{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T21:37:44Z","timestamp":1757453864918,"version":"3.40.5"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5,1]]},"abstract":"<jats:p>A 7-year-old boy with a history of recurrent acute lymphoblastic leukemia (ALL), in remission, presented to primary care clinic after 2 days of progressive right hip pain with weight-bearing activities. He was otherwise asymptomatic at the time of presentation. Blood cultures revealed Gram-negative diplococci, which prompted an MRI that was significant for a hip joint effusion and femoral head bone marrow edema. The patient had no sick contacts and no significant past medical history other than ALL. The patient had been given all recommended childhood vaccinations. Arthrocentesis and needle biopsy of the femoral neck were not diagnostic for malignancy and revealed only mild hip joint inflammation, leading to a diagnosis of osteomyelitis. The organism in the original blood culture was identified as Haemophilus\u2008influenzae type b, \u03b2-lactamase negative. Review of the patient\u2019s medical records showed a history of complete immunization to Haemophilus influenzae type b. An immunologic evaluation was made to determine if the patient retained immunity from his other vaccinations. Pathogen-specific antibody testing revealed detectable antibodies to polio but not measles, mumps, rubella, varicella-zoster virus, tetanus, diphtheria, pertussis, or hepatitis B. This loss of immunologic memory appears to be a rarely described side effect of ALL chemotherapy. There is currently no protocol to evaluate the immunologic memory of patients who underwent chemotherapy for ALL or to revaccinate them after their treatment. It is unclear whether the loss of immunologic memory is genuinely rare or is underdiagnosed because affected patients are protected by herd immunity.<\/jats:p>","DOI":"10.1542\/peds.2012-1126","type":"journal-article","created":{"date-parts":[[2013,4,16]],"date-time":"2013-04-16T00:54:20Z","timestamp":1366073660000},"page":"e1639-e1642","source":"Crossref","is-referenced-by-count":6,"title":["<i>Haemophilus influenzae<\/i> Type b in an Immunocompetent, Fully Vaccinated ALL Survivor"],"prefix":"10.1542","volume":"131","author":[{"given":"John","family":"Nevin","sequence":"first","affiliation":[{"name":"Departments of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Kanter Washko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Hematology\/Oncology, Tulane University Hospital, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Arnold","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, and"},{"name":"Infectious Diseases, Naval Medical Center, San Diego, San Diego, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2013,5,1]]},"reference":[{"issue":"15","key":"2021120900092323700_B1","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1056\/NEJMra023001","article-title":"Acute lymphoblastic leukemia.","volume":"350","author":"Pui","year":"2004","journal-title":"N Engl J Med"},{"issue":"6","key":"2021120900092323700_B2","doi-asserted-by":"crossref","first-page":"e91","DOI":"10.1542\/peds.109.6.e91","article-title":"Current chemotherapy protocols for childhood acute lymphoblastic leukemia induce loss of humoral immunity to viral vaccination antigens.","volume":"109","author":"Nilsson","year":"2002","journal-title":"Pediatrics"},{"issue":"11","key":"2021120900092323700_B3","doi-asserted-by":"crossref","first-page":"2365","DOI":"10.1080\/10428190600799888","article-title":"Incidence rates of the major leukemia subtypes among US Hispanics, blacks, and non-Hispanic whites.","volume":"47","author":"Matasar","year":"2006","journal-title":"Leuk Lymphoma"},{"key":"2021120900092323700_B4","first-page":"2272","article-title":"Evidence that drugs in multiple combinations have materially advanced the treatment of Human Malignancies.","volume":"29","author":"Henderson","year":"1969","journal-title":"Cancer Res"},{"issue":"10","key":"2021120900092323700_B5","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1038\/sj.leu.2404326","article-title":"Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review.","volume":"20","author":"van Tilburg","year":"2006","journal-title":"Leukemia"},{"issue":"7","key":"2021120900092323700_B6","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1002\/pbc.23043","article-title":"Multivariate analysis of the relation between immune dysfunction and treatment intensity in children with acute lymphoblastic leukemia.","volume":"56","author":"Ek","year":"2011","journal-title":"Pediatr Blood Cancer"},{"issue":"11","key":"2021120900092323700_B7","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/00043426-200411000-00008","article-title":"Intensive treatment for childhood acute lymphoblastic leukemia reduces immune responses to diphtheria, tetanus, and Haemophilus influenzae type b.","volume":"26","author":"Ek","year":"2004","journal-title":"J Pediatr Hematol Oncol"},{"key":"2021120900092323700_B8"},{"issue":"8","key":"2021120900092323700_B9","first-page":"887","article-title":"Immunization response varies with intensity of acute lymphoblastic leukemia therapy.","volume":"145","author":"Ridgway","year":"1991","journal-title":"Am J Dis Child"},{"issue":"3","key":"2021120900092323700_B10","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1002\/cncr.20384","article-title":"Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy.","volume":"101","author":"Zignol","year":"2004","journal-title":"Cancer"},{"key":"2021120900092323700_B11"},{"issue":"8","key":"2021120900092323700_B12","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1038\/sj.bmt.1704870","article-title":"Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT.","volume":"35","author":"Ljungman","year":"2005","journal-title":"Bone Marrow Transplant"},{"key":"2021120900092323700_B13"},{"issue":"2","key":"2021120900092323700_B14","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1128\/CMR.13.2.302","article-title":"Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates.","volume":"13","author":"Peltola","year":"2000","journal-title":"Clin Microbiol Rev"},{"key":"2021120900092323700_B15","unstructured":"Centers for Disease Control and Prevention. Vaccination coverage and surveillance Jan 1999\u2013Dec 2009. Available at: www.cdc.gov\/vaccines\/stats-surv\/default.htm. Accessed February 4, 2012"},{"issue":"19","key":"2021120900092323700_B16","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1056\/NEJMsa0806477","article-title":"Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases.","volume":"360","author":"Omer","year":"2009","journal-title":"N Engl J Med"},{"issue":"11-12","key":"2021120900092323700_B17","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/S0264-410X(02)00627-8","article-title":"\u2018Clustering of exemptions\u2019 as a collective action threat to herd immunity.","volume":"21","author":"May","year":"2003","journal-title":"Vaccine"},{"issue":"18","key":"2021120900092323700_B18","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1001\/jama.284.18.2334","article-title":"Antibody concentration and clinical protection after Hib conjugate vaccination in the United Kingdom.","volume":"284","author":"Heath","year":"2000","journal-title":"JAMA"},{"issue":"9693","key":"2021120900092323700_B19","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0140-6736(09)61203-4","article-title":"Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates.","volume":"374","author":"Watt","year":"2009","journal-title":"Lancet"},{"issue":"4","key":"2021120900092323700_B20","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1542\/peds.110.4.653","article-title":"Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis.","volume":"110","author":"Zhou","year":"2002","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/5\/e1639\/1090204\/peds_2012-1126.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/5\/e1639\/1090204\/peds_2012-1126.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T05:38:21Z","timestamp":1639028301000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/131\/5\/e1639\/31259\/Haemophilus-influenzae-Type-b-in-an"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,1]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2013,5,1]]},"published-print":{"date-parts":[[2013,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-1126","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2013,5,1]]}}}