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Comment
. 2021 Jul 15;73(2):e371-e379.
doi: 10.1093/cid/ciaa875.

Epidemiology of Invasive Haemophilus influenzae Serotype a Disease-United States, 2008-2017

Heidi M Soeters  1 , Sara E Oliver  1 , Ian D Plumb  1 , Amy E Blain  1 , Tammy Zulz  2 , Brenna C Simons  2 , Meghan Barnes  3 , Monica M Farley  4 , Lee H Harrison  5 , Ruth Lynfield  6 , Stephanie Massay  7 , Joseph McLaughlin  7 , Alison G Muse  8 , Susan Petit  9 , William Schaffner  10 , Ann Thomas  11 , Salina Torres  12 , James Watt  13 , Tracy Pondo  1 , Melissa J Whaley  1 , Fang Hu  1 , Xin Wang  1 , Elizabeth C Briere  1 , Michael G Bruce  2
Affiliations
Comment

Epidemiology of Invasive Haemophilus influenzae Serotype a Disease-United States, 2008-2017

Heidi M Soeters et al. Clin Infect Dis. .

Abstract

Background: Haemophilus influenzae serotype a (Hia) can cause invasive disease similar to serotype b; no Hia vaccine is available. We describe the epidemiology of invasive Hia disease in the United States overall and specifically in Alaska during 2008-2017.

Methods: Active population- and laboratory-based surveillance for invasive Hia disease was conducted through Active Bacterial Core surveillance sites and from Alaska statewide invasive bacterial disease surveillance. Sterile-site isolates were serotyped via slide agglutination or real-time polymerase chain reaction. Incidences in cases per 100 000 were calculated.

Results: From 2008 to 2017, an estimated average of 306 invasive Hia disease cases occurred annually in the United States (estimated annual incidence: 0.10); incidence increased by an average of 11.1% annually. Overall, 42.7% of cases were in children aged <5 years (incidence: 0.64), with highest incidence among children aged <1 year (1.60). Case fatality was 7.8% overall and was highest among adults aged ≥65 years (15.1%). Among children aged <5 years, the incidence was 17 times higher among American Indian and Alaska Native (AI/AN) children (8.29) than among children of all other races combined (0.49). In Alaska, incidences among all ages (0.68) and among children aged <1 year (24.73) were nearly 6 and 14 times higher, respectively, than corresponding US incidences. Case fatality in Alaska was 10.2%, and the vast majority (93.9%) of cases occurred among AI/AN.

Conclusions: Incidence of invasive Hia disease has increased since 2008, with the highest burden among AI/AN children. These data can inform prevention strategies, including Hia vaccine development.

Keywords: Haemophilus influenzae; American Indian and Alaska Native; epidemiology; invasive disease; serotype a; surveillance.

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Conflict of interest statement

Potential conflicts of interest

Lee Harrison has served as a consultant to GSK, Merck, Pfizer, and Sanofi Pasteur. William Schaffner has served as a consultant to Roche Diagnostics and a member of data safety monitoring boards for Merck and Pfizer. Ruth Lynfield served as a co-editor on a book on Infectious Disease Surveillance, Public Health and Preventive Medicine and American Academy of Pediatrics Committee on Infectious Disease, with all proceeds donated to the Minnesota Department of Health. All other authors: No reported conflicts.

Figures

Figure 1.
Figure 1.
Trends in incidence of invasive H. influenzae serotype a disease in the United States and Alaska, 2008–2017.
Figure 2.
Figure 2.
Trends in incidence of invasive H. influenzae serotype a disease, by age group—United States (A) and Alaska (B), 2008–2017.
Figure 3.
Figure 3.
Infants aged <1 year with invasive H. influenzae serotype a disease, by age in months and race—Active Bacterial Core surveillance sites (A) and Alaska (B), 2008–2017.
Figure 4.
Figure 4.
Trends in incidence of invasive H. influenzae serotype a disease, by age group and race—United States (A) and Alaska (B), 2008–2017.
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