Millar E V, O'Brien K L, Levine O S, Kvamme S, Reid R, Santosham M
Center for American Indian and Alaskan Native Health, Baltimore, MD 21205, USA.
Am J Public Health. 2000 Oct;90(10):1550-4. doi: 10.2105/ajph.90.10.1550.
This report describes the epidemiology of Haemophilus influenzae type b (Hib) invasive disease and oropharyngeal colonization among Navajo and White Mountain Apache children younger than 7 years in an era of widespread immunization.
We conducted active surveillance for invasive H influenzae disease from 1992 to 1999 and an oropharyngeal carriage study from 1997 to 1999. The predominant vaccine used was PedvaxHib.
The average annual incidence of invasive Hib disease among children younger than 24 months was 22 cases per 100,000. Of 381 children younger than 7 years, only 1 (0.3%; 95% confidence interval = 0.0%, 1.3%) was colonized with Hib; 370 (97%) had received 2 or more doses of Hib conjugate vaccine.
Among Navajo and White Mountain Apache children, Hib conjugate vaccines have led to a sustained reduction in invasive Hib disease and a reduction in oropharyngeal Hib carriage. The disease incidence among children younger than 24 months remains 20 times higher than in the general US population. Hib elimination will require additional characterization of colonization and disease in these high-risk populations.
本报告描述了在广泛免疫时代，纳瓦霍族和白山阿帕契族7岁以下儿童中b型流感嗜血杆菌（Hib）侵袭性疾病和口咽部定植的流行病学情况。
我们在1992年至1999年期间对侵袭性流感嗜血杆菌疾病进行了主动监测，并在1997年至1999年期间开展了一项口咽部携带情况研究。使用的主要疫苗是PedvaxHib。
24个月以下儿童侵袭性Hib疾病的年平均发病率为每10万人22例。在381名7岁以下儿童中，只有1名（0.3%；95%置信区间=0.0%，1.3%）被Hib定植；370名（97%）儿童接种了2剂或更多剂次的Hib结合疫苗。
在纳瓦霍族和白山阿帕契族儿童中，Hib结合疫苗使侵袭性Hib疾病持续减少，口咽部Hib定植也有所减少。24个月以下儿童的疾病发病率仍比美国普通人群高20倍。要消除Hib，需要对这些高危人群中的定植和疾病情况进行进一步的特征描述。
