Invasive Haemophilus influenzae type b disease in Sydney children 1985-1987: a population-based study.
OBJECTIVE
To determine the incidence and age distribution of invasive Haemophilus influenzae type b (Hib) disease in children (0-14 years) in the Sydney Statistical Division (SSD).


METHODS
Retrospective ascertainment from a defined population, 1985-1987. Eligible cases had Hib isolated from a normally sterile site or endoscopically proven epiglottitis.


METHODS
Sydney Statistical Division, which had a population of children aged 0-4 years of 229 165 in 1986.


METHODS
Cases were identified from all potential sources of relevant recorded information.


RESULTS
There were 292 eligible cases. Among 284 previously well children, those under 18 months of age contributed 81 of 143 cases (57%) of meningitis and 22 of 71 (71%) of cellulitis/arthritis but only 8 of 91 (11%) of epiglottitis and 4 of 18 (22%) of infection in other foci. Overall, 9% of cases had occurred by 6 months of age, 42% by 18 months and 55% by 24 months. The annual incidence of invasive Hib disease was 38.5 per 100,000 children aged 0-4 years. In areas with the lowest proportion of young children (less than 5.5%), the incidence of Hib disease in the first 12 months of life was significantly lower than in the remainder of Sydney, although there were no differences in overall disease incidence in the age group 0-4 years.


CONCLUSIONS
This study indicates that approximately 1 in 500 urban Australian children develop invasive Hib disease by their fifth birthday. Vaccination of children in Sydney with a conjugate Hib vaccine at 18 months of age would result in a greater potential reduction in Hib disease than in the United States, where universal vaccination at this age is current policy.
McIntyre
P B
PB
Westmead Hospital, NSW.
Leeder
S R
SR
Irwig
L M
LM
D000293:Adolescent; D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004352:Drug Resistance, Microbial; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010403:Penicillin Resistance; D012621:Seasons; D012698:Serologic Tests; D015996:Survival Rate
D001428:Bacterial Vaccines; D000667:Ampicillin