Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Clin Infect Dis. 2018 Aug 31;67(6):881-889. doi: 10.1093/cid/ciy187.
Following Haemophilus influenzae serotype b (Hib) conjugate vaccine introduction in the 1980s, Hib disease in young children dramatically decreased, and epidemiology of invasive H. influenzae changed.
Active surveillance for invasive H. influenzae disease was conducted through Active Bacterial Core surveillance sites. Incidence rates were directly standardized to the age and race distribution of the US population.
During 2009-2015, the estimated mean annual incidence of invasive H. influenzae disease was 1.70 cases per 100000 population. Incidence was highest among adults aged ≥65 years (6.30) and children aged <1 year (8.45); many cases in infants aged <1 year occurred during the first month of life in preterm or low-birth-weight infants. Among children aged <5 years (incidence: 2.84), incidence was substantially higher in American Indian and Alaska Natives AI/AN (15.19) than in all other races (2.62). Overall, 14.5% of cases were fatal; case fatality was highest among adults aged ≥65 years (20%). Nontypeable H. influenzae had the highest incidence (1.22) and case fatality (16%), as compared with Hib (0.03; 4%) and non-b encapsulated serotypes (0.45; 11%). Compared with 2002-2008, the estimated incidence of invasive H. influenzae disease increased by 16%, driven by increases in disease caused by serotype a and nontypeable strains.
Invasive H. influenzae disease has increased, particularly due to nontypeable strains and serotype a. A considerable burden of invasive H. influenzae disease affects the oldest and youngest age groups, particularly AI/AN children. These data can inform prevention strategies, including vaccine development.
自 20 世纪 80 年代引入乙型流感嗜血杆菌（Hib）结合疫苗以来，儿童中 Hib 疾病的发病率显著下降，侵袭性流感嗜血杆菌的流行病学也发生了变化。
通过主动细菌性核心监测点对侵袭性流感嗜血杆菌病进行主动监测。发病率按美国人口的年龄和种族分布直接标准化。
2009-2015 年，侵袭性流感嗜血杆菌病的估计年平均发病率为每 10 万人 1.70 例。发病率最高的是年龄≥65 岁的成年人（6.30）和年龄<1 岁的儿童（8.45）；许多<1 岁的婴儿在早产或低出生体重婴儿的第一个月发生病例。在<5 岁的儿童中（发病率：2.84），美洲印第安人和阿拉斯加原住民（AI/AN）的发病率明显高于所有其他种族（2.62）。总体而言，14.5%的病例是致命的；年龄≥65 岁的成年人的病死率最高（20%）。与 Hib（0.03；4%）和非包膜血清型（0.45；11%）相比，无定型流感嗜血杆菌的发病率（1.22）和病死率（16%）最高。与 2002-2008 年相比，侵袭性流感嗜血杆菌病的估计发病率增加了 16%，这主要是由于血清型 a 和无定型菌株引起的疾病增加所致。
侵袭性流感嗜血杆菌病的发病率增加，特别是由于无定型菌株和血清型 a。侵袭性流感嗜血杆菌病对年龄最大和最小的年龄组造成了相当大的负担，特别是 AI/AN 儿童。这些数据可以为预防策略提供信息，包括疫苗的开发。
