Haemophilus influenza Serotype b, Invasive Disease

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Nationally notifiable since 1979

1.0 National Notification

Only confirmed cases of disease should be notified.

2.0 Type of Surveillance

Routine case-by-case notification to the federal level

Enhanced case-by-case notification to International Circumpolar Surveillance in participating Northern regions

Enhanced, active case-by-case notification by paediatric tertiary care hospitals involved in the Immunization Monitoring Program, Active (IMPACT)

3.0 Case Classification

3.1 Confirmed case

Clinical evidence of invasive disease(see section 5.0) with laboratory confirmation of infection:

• isolation of H. influenzae (serotype b) (Hib) from a normally sterile site
  OR
• isolation of H. influenzae (serotype b) from the epiglottis in a person with epiglottitis

3.2 Probable case

Clinical evidence of invasive disease with laboratory evidence of infection:

• demonstration of H. influenzae type b antigen in cerebrospinal fluid
  OR
• demonstration of H. influenzae DNA in a normally sterile site
  OR
• Buccal cellulitis or epiglottitis in a child < 5 years of age with no other causative organisms isolated

4.0 Laboratory Comments

Detection of H. influenzae DNA is considered probable, not confirmed, because Hib may be present in a non-pathogenic role and thus, depending on the site, may NOT reflect the actual pathogen. Additionally, detection of H. influenzae DNA in a sterile site does NOT indicate that it is type b, since this test does not differentiate between serotypes.

5.0 Clinical Evidence

Clinical illness associated with invasive disease due to H. influenzae includes meningitis, bacteraemia, epiglottitis, pneumonia, pericarditis, septic arthritis and empyema.

6.0 ICD Code(s)

Note: ICD codes do not differentiate between b and non-b serotypes

6.1 ICD-10 Code(s)

A41.3

Septicaemia due to Haemophilus influenzae

A49.2

H. influenzae infection, unspecified site

B96.3

H. influenzae as cause of disease classified elsewhere

G00.0

Meningitis due to Haemophilus influenzae

J05.1

Acute epiglottitis

J14

Pneumonia due to Haemophilus influenzae

P23.6

Congenital pneumonia due to Haemophilus influenzae

6.2 ICD-9/ICD-9CM Code(s)

038.41

Septicaemia due to Haemophilus influenzae

041.5

H. influenzae infection of unspecified site and in conditions classified elsewhere

320.0

Meningitis due to Haemophilus influenzae

464.3

Acute epiglottitis

482.2

Pneumonia due to Haemophilus influenzae

7.0 Type of International Reporting

8.0 Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

Between 1979 and 1985, only H. influenzae type b (Hib) meningitis was nationally notifiable. Beginning in 1986, all invasive forms of H. influenzae type b disease were nationally notifiable. Current vaccination programs only provide protection against Hib.

Although rare, increasingly non-b serotypes of H. influenzae have been found to cause invasive disease in Canada. Cases with clinically compatible illness and isolation of non-b serotypes of H. influenzae are also nationally notifiable (see Haemophilus influenzae non-b, Invasive Disease).

9.0 References

10.0 Previous Case Definitions

Canadian Communicable Disease Surveillance System: disease-specific case definitions and surveillance methods. Can Dis Wkly Rep 1991;17(S3).

Case definitions for diseases under national surveillance. CCDR 2000;26(S3).

Date of Last Revision/Review:

May 2008