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Decline of pediatric admissions with Haemophilus influenzae type b in New York State, 1982 through 1993: relation to
G S Liptak1, K M McConnochie, K J Roghmann
1Division of General Pediatrics, Children's Hospital at Strong Memorial Hospital, Rochester, New York 14642-8777, USA.
Insights
Haemophilus influenzae type b (Hib) vaccination significantly reduced pediatric hospital admissions in New York. Targeted programs are needed to reach high-risk urban and minority populations for complete Hib disease elimination.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health Surveillance
Background:
- Haemophilus influenzae type b (Hib) was a leading cause of bacterial meningitis and other severe invasive diseases in young children.
- The introduction of Hib vaccines aimed to drastically reduce the incidence of these life-threatening infections.
Purpose of the Study:
- To assess the effectiveness of Hib vaccination on pediatric hospitalizations in New York State.
- To identify demographic and geographic risk factors associated with ongoing Hib invasive disease admissions.
Main Methods:
- Retrospective analysis of New York State hospitalization data from 1982 to 1993.
- Review of immunization records from physician offices in Monroe County, New York.
Main Results:
- Hib-related hospital admissions in New York decreased from 769 in 1982 to 133 in 1993.
- Significant reductions observed in Hib meningitis, septicemia, pneumonia, and epiglottitis; arthritis and osteomyelitis rates did not decline.
- In 1993, an estimated 712 admissions, 18 deaths, and 135 morbidity episodes were averted due to vaccination.
- Minority children and those in urban areas remained at higher risk and had lower immunization rates.
Conclusions:
- Hib vaccination has substantially decreased pediatric hospital admissions for invasive Hib disease.
- Continued efforts and targeted interventions are necessary to address disparities and eliminate Hib disease in high-risk populations, including urban and minority children.
Objectives:
To evaluate the impact of vaccination for Haemophilus influenzae type b (Hib) on pediatric hospital admissions in New York State, and to identify risk factors in children who continue to be admitted for Hib invasive disease.
Methods:
Retrospective review of hospitalizations in New York state from 1982 through 1993 and a survey of immunization records from physician offices in Monroe Country, New York.
Results:
In 1982, 769 children were admitted to New York state hospitals for Hib-related conditions; by 1993, this had decreased to 133. Significant declines during the study period occurred in the age-adjusted admission rates for Hib meningitis, septicemia, pneumonia, and epiglottitis, but not for arthritis and osteomyelitis. In 1993 alone, 712 admissions, 18 deaths, and 135 episodes of morbidity were avoided. Since 1991, the rates of admissions for Hib-related conditions have remained fairly constant. Minority subjects continue to be twice as likely as white subjects to be admitted for invasive Hib disease (0.44 vs 0.17/100,000). Children living in urban Rochester also are more likely to be admitted and less likely to be completely immunized against Hib (61%) than those living in suburban areas (82%).
Conclusions:
Although Hib vaccine has had a major impact on hospital admissions for Hib-related conditions, the goal of completely eliminating Hib disease will require programs targeted at groups at high risk, such as minorities and those living in cities.