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Experience with the prevention of invasive Haemophilus influenzae type b disease by vaccination in Alaska: the impact of persistent oropharyngeal carriage.
Singleton, R; Bulkow, L R; Levine, O S; Butler, J C; Hennessy, T W; Parkinson, A.
Afiliación
  • Singleton R; Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska 99508, USA.
J Pediatr ; 137(3): 313-20, 2000 Sep.
Article en En | MEDLINE | ID: mdl-10969253
OBJECTIVES: To report the epidemiology of invasive Haemophilus influenzae type b (Hib) disease in high-risk Alaska Native infants before and after universal infant Hib vaccination and evaluate an increase in invasive Hib disease in 1996 after changing Hib vaccine type. STUDY DESIGN: Statewide laboratory surveillance for invasive Hib disease has been conducted since 1980. Three cross-sectional Hib carriage studies were conducted in 1997 and 1998. RESULTS: The invasive Hib disease rate in Alaska Natives decreased from 332 cases per 100,000 children <5 years old in 1980-1991 to 17:100,000 in 1992-1995 but increased primarily in rural areas to 57.9:100,000 after a switch in Hib vaccine types. Carriage studies in 5 rural Alaska Native villages showed oropharyngeal Hib carriage as high as 9.3% in children aged 1 to 5 years; in contrast, carriage in urban Alaska Native children was <1%. CONCLUSIONS: Although Hib disease has decreased in Alaska, the rate of Hib disease and carriage in rural Alaska Natives did not decrease to the same extent as in non-Natives and urban Alaska Natives. Use of polyribosylribitol phosphate-outer-membrane protein conjugate vaccine for the first vaccine dose is critical to disease control in this population with continued transmission in infants <6 months of age. The ability to eliminate Hib carriage and disease may be affected by population characteristics, vaccination coverage, and Hib vaccine type used. This may pose a challenge to global elimination of Hib.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Orofaringe / Portador Sano / Vacunas Conjugadas / Vacunas contra Haemophilus / Haemophilus influenzae tipo b / Infecciones por Haemophilus Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies / Screening_studies Límite: Adolescent / Child / Child, preschool / Humans / Infant País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2000 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Orofaringe / Portador Sano / Vacunas Conjugadas / Vacunas contra Haemophilus / Haemophilus influenzae tipo b / Infecciones por Haemophilus Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies / Risk_factors_studies / Screening_studies Límite: Adolescent / Child / Child, preschool / Humans / Infant País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2000 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos