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. 2023 Jun 8;76(11):1889-1895.
doi: 10.1093/cid/ciad054.

Epidemiology of Invasive Nontypeable Haemophilus influenzae Disease-United States, 2008-2019

Sara E Oliver  1 , Amy B Rubis  1 , Heidi M Soeters  1 , Arthur Reingold  2 , Meghan Barnes  3 , Susan Petit  4 , Monica M Farley  5 , Lee H Harrison  6 , Kathy Como-Sabetti  7 , Sarah A Khanlian  8 , Rachel Wester  9 , Ann Thomas  10 , William Schaffner  11 , Henju Marjuki  1 , Xin Wang  1 , Susan Hariri  1
Affiliations

Epidemiology of Invasive Nontypeable Haemophilus influenzae Disease-United States, 2008-2019

Sara E Oliver et al. Clin Infect Dis. .

Abstract

Background: Nontypeable Haemophilus influenzae (NTHi) is the most common cause of invasive H. influenzae disease in the United States (US). We evaluated the epidemiology of invasive NTHi disease in the US, including among pregnant women, infants, and people with human immunodeficiency virus (PWH).

Methods: We used data from population- and laboratory-based surveillance for invasive H. influenzae disease conducted in 10 sites to estimate national incidence of NTHi, and to describe epidemiology in women of childbearing age, infants aged ≤30 days (neonates), and PWH living in the surveillance catchment areas. H. influenzae isolates were sent to the Centers for Disease Control and Prevention for species confirmation, serotyping, and whole genome sequencing of select isolates.

Results: During 2008-⁠2019, average annual NTHi incidence in the US was 1.3/100 000 population overall, 5.8/100 000 among children aged <1 year, and 10.2/100 000 among adults aged ≥80 years. Among 225 reported neonates with NTHi, 92% had a positive culture within the first week of life and 72% were preterm. NTHi risk was 23 times higher among preterm compared to term neonates, and 5.6 times higher in pregnant/postpartum compared to nonpregnant women. More than half of pregnant women with invasive NTHi had loss of pregnancy postinfection. Incidence among PWH aged ≥13 years was 9.5 cases per 100 000, compared to 1.1 cases per 100 000 for non-PWH (rate ratio, 8.3 [95% confidence interval, 7.1-9.7]; P < .0001).

Conclusions: NTHi causes substantial invasive disease, especially among older adults, pregnant/postpartum women, and neonates. Enhanced surveillance and evaluation of targeted interventions to prevent perinatal NTHi infections may be warranted.

Keywords: Haemophilus influenzae; Haemophilus influenzae vaccines; epidemiology; nontypeable Haemophilus influenzae.

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Conflict of interest statement

Potential conflicts of interest. L. H. H. has served as a member of data and safety monitoring boards for Merck and reports reimbursement for travel expenses from Merck and Pfizer. S. P. reports funding awarded by the Connecticut Department of Public Health by the CDC (Emerging Infections Cooperative Agreement). All other authors report no potential conflicts. 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 H. influenzae disease—United States, 2008–2019
Figure 2.
Figure 2.
Trends in estimated incidence of invasive nontypeable H. influenzae disease, by age group—United States, 2008–2019
Figure 3.
Figure 3.
Annual estimated incidence of invasive nontypeable H. influenzae disease by race and sex —United States, 2008–2019 AI/AN, American Indian/Alaska Native; PI, Pacific Islander
See this image and copyright information in PMC

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