Evaluating a Cluster and the Overall Trend of Invasive Haemophilus influenzae Serotype b in Alaska 2005-2019

Pediatr Infect Dis J. 2022 Apr 1;41(4):e120-e125. doi: 10.1097/INF.0000000000003470.

Abstract

Background: In 2019, 5 cases of invasive Haemophilus influenzae serotype b (Hib) occurred in the Anchorage region of Alaska over a period of 16 days. No cases had occurred in Alaska in the preceding 26 months.

Methods: Alaska Hib isolates from 2005 through 2019 were analyzed using whole-genome sequencing (WGS). Rates were compared with the CDC's Active Bacterial Core surveillance (ABCs) data.

Results: A total of 33 cases of invasive Hib occurred in Alaska from 2005 through 2019. Of the 5 cases associated with the cluster, 2 (40%) occurred in adults and all occurred in the Anchorage region. In contrast, only 14% (4/28) of the noncluster cases occurred in this region (P < 0.01). Two cluster cases were linked epidemiologically and the bacteria were nearly identical. The other 3 cluster cases were caused by 3 genetically distinct bacteria. When the full period was evaluated, the unadjusted rate of invasive Hib disease in Alaska was 15.5 times higher in Alaska Native (AN) people than non-AN people [1.3/100,000 vs. 0.07/100,000, 95% confidence intervals (CI): 10.2-22.5). The age-adjusted rate of invasive Hib disease in Alaska was 9.4 times higher than the ABCs rate (95% CI: 6.3-14.1).

Conclusions: While clustered in time and space, the 5 cases in 2019 were not due to a single bacterial strain. AN people continue to have elevated rates of invasive Hib infection compared with both non-AN people in Alaska and the ABCs population.

MeSH terms

  • Adult
  • Alaska / epidemiology
  • Alaska Natives*
  • Haemophilus Infections* / epidemiology
  • Haemophilus Infections* / microbiology
  • Haemophilus Vaccines*
  • Haemophilus influenzae
  • Haemophilus influenzae type b*
  • Humans
  • Infant
  • Serogroup

Substances

  • Haemophilus Vaccines