title: Haemophilus influenzae type b infection, vaccination, and H. influenzae carriage in children in Minnesota, 2008-2009.
abstract: An increase in invasive Haemophilus influenzae type b (Hib) cases occurred in Minnesota in 2008 after the recommended deferral of the 12-15 months Hib vaccine boosters during a US vaccine shortage. Five invasive Hib cases (one death) occurred in children; four had incomplete Hib vaccination (three refused/delayed); one was immunodeficient. Subsequently, we evaluated Hib carriage and vaccination. From 18 clinics near Hib cases, children (aged 4 weeks-60 months) were surveyed for pharyngeal Hib carriage. Records were compared for Hib, diphtheria-tetanus-acellular pertussis (DTaP), and pneumococcal (PCV-7) vaccination. Parents completed questionnaires on carriage risk factors and vaccination beliefs. In 1631 children (February-March 2009), no Hib carriage was detected; Hib vaccination was less likely to be completed than DTaP and PCV-7. Non-type b H. influenzae, detected in 245 (15%) children, was associated with: male sex, age 24-60 months, daycare attendance >15 h/week, a household smoker, and Asian/Pacific Islander race/ethnicity. In 2009, invasive Hib disease occurred in two children caused by the same strain that circulated in 2008. Hib remains a risk for vulnerable/unvaccinated children, although Hib carriage is not widespread in young children.
authors.affiliation: Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. sgl6@cdc.gov
authors.forename: S A
authors.initials: SA
authors.lastname: Lowther
authors.forename: N
authors.initials: N
authors.lastname: Shinoda
authors.forename: B A
authors.initials: BA
authors.lastname: Juni
authors.forename: M J
authors.initials: MJ
authors.lastname: Theodore
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: S L
authors.initials: SL
authors.lastname: Jawahir
authors.forename: M L
authors.initials: ML
authors.lastname: Jackson
authors.forename: A
authors.initials: A
authors.lastname: Cohn
authors.forename: R
authors.initials: R
authors.lastname: Danila
authors.forename: R
authors.initials: R
authors.lastname: Lynfield
mesh_terms: D000367:Age Factors; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D019741:Haemophilus influenzae type b / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010614:Pharynx / Q000382:microbiology; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D018073:Haemophilus Vaccines