Re-emergence of Haemophilus influenzae type b (Hib) disease in The Gambia following successful elimination with conjugate Hib vaccine
Re-emergence of Haemophilus influenzae type b (Hib) disease in The Gambia following successful elimination with conjugate Hib vaccine
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DOI：
10.1016/j.vaccine.2007.06.023
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发表时间：
2007-08-21
期刊：
影响因子：
5.5
通讯作者：
Adegbola, Richard A.
中科院分区：
文献类型：
--
作者：
Howie, Stephen R. C.;Antonio, Martin;Adegbola, Richard A.
侵袭性Hib病仍然是大多数发展中世界儿童死亡和发病的主要原因，在1997年引入结合Hib疫苗后，冈比亚于2002年消除了这种疾病。2002年停止了正式的疾病监测，但在2005年7月至2006年4月期间发现了5例非系统病例(包括3例脑膜炎)。这相当于脑膜炎的发病率为每年10万人中有3人，这可能是低估了。病例的年龄分布(中位数15个月，范围0-36个月)比以前看到的年龄更大，也有明显疫苗失败的例子，但重新出现的原因尚不清楚。没有发现超强毒力菌株出现的证据。重新建立持续监测是回答本报告提出的问题所必需的，在冈比亚这样的环境中尤其重要，因为冈比亚没有给予加强剂量，以确定国家接种Hib疫苗的长期效果。(C)2007爱思唯尔有限公司。保留所有权利。
Invasive Hib disease, which remains a major cause of childhood mortality and morbidity in most of the developing world, was eliminated in The Gambia by 2002 following the introduction of conjugate Hib vaccine in 1997. Formal disease surveillance was stopped in 2002 but five cases (including three of meningitis) were detected non-systematically between July 2005 and April 2006. This equates to an incidence of 3 per 100,000 annually for meningitis, a likely underestimate. The age distribution of cases (median 15 months, range 0-36 months) was older than previously seen and there were examples of apparent vaccine failure, but the cause for this re-emergence is not clear. No evidence was found of the emergence of a hypervirulent strain. The re-establishment of continuing surveillance is required to answer the questions raised by this report, and is particularly important in settings like The Gambia, where a booster dose is not given, to determine long-term effects of national immunisation with Hib vaccine. (c) 2007 Elsevier Ltd. All rights reserved.