Booy R, Hodgson S A, Slack M P, Anderson E C, Mayon-White R T, Moxon E R
Department of Paediatrics, John Radcliffe Hospital, Headington, Oxford.
Arch Dis Child. 1993 Aug;69(2):225-8. doi: 10.1136/adc.69.2.225.
For a seven year period (1985-91) clinical and epidemiological data were prospectively collected on children aged < 10 years with microbiologically confirmed invasive Haemophilus influenzae type b infection in the Oxford region to study the epidemiology of the disease and determine the potential impact of early primary immunisation in infants. Computer records of primary immunisations given to these cases were retrospectively analysed and, where necessary, hospital and general practitioner records were searched to determine the immunisation history. Over the seven year period, 416 cases of invasive H influenzae type b disease were reported. Widescale immunisation against H influenzae type b began in 1991 as part of a regional trial. The estimated annual incidence for invasive disease between 1985 and 1990 was 35.5 cases per 100,000 children aged less than 5 years; for H influenzae type b meningitis it was 25.1 per 100,000 children aged less than 5 years. The cumulative risks for invasive disease and meningitis by the fifth birthday were one in 560 and one in 800 respectively. The majority of disease (71%) occurred in children less than 2 years of age with the peak monthly incidences at 6 and 7 months of age. The overall mortality was 4.3% and 50% of these deaths occurred suddenly. Most (91%) of the children had received at least one primary immunisation against diphtheria, tetanus, and pertussis before H influenzae type b infection and there was only one case of parental refusal of immunisation. None had received H influenzae type b immunisation. Given a vaccine uptake of 90% by 5 months of age it is estimated that at least 82% of the H influenzae type b infections could have been prevented. Extrapolated nationally, 1150 cases of infection and 50 deaths could be prevented each year by routine primary immunisation.
在七年期间（1985 - 1991年），前瞻性收集了牛津地区10岁以下经微生物学确诊为侵袭性b型流感嗜血杆菌感染儿童的临床和流行病学数据，以研究该疾病的流行病学情况，并确定早期婴儿初级免疫的潜在影响。对这些病例的初级免疫计算机记录进行了回顾性分析，必要时还查阅了医院和全科医生记录以确定免疫史。在这七年期间，共报告了416例侵袭性b型流感嗜血杆菌病病例。作为一项区域试验的一部分，1991年开始大规模接种b型流感嗜血杆菌疫苗。1985年至1990年期间侵袭性疾病的估计年发病率为每10万名5岁以下儿童35.5例；b型流感嗜血杆菌脑膜炎的年发病率为每10万名5岁以下儿童25.1例。到五岁生日时，侵袭性疾病和脑膜炎的累积风险分别为560分之一和800分之一。大多数疾病（71%）发生在2岁以下儿童，每月发病率高峰出现在6个月和7个月大时。总体死亡率为4.3%，其中50%的死亡为突然死亡。大多数（9 | %）儿童在感染b型流感嗜血杆菌之前至少接受过一次白喉、破伤风和百日咳的初级免疫，只有一例家长拒绝免疫。没有人接种过b型流感嗜血杆菌疫苗。如果5个月大时疫苗接种率达到90%，估计至少82%的b型流感嗜血杆菌感染可以预防。全国范围内推断，通过常规初级免疫每年可预防1150例感染和50例死亡。
