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. 2018 Aug 31;67(6):881-889.
doi: 10.1093/cid/ciy187.

Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease-United States, 2009-2015

Heidi M Soeters  1   2 , Amy Blain  2 , Tracy Pondo  2 , Brooke Doman  3 , Monica M Farley  4   5 , Lee H Harrison  6 , Ruth Lynfield  7 , Lisa Miller  8 , Susan Petit  9 , Arthur Reingold  10 , William Schaffner  11 , Ann Thomas  12 , Shelley M Zansky  13 , Xin Wang  2 , Elizabeth C Briere  2
Affiliations

Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease-United States, 2009-2015

Heidi M Soeters et al. Clin Infect Dis. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

Potential conflicts of interest. R. L. coedited a book on infectious disease surveillance and donated received royalties to the Minnesota Department of Health. W. S. has served as a consultant and member of a data safety monitoring board for various pharmaceutical companies. All other authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Trends in estimated incidence of invasive Haemophilus influenzae disease, by serotype—United States, 2002–2015. The 2002–2008 cases are a subset of data previously published by MacNeil et al [1]. Abbreviation: H. influenzae, Haemophilus influenzae.
Figure 2.
Figure 2.
Trends in estimated incidence of invasive Haemophilus influenzae disease caused by non-b encapsulated serotypes—United States, 2002–2015. The 2002–2008 cases are a subset of data previously published by MacNeil et al [1].
Figure 3.
Figure 3.
Trends in estimated incidence of invasive Haemophilus influenzae disease, by age group—United States, 2002–2015. The 2002–2008 cases are a subset of data previously published by MacNeil et al [1].
Figure 4.
Figure 4.
Trends in estimated incidence of invasive Haemophilus influenzae disease among children aged <5 years, by serotype—United States, 2002–2015. The 2002–2008 cases are a subset of data previously published by MacNeil et al [1]. Abbreviation: NT, nontypeable.
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