Haemophilus influenzae tip b

(Hib)
- determina infectii invazive la copii
<5 ani
 Haemophilus influenzae tip b (Hib)

 In absenta vaccinarii determina infectii invazive:

 Epiglotite
 Pneumonii
 Meningite
 Osteomielita
 Celulita
 Pericardita
 Sepsis

 Epidemiologie (la nivel mondial) inainte de introducerea vaccinarii

- 90% din cazurile de infectii invazive cu Hib apar la copii sub 5 ani
-  8,13 milioane de cazuri de infectii invazive la copii cu varsta intre 1-59 de
luni (59%<1 an)
-  371 000 de decese

1. Whittaker R, Economopoulou A, Dias J, Bancroft E, Ramliden M, Celentano L. Epidemiology of Invasive Haemophilus influenzae Disease, Europe,
2007–2014. Emerg Infect Dis. 2017;23(3):396-404.
2. World Health Organization. WHO position paper on Haemophilus influenzae type b conjugate vaccines. Wkly Epidemiol Rec. 2013;88:413–428.
 Rata de incidenta raportata la 100 000 de copii cu
varsta sub 5 ani, anul 2000

World Health Organization. Immunization, Vaccines and Biologicals. Disponibil la:

https://www.who.int/immunization/monitoring_surveillance/burden/estimates/Pneumo_hib_2000/en/index1.html
 Rata de mortalitate raportata la 100 000 de copii cu
varsta sub 5 ani, anul 2000

World Health Organization. Immunization, Vaccines and Biologicals. Disponibil la:

https://www.who.int/immunization/monitoring_surveillance/burden/estimates/Pneumo_hib_2000/en/index1.html
 Vaccin Hib

Vaccin bacterian inactivat polizaharidic conjugat

Schema de vaccinare recomandata: 2-4-11 luni

Introdus in schemele nationale de vaccinare incepand cu anul 1989 in

forma conjugata; pana in anul 2000, prezent in majoritatea tarilor din Europa

 Epidemiologie dupa vaccinare

Scaderea infectiilor cauzate de Hib cu pana la 90%, precum si a portajului
faringian la grupele de varsta 1-5 luni si 1-4 ani.
 Distributia cazurilor confirmate de infectie cu Haemophilus
influenzae la 100 000 de locuitori, 2017

European Centre for Disease Prevention and Control. Annual Epidemiological Report 2017 – Invasive Haemophilus influenzae. 2019.
Disponibil pe: https://ecdc.europa.eu/en/publications-data/haemophilus-influenzae-annual-epidemiological-report-2017
 Virusul poliomielitic

- determina paralizii ireversibile in

special la copii <5 ani
 Virusul poliomielitic
Poliomielita afecteaza in principal copiii sub 5 ani.

In absenta vaccinarii:
 1 din 200 de infectii duce la o paralizie
ireversibila.
 dintre cei cu paralizie, între 5% și 10% mor atunci
cand apare afectarea muschilor respiratori.
 350 000 cazuri la nivel mondial in 1988

World Health Organization. Poliomyelitis. Disponibil la: https://www.who.int/news-room/fact-sheets/detail/poliomyelitis

 Vaccin antipoliomielitic
• Vaccin viral inactivat complet
• Schema de vaccinare recomandata in Romania: 2-4-11 luni-6 ani
• Introdus in Romania din anul 1957, utilizat timp de 50 de ani sub
forma de vaccin polio oral; din 2009 se utilizeaza vaccinul inactivat.

• Epidemiologie dupa introducerea vaccinarii:

 numarul de cazuri a scazut cu peste 99%: 33 cazuri raportate in 2018
(la nivel mondial).
 ultimul caz de poliomielita din Romania - aprilie 1992.
 in iunie 2002 s-a declarat eradicarea poliomielitei in Europa; in
prezent, 80% din populatia globului traieste in zone “polio-free”
– regiuni fara poliomielita.

1. Pitigoi D, Ciufecu C. Cronologia eradicării poliomielitei în România. Viața medicală. 2012;32(1178).

2. World Health Organization. Poliomyelitis. Disponibil la: https://www.who.int/news-room/fact-sheets/detail/poliomyelitis
 Distributia cazurilor confirmate de poliomielita, 1988

Hamborsky, Jennifer, and Andrew Kroger, eds. Epidemiology and prevention of vaccine-preventable diseases, E-Book: The Pink Book.
Public Health Foundation, 2015.
 Distributia cazurilor confirmate de poliomielita, 2012

Hamborsky, Jennifer, and Andrew Kroger, eds. Epidemiology and prevention of vaccine-preventable diseases, E-Book: The Pink Book.
Public Health Foundation, 2015.
Corynebacterium diphtheriae

- determina crupul difteric si

toxicitate sistemica, cu rate crescute
de mortalitate
 Corynebacterium diphtheriae
• In absenta vaccinarii:
 Faringita pseudomembranoasa (crup difteric) cu insuficienta
respiratorie
 Neuropatii
 Miocardita
 Insuficienta renala
 Deces

• Epidemiologie inainte de introducerea vaccinarii:

1 milion de cazuri si 50 000 de decese in 1943 in Europa
World Health Organization. WHO position paper on Diphtheria vaccine. Wkly Epidemiol Rec. 2017;92:417–436.
 Vaccinul anti-difteric
• Vaccin bacterian inactivat fractionat (anatoxina)
• Schema de vaccinare recomandata: 2-4-11 luni-6 ani-14 ani
• Introdus in anul 1923

• Epidemiologie dupa introducerea vaccinarii:

 Ultimul caz raportat in Romania in 1989
 In 2016, 47 cases of diphtheria due to toxigenic C. diphtheriae or
C. ulcerans were reported to ECDC.
 Among C. diphtheriae cases, 65% were reported as imported.
 The majority of cases were not vaccinated or their vaccination
status was reported as unknown.
European Centre for Disease Prevention and Control. Annual Epidemiological Report for 2016 – Diphtheria. 2018. Disponibil pe:
https://ecdc.europa.eu/en/publications-data/diphtheria-annual-epidemiological-report-2016
Numarul de cazuri de difterie raportate in Europa, 2016

European Centre for Disease Prevention and Control. Annual Epidemiological Report for 2016 – Diphtheria. 2018. Disponibil pe:
https://ecdc.europa.eu/en/publications-data/diphtheria-annual-epidemiological-report-2016