Risk factors for invasive Haemophilus influenzae disease among children 2-16 years of age in the vaccine era, Switzerland 1991-1993. The Swiss H. Influenzae Study Group.
BACKGROUND
Continued surveillance, and detailed investigation of direct and indirect effects of conjugated vaccines and risk factors for invasive H.influenzae serotype B (Hib) disease in the vaccine era are important.


METHODS
143 cases with invasive disease between 1991 and 1993 aged 2-16 years were selected retrospectively from a large incidence trend study. Controls (n = 336) were recruited from local vital registries and matched to cases for age, gender, and residence. Hib vaccination histories among study subjects and their siblings and other sociodemographic variables were obtained by questionnaires completed by the parents of these children. Adjusted odds ratio (OR) estimates were calculated by conditional logistic regression analysis.


RESULTS
Most vaccinated subjects had received the Polysaccharide-Diphtheria Toxoid vaccine and estimated vaccine efficacy was high (95%; 95% confidence interval [CI] 60-99%). Also, the results suggested that protection afforded by vaccination against Hib extended to the family members of vaccinated children. School attendance was found to be protective against invasive Hib disease (OR:0.33; CI:1.2-14.4). Cases more often than controls reported suffering from asthma and allergies (OR:4.8; CI:1.2-19.4).


CONCLUSIONS
Post-licensure vaccine efficacy is high among children > or = 2 years of age. The observed association between asthma and epiglottitis is novel and deserves further investigation.
Mühlemann
K
K
Institute of Medical Microbiology, University of Berne, Switzerland.
Alexander
E R
ER
Weiss
N S
NS
Pepe
M
M
Schopfer
K
K
D000293:Adolescent; D001249:Asthma / Q000139:chemically induced; D001425:Bacterial Outer Membrane Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004168:Diphtheria Toxoid / Q000008:administration & dosage* / Q000009:adverse effects; D004826:Epiglottitis / Q000139:chemically induced; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D006193:Haemophilus influenzae / Q000472:pathogenicity*; D006801:Humans; D015994:Incidence; D008297:Male; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage* / Q000009:adverse effects; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D013745:Tetanus Toxoid / Q000008:administration & dosage* / Q000009:adverse effects; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000009:adverse effects
D001425:Bacterial Outer Membrane Proteins; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; C055753:Haemophilus influenza type b polysaccharide vaccine-tetanus toxin conjugate; C052180:Haemophilus influenzae type b-polysaccharide vaccine-diphtheria toxoid conjugate; C061964:Haemophilus influenzae-type b polysaccharide-Neisseria meningitidis outer membrane protein conjugate vaccine; D011135:Polysaccharides, Bacterial; D013745:Tetanus Toxoid; D018074:Vaccines, Conjugate