Reemergence of invasive Haemophilus influenzae type b disease in awell-vaccinated population in remote Alaska

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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9841828&dopt=Abstract

 

: J Infect Dis 1999 Jan;179(1):101-6

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·         J Infect Dis. 2000 Feb;181(2):806-9

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Reemergence of invasive Haemophilus influenzae type b disease in a well-vaccinated population in remote Alaska.

Galil K, Singleton R, Levine OS, Fitzgerald MA, Bulkow L, Getty M, Perkins BA, Parkinson A.

National Immunization Program, CDC Mailstop E61, 1600 Clifton Road, Atlanta, GA 30333, USA.

Before vaccination, Alaska Natives experienced very high rates of invasive Haemophilus influenzae type b (Hib) disease and carriage. Vaccination with Hib conjugate vaccine PRP-OMP (polyribosylribitol phosphate Neisseria meningitidis outer membrane protein) began in 1991 and resulted in a sharp decline in cases. In 1996, after switching to a different Hib conjugate vaccine, DTP-HbOC (which combines diphtheria-tetanus-whole cell pertussis vaccines with HbOC [Hib oligosaccharide CRM197]), cases of invasive Hib disease increased, suggesting ongoing Hib transmission despite widespread vaccination. To determine the prevalence of and risk factors for carriage, a cross-sectional study of oropharyngeal Hib carriage was conducted among Alaska Native children aged 1-5 years in remote southwestern Alaska. Of 496 children with swabs taken, 46 (9.3%) were colonized with Hib. Carriage rates varied by village from 2.2% to 13.2% and by age from 6.1% in 1-year-olds to 14.7% in 5-year-olds. Crowding was associated with Hib carriage. Widespread vaccination with PRP-OMP Hib conjugate vaccine did not eliminate carriage in this population of Alaska Natives, and ongoing carriage contributed to disease resurgence.

PMID: 9841828 [PubMed - indexed for MEDLINE]

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