Paediatric invasive Haemophilus influenzae in Queensland, Australia, 2002-2011: Young Indigenous children remain at highest risk

J Paediatr Child Health. 2018 Jan;54(1):36-41. doi: 10.1111/jpc.13662. Epub 2017 Sep 4.

Abstract

Aim: Haemophilus influenzae continues to cause invasive disease in children despite widespread Hib immunisation. The significance of non-B serotypes continues to be investigated, with evidence of increased invasive non-typeable H. influenzae (NTHi) world-wide. The aim of this study was to examine the current epidemiological and clinical features of invasive H. influenzae disease in children in Queensland, Australia.

Methods: A retrospective review was performed of all cases of invasive H. influenzae disease in children <18 years of age in Queensland between January 2002 and December 2011. Cases were identified from pathology records and data requested from treating hospitals.

Results: Laboratory data were obtained for 144 cases and clinical/demographic data for 123 cases. The majority (72%) of cases were children <5 years of age. Annual incidence rate for all children <5 years was 7.4/100 000, and for Aboriginal and Torres Strait Islander children <5 years was 10.2/100 000. Serotype was reported for 132 isolates, 69 NTHi and 63 encapsulated strains. The most common clinical diagnoses were pneumonia, meningitis and bacteraemia without clinical focus. Of the patients, 5 patients died, and 12 had significant morbidity at hospital discharge.

Conclusions: While rates of invasive H. influenzae disease have decreased dramatically following the introduction of Hib vaccination, H. influenzae remains a cause of significant morbidity and mortality, and Aboriginal and Torres Strait Islander children remain particularly vulnerable.

Keywords: Haemophilus influenzae infections; Queensland; immunisation; paediatric.

MeSH terms

  • Adolescent
  • Age Factors
  • Analysis of Variance
  • Australian Aboriginal and Torres Strait Islander Peoples
  • Bacteremia / epidemiology*
  • Bacteremia / prevention & control
  • Child
  • Child, Preschool
  • Cohort Studies
  • Communicable Disease Control / organization & administration*
  • Female
  • Haemophilus Infections / epidemiology*
  • Haemophilus Infections / prevention & control
  • Haemophilus Vaccines / administration & dosage*
  • Haemophilus influenzae / pathogenicity*
  • Humans
  • Infant
  • Male
  • Multivariate Analysis
  • Prevalence
  • Queensland / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Statistics, Nonparametric
  • Survival Analysis
  • Vulnerable Populations

Substances

  • Haemophilus Vaccines