Racial Disparities in Invasive Haemophilus influenzae Disease—United States, 2008–2017. (16th May 2021)

• Record Type: Journal Article
• Authors: Brown, Nicole E; Blain, Amy E; Burzlaff, Kari; Harrison, Lee H; Petit, Susan; Schaffner, William; Smelser, Chad; Thomas, Ann; Triden, Lori; Watt, James P; Pondo, Tracy; Whaley, Melissa J; Hu, Fang; Wang, Xin; Oliver, Sara; Soeters, Heidi M
• Is Part Of: Clinical infectious diseases. Volume 73:Number 9(2021)
• Page Start: 1617
• Page End: 1624
• Publication Date: 2021-05-16
• Subjects: Haemophilus influenza -- Haemophilus influenzae vaccines -- epidemiology -- public health surveillance -- minority health; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab449
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Since the introduction of Haemophilus influenzae serotype b (Hib) conjugate vaccines in the United States, invasive H. influenzae disease epidemiology has changed, and racial disparities have not been recently described. Methods: Active population- and laboratory-based surveillance for H. influenzae was conducted through Active Bacterial Core surveillance at 10 US sites. Data from 2008–2017 were used to estimate projected nationwide annual incidence, as cases per 100 000. Results: During 2008–2017, Active Bacterial Core surveillance identified 7379 H. influenzae cases. Of 6705 patients (90.9%) with reported race, 76.2% were White, 18.6% were Black, 2.8% were Asian/Pacific Islander, and 2.4% were American Indian or Alaska Native (AI/AN). The nationwide annual incidence was 1.8 cases/100 000. By race, incidence was highest among AI/AN populations (3.1) and lowest among Asian/Pacific Islander populations (0.8). Nontypeable H. influenzae caused the largest incidence within all races (1.3), with no striking disparities identified. Among AI/AN children aged <5 years, incidence of H. influenzae serotype a (Hia) was 16.7 times higher and Hib incidence was 22.4 times higher than among White children. Although Hia incidence was lower among White and Black populations than among AI/AN populations, Hia incidence increased 13.6% annually among White children and 40.4% annually among Black children aged <5 years. Conclusions: While nontypeable H. influenzae causes the largest H. influenzae burden overall, AI/AN populations experience disproportionately high rates of Hia and Hib, with the greatest disparity among AI/AN children aged <5 years. Prevention tools are needed to reduce disparities affecting AI/AN children and address increasing Hia incidence in other communities. Abstract : Invasive Haemophilus influenzae serotype a (Hia) incidence increased among white and black children. American Indian and Alaska Native populations experienced disproportionally high rates of invasive Hia and H. influenzae serotype b, with the greatest disparity among children aged <5 years.