Haemophilus influenzae type b (Hib) causes many severe diseases, including epiglottitis, pneumonia, sepsis, and meningitis. In developed countries, the annual incidence of meningitis caused by bacteria is approximately 5–10 cases per population of 100,000. The Hib conjugate vaccine is considered protective and safe. Adjuvants, molecules that can enhance and/or regulate the fundamental immunogenicity of an antigen, comprise a wide range of diverse compounds. While earlier developments of adjuvants created effective products, there is still a need to create new generations, rationally designed based on recent discoveries in immunology, mainly in innate immunity. Many factors may play a role in the immunogenicity of Hib conjugate vaccines, such as the polysaccharides and proteins carrier used in vaccine construction, as well as the method of conjugation. A Hib conjugate vaccine has been constructed via chemical synthesis of a Hib saccharide antigen. Two models of carbohydrate-protein conjugate have been established, the single ended model (terminal amination-single method) and cross-linked lattice matrix (dual amination method). Increased knowledge in the fields of immunology, molecular biology, glycobiology, glycoimmunology, and the biology of infectious microorganisms has led to a dramatic increase in vaccine efficacy.

Encapsulated H. influenzae type b (Hib) causes many severe infections, including sepsis, epiglottitis, pneumonia, and meningitis. Occasionally, encapsulated nontype b strains of H. influenzae, mostly type a, are able to produce invasive infections similar to Hib infections. In contrast, nontypeable (unencapsulated) strains are rarely a source of severe infections but most frequently generate infections of mucus membrane, such as conjunctivitis, sinusitis, and otitis media. Hib meningitis has been common in developed countries and hence must be presented along with the other Hib systemic diseases. In 1972, it was approximated that one in 280 newborns are infected with Hib in the first 5 years of life. In a number of populations, including Australian aboriginal and Alaskan Eskimo children, incidence of meningitis caused by Hib has reached 1/50 to 1/30 newborns per year. The Hib meningitis mortality rate is about 5 to 10%, and around 30% of cured infected children have deficits of the central nervous system (CNS) varying from seizures, to deafness, to mental retardation. Furthermore, Hib antibiotics resistance is increasing; around 30% of isolated Hib is ampicillin-resistant, and Hib meningitis in children is tenfold more transmissible than Neisseria meningitidis meningitis. In the prevaccination era, Hib epiglottitis caused much more morbidity and mortality than Hib meningitis and was second to Hib meningitis as the most common systemic Hib infection in Sweden

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