Fleming D W, Leibenhaut M H, Albanes D, Cochi S L, Hightower A W, Makintubee S, Helgerson S D, Broome C V
JAMA. 1985 Jul 26;254(4):509-14.
The risk factors for acquisition of secondary day-care-associated Haemophilus influenzae type b disease were evaluated in a cohort of children in Seattle-King County, Washington; Atlanta; and the state of Oklahoma. During the study period, 129 primary cases were identified in children less than 5 years old who attended day-care facilities. In ten instances (8%), a secondary case occurred between one and 60 days after a primary case in the same classroom. Risk of secondary disease in classroom contacts was strongly age related: 2.4% in children 0 to 11 months old, 1.2% in children 12 to 23 months old, and 0.0% in children 24 to 59 months old. Controlling for age, children attending day-care more hours per week were more likely to transmit or acquire secondary disease. Risk of secondary disease for children in other classrooms at a center where a case had occurred was not significantly greater than risk of primary disease. Administration of rifampin to classroom contacts of a child with invasive H influenzae was effective in preventing secondary cases (95% confidence interval for rifampin efficacy, 47% to 100%). For children 0 to 23 months old not treated with rifampin, risk of secondary disease was 2.7% (95% confidence interval, 1.1% to 4.3%), a risk approaching that reported in household contacts.
在华盛顿州西雅图-金县、亚特兰大以及俄克拉何马州的一组儿童中，对获得继发性日托相关b型流感嗜血杆菌病的危险因素进行了评估。在研究期间，在参加日托机构的5岁以下儿童中确定了129例原发性病例。在10例（8%）中，同一教室的原发性病例出现后1至60天内发生了继发性病例。教室接触者中继发性疾病的风险与年龄密切相关：0至11个月大的儿童为2.4%，12至23个月大的儿童为1.2%，24至59个月大的儿童为0.0%。在控制年龄因素后，每周参加日托时间更长的儿童更有可能传播或获得继发性疾病。在发生病例的中心，其他教室的儿童发生继发性疾病的风险并不显著高于原发性疾病的风险。对侵袭性b型流感嗜血杆菌患儿的教室接触者给予利福平预防继发性病例有效（利福平疗效的95%置信区间为47%至100%）。对于未接受利福平治疗的0至23个月大的儿童，继发性疾病的风险为2.7%（95%置信区间为1.1%至4.3%），这一风险接近家庭接触者中报告的风险。
