat. These bacteria do not usually make people ill. This is because the bacteria usually do not pass through the mucous membrane. That means they cannot get deeper into the body. If a person does have any symptoms, it often involves the nose, throat or eyes. Examples include:

• nasal cold
• throat infection
• ear infection
• sinus infection
• epiglottitis (inflammation of the flap that prevents food from entering your windpipe)

Epiglottitis may be accompanied by major swelling in the throat, leading to intense shortness of breath. This could cause the patient to suffocate.

Sometimes the Hib bacteria enter the bloodstream. This is called invasive Hib disease. 
If that happens, the bacteria can cause meningitis (inflammation of the protective membranes around your brain and spinal cord). This serious infection can progress very quickly. A patient with meningitis can become seriously ill within a few hours or a day, and could even die within a few days.

What are the symptoms of invasive Hib disease?

The first symptoms of invasive Hib disease are:

• high fever
• headache
• vomiting
• pallor
• signs of meningitis

Signs of meningitis include a stiff neck, nappy pain (the baby cries hard during nappy changing and when the legs are lifted), vomiting, listlessness. There may also be indications of septicaemia (blood poisoning). Septicaemia sometimes causes red or purple dots or small bruises on the skin.

Other severe symptoms of invasive Hib disease include inflammation of the lungs, joints, bones and skin.

Who can become very ill from Hib disease?

Some people have a higher risk of becoming seriously ill from Hib disease:

• people with impaired spleen function or without a spleen
• children aged 5 years and under who have not yet had all their vaccinations against Hib disease
• people with impaired immunity who have less effective resistance to disease
• older people (over 65)

How does Hib disease spread?

Hib disease is contagious. Hib infections are most common among babies and toddlers. The bacteria are found in the nose and throat of people and spread through coughing, sneezing or kissing. During those activities, tiny droplets are released into the air. If people inhale the droplets, they could become infected. People do not usually know that they are carrying the bacteria, because they are not feeling ill. Even if people do not feel ill, they can still infect others as long as they carry the bacteria in their nose and throat.

How can I prevent Hib disease?

Since 1993, children are offered a vaccine against Hib disease through the National Immunisation Programme. The vaccine (DTaP-IPV-Hib-HBV) is given to children at the ages of 3, 5 and 12 months. Healthy children over 1 year old who have not yet been vaccinated against Hib will have enough protection from a single vaccine dose.
This vaccine also protects against diphtheria, tetanus, pertussis (whooping cough), polio and hepatitis B.

If a person develops invasive Hib disease, they will be treated with antibiotics. Antibiotics may sometimes also be given to other household members and people who have close contact with a person who has invasive Hib disease. This only happens if the household includes young children who are not fully vaccinated against Hib disease, or people in vulnerable health. This preventive antibiotic treatment clears up the Hib bacteria in their nose and throat, so they can no longer infect others around them. This precaution is to protect the people who could become very ill from Hib disease.

Is there any treatment for Hib disease?

Milder forms of Hib disease may go away on their own. Sometimes people need to be treated with antibiotics for fast, effective recovery. More severe forms of Hib disease, such as epiglottitis, pneumonia or invasive Hib infections, must be treated in hospital with antibiotics as soon as possible. Otherwise patients could become very ill or even die within a short time.

How common is Hib disease in the Netherlands? 

Before the vaccination against Hib disease was introduced, about 700 children in the Netherlands contracted a severe Hib infection every year. One-quarter of all cases of bacterial meningitis were caused by the bacteria Haemophilus influenzae type B (Hib).

Since the vaccination was introduced in 1993, there has been a significant decrease in the number of people who contract Hib disease. In recent years, there have been over 50 people a year who had Hib disease. They were mainly children under 5 years and people aged 65 years or older. Although the vaccine is very effective against severe Hib disease, there are still a small number of vaccinated children who become seriously ill every year. There are between 7 and 18 cases of invasive Hib disease in vaccinated children every year.

Can a person with Hib disease go to childcare, school or work?

Children with Hib disease in the form of an ear infection or sinus infection who feel well again can go to childcare or school as usual.

Do you have a Hib infection? Then you can go to work as usual if you feel well enough. If you have had contact with a person who has Hib disease, you do not need to stay home. Staying at home does not help prevent you from becoming ill. However, you may be able to arrange a course of antibiotics through the Municipal Public Health Service (GGD) to kill off any bacteria in your nose and throat. The GGD will determine if you are eligible for this treatment based on the type of contact you had with the infected person.