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Non-type b Haemophilus influenzae disease:
clinical and epidemiologic characteristics in the Haemophilus influenzae type
b vaccine era.
Heath PT, Booy R, Azzopardi HJ, Slack MP, Fogarty J, Moloney AC, Ramsay
ME, Moxon ER.
Oxford Vaccine Group, UK.
BACKGROUND: As a result of the decline in Haemophilus influenzae type b (Hib)
disease caused by the widespread use of conjugate vaccines, non-type b H.
influenzae will become a more important cause of H. influenzae (Hi) disease.
Characterization of the clinical and epidemiologic features of non-b Hi
disease is needed in the Hib vaccine era. METHODS: A prospective active
surveillance study of invasive Hi disease involving pediatricians in the
United Kingdom and Republic of Ireland. For the first phase of the study
(October 1, 1992, to October 31, 1995) pediatricians were asked to report any
child who had invasive Hi disease and who had received Hib conjugate vaccine.
For the second phase of the study (November 1, 1995. To December 31, 1998)
pediatricians were asked to report any child with invasive Hi disease
regardless of vaccination status. RESULTS: During the study period 102 cases
of invasive non-type b Hi disease and 106 cases of invasive Hib disease were
reported in children who had been fully vaccinated against Hib. Children with
non-type b disease were younger (16 vs. 22 months of age, P = 0.08), less
likely to have meningitis and epiglottitis (P < or = 0.001) and more
likely to have pneumonia and bacteremia (P < or = 0.001) than children
with type b disease. For the last 2 years of the study invasive Hi disease
occurring in a fully vaccinated child was more likely to be caused by a non-b
strain than by a type b strain (58 vs. 38). In 1998 the incidence of non
type-b Hi disease in all children <5 years of age in the UK was
1.3/100,000 as compared with an incidence of Hib disease of 0.6/100,000. The
majority (88%) of non-b strains isolated in children were nontypable strains.
CONCLUSIONS: Non-b Hi is a rare cause of disease in children, but in the Hib
vaccine era it has become more common than type b as a cause of Hi disease in
fully vaccinated children.
PMID: 11303834 [PubMed - in process]
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