Public health management of Haemophilus influenzae type b epiglottitis
Haemophilus influenzae type b (Hib) epiglottitis is an invasive infection; report cases to the local public health authority1 2. For detailed recommendations about diagnosis and management of H. influenzae type b epiglottitis, see Haemophilus influenzae type b Invasive Infection: CDNA National Guidelines for Public Health Units.
Clearance antibiotics have a role in eradicating asymptomatic nasopharyngeal carriage of H. influenzae type b in both the patient (index case) and close contacts. Clearance of nasopharyngeal carriage prevents susceptible contacts acquiring the organism and developing invasive infection. Among close contacts there is often an asymptomatic individual who is carrying the organism that caused infection in the patient (index case).
If the patient (index case) was not treated with ceftriaxone, cefotaxime or moxifloxacin, clearance antibiotics are required. However, if the patient was treated with ceftriaxone, cefotaxime or moxifloxacin (as recommended in Intravenous antibiotic therapy for acute epiglottitis), additional clearance antibiotics are not required because these drugs clear nasopharyngeal carriage. Close contacts of the index case may also require clearance antibiotics; these should be initiated in collaboration with the local public health authority2. For clearance antibiotic regimens and further information, see Clearance antibiotics for invasive meningococcal or Hib disease.
If the patient (index case) or a close contact is younger than 5 years and is not fully vaccinated, give age-appropriate catch-up Haemophilus influenzae type b vaccination after recovery – see the Australian Immunisation Handbook.