BACKGROUND: Before the introduction of Haemophilus influenzae type b (Hib) conjugate vaccines, rates of H. influenzae disease among Navajo and White Mountain Apache (WMA) children were among the highest reported worldwide. Routine Hib vaccination has significantly reduced rates of Hib disease in these populations. As Hib disease rates decrease to very low levels, there are concerns that non-type b strains of H. influenzae may emerge as more prevalent causes of invasive disease in children. METHODS: We reviewed population-based, active laboratory surveillance data from the period of 1988-2003 for invasive H. influenzae type a (Hia) disease among Navajo and WMA children aged <5 years. Clinical information on cases was collected by chart review. A sample of Hia isolates from Navajo children was typed by pulsed-field gel electrophoresis (PFGE). RESULTS: During 1988-2003, a total of 76 reported cases of invasive Hia disease occurred among Navajo and WMA children. The overall annual incidence was 20.2 cases per 100,000 population aged <5 years. There was no increase in Hia disease rates after Hib vaccination was introduced. The median age of patients was 12 months. Meningitis (50% of cases) was the most common presentation, followed by pneumonia (27.6%). Two children with Hia disease died. PFGE analysis revealed a limited genetic diversity of Hia strains in this population. CONCLUSIONS: Active surveillance data showed high rates of invasive Hia disease among Navajo and WMA children but no increase in the incidence after Hib vaccination was introduced. The presentation of Hia disease is similar to that of Hib disease in the prevaccine era.
BACKGROUND: Before the introduction of Haemophilus influenzae type b (Hib) conjugate vaccines, rates of H. influenzae disease among Navajo and White Mountain Apache (WMA) children were among the highest reported worldwide. Routine Hib vaccination has significantly reduced rates of Hib disease in these populations. As Hib disease rates decrease to very low levels, there are concerns that non-type b strains of H. influenzae may emerge as more prevalent causes of invasive disease in children. METHODS: We reviewed population-based, active laboratory surveillance data from the period of 1988-2003 for invasive H. influenzae type a (Hia) disease among Navajo and WMA children aged <5 years. Clinical information on cases was collected by chart review. A sample of Hia isolates from Navajo children was typed by pulsed-field gel electrophoresis (PFGE). RESULTS: During 1988-2003, a total of 76 reported cases of invasive Hia disease occurred among Navajo and WMA children. The overall annual incidence was 20.2 cases per 100,000 population aged <5 years. There was no increase in Hia disease rates after Hib vaccination was introduced. The median age of patients was 12 months. Meningitis (50% of cases) was the most common presentation, followed by pneumonia (27.6%). Two children with Hia disease died. PFGE analysis revealed a limited genetic diversity of Hia strains in this population. CONCLUSIONS: Active surveillance data showed high rates of invasive Hia disease among Navajo and WMA children but no increase in the incidence after Hib vaccination was introduced. The presentation of Hia disease is similar to that of Hib disease in the prevaccine era.
Authors: Nadine G Rouphael; Sarah Satola; Monica M Farley; Karen Rudolph; Daniel S Schmidt; Patricia Gomez-de-León; John B Robbins; Rachel Schneerson; George M Carlone; Sandra Romero-Steiner Journal: Clin Vaccine Immunol Date: 2010-12-22
Authors: Ian D Plumb; K Danielle Lecy; Rosalyn Singleton; Michael C Engel; Matthew Hirschfeld; James W Keck; Joseph Klejka; Karen M Rudolph; Thomas W Hennessy; Michael G Bruce Journal: Pediatr Infect Dis J Date: 2018-04 Impact factor: 2.129
Authors: J P Bruin; M Kostrzewa; A van der Ende; P Badoux; R Jansen; S A Boers; B M W Diederen Journal: Eur J Clin Microbiol Infect Dis Date: 2013-09-10 Impact factor: 3.267
Authors: Raymond S W Tsang; Samira Mubareka; Michelle L Sill; John Wylie; Stuart Skinner; Dennis K S Law Journal: J Clin Microbiol Date: 2006-04 Impact factor: 5.948
Authors: Daniel S Schmidt; Kathryn T Bieging; Patricia Gomez-de-León; Alberto Villaseñor-Sierra; Jaime Inostroza; John B Robbins; Rachel Schneerson; George M Carlone; Sandra Romero-Steiner Journal: Pediatr Infect Dis J Date: 2012-08 Impact factor: 2.129