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Pediatrician Remembers Hib on Navajo Reservation in the 1970s

By: Lance Chilton, MD, FAAP

When parents come into my practice today and tell me that they don't want to immunize their children, I do not throw them out of my office, but I do strongly urge them to immunize—particularly for the Hib vaccine. Then I discuss my experiences when I worked on the Navajo Reservation in 1970 as a young pediatrician. Meningitis was rampant, usually due to the bacterium commonly known as Hib (short for Haemophilus influenzae type B).

Unfortunately, Navajo children were particularly susceptible to Haemophilus influenzae. We also saw the occasional pneumococcal and even tuberculous meningitis. Infants and toddlers were struck, seemingly one a week. To make matters worse, treatment was often delayed due to the long distances to my clinic on the reservation and difficulty of travel along dirt roads. Children would often be severely ill by the time they arrived at clinic. We would know right away that they would need a spinal tap and antibiotics and very careful care.

Children suffered the consequences of Hib. About 20 percent died, and another 20 percent were left with permanent damage, including severe seizure disorders, hearing loss, learning disabilities, and intellectual disabilities. This may seem incredible today due to the success of immunizations, but it was a sad reality in the early years of my service as a pediatrician.

It was well known that the Navajo (and some other Native American tribes) were particularly susceptible to Hib, and as a result they were the first to get the new vaccine for Hib in the 1980s. The vaccine was tested on the reservation, because this was the population with the most to gain if the test was successful. The results were truly remarkable!​

The Hib vaccine released the tribes from a terrible burden of disease. The Indian Health Service has done an excellent job getting immunizations to children, so pediatricians on the "Rez" now see meningitis no more frequently than most pediatricians anywhere across the country – which is hardly at all. The vaccine is truly a blessing!

About Dr. Chilton:

Lance Chilton, MD, FAAP, trained in Baltimore and Seattle before being recruited to the Indian Health Service in 1970. He served as a general medical officer at the Gallup (N.M.) Indian Medical Center for two years, and after finishing pediatric residency in Pittsburgh, he returned to New Mexico, where he has been employed ever since as a pediatrician and at the University of New Mexico where he is now professor of pediatrics. He has served both on the AAP Committee on Infectious Diseases and on the CDC Advisory Committee on Immunization Practices. He and his wife have two daughters and five grandchildren, all fully immunized.


Medicine Before Vaccines

This article is part of a series of first-person accounts from senior pediatricians about what it was like to practice pediatric medicine before vaccines for diseases like meningitis, measles, and the flu were available. These articles are being published in recognition of National Immunization Awareness Month, which is held in August every year.

 

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Author
​Lance Chilton, MD, FAAP​
Last Updated
11/21/2015
Source
American Academy of Pediatrics (Copyright © 2015)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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