Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska 99507, USA.
Emerg Infect Dis. 2013 Jun;19(6):932-7. doi: 10.3201/eid1906.121805.
Before introduction of Haemophilus influenzae type b (Hib) vaccines, rates of Hib disease in Alaska's indigenous people were among the highest in the world. Vaccination reduced rates dramatically; however, invasive H. influenzae type a (Hia) disease has emerged. Cases of invasive disease were identified through Alaska statewide surveillance during 1983-2011. Of 866 isolates analyzed for serotype, 32 (4%) were Hia. No Hia disease was identified before 2002; 32 cases occurred during 2002-2011 (p<0.001). Median age of case-patients was 0.7 years; 3 infants died. Incidence of Hia infection (2002-2011) among children <5 years was 5.4/100,000; 27 cases occurred in Alaska Native children (18/100,000) versus 2 cases in non-Native children (0.5/100,000) (risk ratio = 36, p<0.001). From 12/2009 to 12/2011, 15 cases of Hia disease occurred in southwestern Alaska (in children <5 years, rate = 204/100,000). Since introduction of the Hib conjugate vaccine, Hia infection has become a major invasive bacterial disease in Alaska Native children.
在乙型流感嗜血杆菌 (Hib) 疫苗问世之前，阿拉斯加原住民的 Hib 疾病发病率位居世界之首。疫苗的接种大大降低了发病率；然而，侵袭性甲型流感嗜血杆菌 (Hia) 疾病已经出现。通过 1983 年至 2011 年期间在阿拉斯加全州范围内的监测发现了侵袭性疾病病例。在对 866 株分离株进行血清型分析中，有 32 株（4%）为 Hia。2002 年之前没有发现 Hia 疾病；2002 年至 2011 年期间发生了 32 例（p<0.001）。病例患者的中位年龄为 0.7 岁；有 3 名婴儿死亡。2002-2011 年期间，<5 岁儿童的 Hia 感染发病率为 5.4/10 万；在阿拉斯加原住民儿童中发生了 27 例（18/10 万），而非原住民儿童中发生了 2 例（0.5/10 万）（风险比=36，p<0.001）。从 2009 年 12 月至 2011 年 12 月，在阿拉斯加西南部发生了 15 例 Hia 疾病（在<5 岁儿童中，发病率为 204/10 万）。自从 Hib 结合疫苗问世以来，Hia 感染已成为阿拉斯加原住民儿童的主要侵袭性细菌性疾病。
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