A longitudinal study of pharyngeal colonization with Haemophilus influenzae type b included 264 members of families that had a child with meningitis or epiglottitis due to this organism. It was found that (1) 52 of 67 such families contained at least one carrier of H. influenzae type b, who was usually a sibling; (2) H. influenzae type b spread slowly in 39 families colonized continuously during a six-month period, with only eight of 19 uncolonized siblings acquiring the organism during that time; (3) 18 of 30 initially colonized families contained one or more carriers after 12 months, including 30% of initially colonized siblings; (4) the highest carrier rate of H. influenzae type b occurred in recovered patients, 80% of whom were colonized after hospital discharge; (5) titers of antibody in serum were higher in colonized than in uncolonized individuals (P less than 0.001); (6) levels of antibody in colonized children were lower in those younger than two years than in older children (P less than 0.001); and (7) prolonged or heavy colonization with H. influenzae type b was not associated with unusually high titers of antibody.

No abstract

No abstract

No abstract

The purposes of this study were to describe the incidence of acute-phase neurologic complications in a sample of 126 children with Haemophilus influenzae type b meningitis, and to determine if these complications were associated with higher rates of learning and behavior problems at school age. Risks were assessed by comparing rates of adverse psychoeducational outcomes in the 53 children in the sample with complications to corresponding outcome rates in the 67 children who were free of neurologic complications and who did not have abnormal electroencephalograms (EEGs) or computed tomographic (CT) scans. Comparisons were made by means of logistic regression analysis. Twenty-nine children (23% of the sample) had seizures, 16 (13%) were comatose or obtunded, 15 (12%) had sensorineural hearing loss, 8 (6%) had hemiparesis, and 7 (6%) had cranial nerve deficits other than hearing loss. Relative to children without complications, those with complications had higher rates of grade repetition and substandard performance on neuropsychological and achievement testing. Adverse outcomes, however, consisted primarily of more subtle cognitive and learning problems; only two of the children in the sample obtained prorated IQ scores below 70. Sequelae were associated with persistent neurologic deficits and bilateral hearing loss, as well as with transient symptoms including seizures, coma, and hemiparesis. While study findings argue against adverse consequences for the vast majority of children treated for this disease, the results clarify learning and behavior outcomes and indicate which children are at greatest risk.