Takala A K, Peltola H, Eskola J
National Public Health Institute, Helsinki University, Stenbäckinkatu, Finland.
Laryngoscope. 1994 Jun;104(6 Pt 1):731-5. doi: 10.1288/00005537-199406000-00013.
Surveillance of blood-culture-proven epiglottitis was conducted in Finland from 1985 through 1992. Among children (< 16 years), all bacteria causing epiglottitis, and among adults, Haemophilus influenzae were included. H influenzae type b (Hib) caused 226 (97%) of cases among children. Among adults with H influenzae epiglottitis (total of 20), 19 were caused by Hib. In 1986, vaccine trials with Hib-conjugate vaccines started in Finland, with vaccination coverage of 94% to 98% of infants. Vaccinations did not yet have an effect on the occurrence of epiglottitis in 1985 or 1986 when the annual incidence among children was 5.3/100,000, among those less than 5 years of age was 13.2/100,000, and among adults was 0.08/100,000. In 1987 through 1992 the proportion of vaccinated children increased steadily while the incidence of Hib epiglottitis decreased from 50 to 60 cases seen annually in 1985 and 1986 to 2 cases in 1992. There was no increase in the occurrence of epiglottitis caused by other pathogens. In conclusion, there is now a safe and efficient way to prevent the majority of epiglottitis cases among children with the new Hib-conjugate vaccines.
1985年至1992年期间，芬兰开展了血培养确诊的会厌炎监测。在儿童（<16岁）中，监测所有引起会厌炎的细菌，在成人中，监测流感嗜血杆菌。b型流感嗜血杆菌（Hib）导致了儿童中226例（97%）的病例。在患有流感嗜血杆菌会厌炎的成人中（共20例），19例由Hib引起。1986年，芬兰开始了Hib结合疫苗的疫苗试验，婴儿的疫苗接种覆盖率为94%至98%。1985年或1986年，疫苗接种对会厌炎的发生尚未产生影响，当时儿童的年发病率为5.3/10万，5岁以下儿童为13.2/10万，成人则为0.08/10万。1987年至1992年，接种疫苗的儿童比例稳步上升，而Hib会厌炎的发病率从1985年和1986年每年出现50至60例降至1992年的2例。其他病原体引起的会厌炎发生率没有增加。总之，现在有一种安全有效的方法，即使用新的Hib结合疫苗来预防大多数儿童会厌炎病例。
