Epidemiology of Haemophilus influenzae invasive disease in Jamaica, 1990-1993.

Haemophilus influenzae (H influenzae) invasive disease was studied retrospectively over a four-year period in children admitted to the Bustamante Hospital for Children in Kingston, Jamaica. A total of 86 cases were identified. The mean estimated annual incidence of H influenzae invasive disease in Kingston and St Andrew was 39 per 100,000 children under 5 years of age. The majority (77%) of cases were in the under 2-year age group. A distinct seasonal pattern was noted, with a significantly higher proportion of patients (57-73%) presenting in the cooler months. Meningitis was the most common clinical diagnosis, accounting for 76% of the cases. Poor outcome was demonstrated in 21.5% of patients with meningitis. Sensitivity testing of H influenzae isolates revealed a resistance rate of 26% for ampicillin and 7% for chloramphenicol. The epidemiological findings in this study provide reasonable guidelines for empiric antibiotic therapy and also support the need to seriously consider vaccine prophylaxis in Jamaican children.