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Paediatric invasive Haemophilus influenzae in Queensland, Australia, 2002-2011: Young Indigenous children remain at
Gavin Cleland1,2, Clare Leung3,4, Jenny Wan Sai Cheong4,5
1Department of Paediatrics, Western Australian Country Health Service, Kimberley Region, Western Australia, Australia.
Insights
Despite Hib vaccination, invasive Haemophilus influenzae disease remains a threat to children, particularly Indigenous children in Australia. Non-typeable strains are a growing concern, causing pneumonia, meningitis, and bacteraemia with significant morbidity and mortality.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Haemophilus influenzae causes invasive disease in children, even with widespread Hib vaccination.
- There is increasing global evidence of invasive non-typeable H. influenzae (NTHi).
Purpose of the Study:
- To investigate the current epidemiological and clinical characteristics of invasive H. influenzae disease in children in Queensland, Australia.
Main Methods:
- Retrospective review of invasive H. influenzae cases in children (<18 years) in Queensland from 2002-2011.
- Data collected from pathology records and treating hospitals.
Main Results:
- 144 cases with laboratory data and 123 with clinical/demographic data were analyzed.
- The majority of cases (72%) were in children under 5 years old.
- Annual incidence was 7.4/100,000 for children under 5, and 10.2/100,000 for Indigenous children under 5.
- NTHi accounted for 69 of 132 typed isolates.
- Pneumonia, meningitis, and bacteraemia were common diagnoses; 5 deaths and 12 cases of significant morbidity occurred.
Conclusions:
- Invasive H. influenzae disease rates have decreased post-Hib vaccination but remain significant.
- H. influenzae continues to cause substantial morbidity and mortality in children.
- Aboriginal and Torres Strait Islander children are disproportionately affected and remain particularly vulnerable.
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.
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