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Prompt treatment and modern antibiotics have greatly reduced the mortality rate from Hemophilus influenzae meningitis. While mortality rates have fallen below 10 percent, children who survive this disease may have permanent deficits resulting from brain injury sustained during the acute infection. However, the majority of children will recover uneventfully. It is important to determine what characteristics might distinguish the minority of children who will suffer permanent disability. Possible prognostic factors were studied in 97 school-aged children who were treated for meningitis due to infection with Hemophilus influenzae type b. Each of the subjects in the study had a school-aged sibling with whom they were compared. Almost half the children, 41 of 97, suffered neurologic complications during the acute infection. However, only 14 children suffered any sort of persisting neurological deficit. Sensorineural hearing loss was the most common complication, occurring in 11 children. Two patients developed seizure disorders, and one had hemiplegia and mental retardation. The age at time of infection was related to some behavioral changes; older children were more likely to have behavioral problems. Boys were more likely than girls to display difficulties with adaptive behavior when compared with their siblings. These differences were unrelated to cognitive deficits; although some overall cognitive deficit was observed among the patients compared to the siblings, the difference was so slight as to be of negligible clinical importance. It is not known what mechanisms are involved in meningitis that influence adaptive behavior and manifest differently by the sex of the patient. Meningitis patients of lower socioeconomic status were more likely to have poorer performance on tests of intelligence, lower academic performance, and more difficulties with adaptive behavior. Researchers also found that a lower ratio of glucose in the cerebrospinal fluid compared with the blood glucose during the infection correlated with a greater likelihood of deficits. However, the majority of children recovering from H. influenzae meningitis have a good prognosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

The measles, mumps, and rubella vaccine (MMR) is grown in chick embryo cell cultures. It is not uncommon for children under one year to be allergic to eggs. The American Academy of Pediatric has recommended that children have a egg skin test prior to receiving this vaccine if an allergic condition is suspected. The MMR vaccine was diluted and used in a skin test for children with a recent history of egg allergy and a positive reaction to the egg skin test. A total of 114 children ranging from 13 to 36 months old were evaluated. Their reactions to the diluted vaccine were compared with reactions to the egg skin test. The prevalence of positive reactions, along with the safety and the efficacy of the vaccine were examined. Of the 114 children, 24 (21.1 percent) reacted positively to the skin test with the diluted MMR vaccine. The probability and severity of the reactions to the egg test were comparable to the degree of reaction to the diluted MMR vaccine skin test. Although a relationship was detected between these two reactions, observations revealed that clinical evidence may not be sufficient to predict the safety of the MMR vaccine. Eleven of the children who previously exhibited respiratory allergy symptoms to egg had negative reactions to the diluted MMR vaccine skin tests; they were successfully vaccinated. Of the total group, 90 children had negative reactions to the diluted MMR vaccine skin test and were safely vaccinated. It was concluded that there exists a specific group of highly sensitive children who react positively to the diluted MMR vaccine. To screen out children with severe allergy it is recommended that the diluted MMR vaccine skin test be given to all children who are egg sensitive.