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Laurel Evans Broadhurst, MD, MPH; Ralph L. Erickson, MD, MPH; Patrick W. Kelley, MD, MPH

JAMA. 1993;269(2):227-231.

Abstract
Objective.
—To document trends in the incidence of invasive Haemophilus influenzae diseases in young children of US Army active duty soldiers following the publication of H influenzae type b immunization recommendations for young children between 1985 and 1990.

Design.
—A population-based surveillance of hospital discharge diagnoses for H influenzae invasive diseases.

Setting.
—Military and civilian medical treatment facilities around the world.

Patients.
—There was a mean population of nearly 200 000 US Army health care beneficiaries younger than 5 years of age each year of the study.

Outcome Measures.
—Annual total and age-specific incidences of the six most common H influenzae invasive diseases in this population (meningitis, epiglottitis, septicemia, pneumonia, cellulitis, and septic arthritis).

Results.
—The annual number of cases of H influenzae invasive diseases decreased from a high of 188 in 1986 to 43 in 1991. The incidence in the age group at highest risk for H influenzae disease, those 6 to 11 months of age, decreased from 355 per 100 000 children in 1986 to 116 per 100 000 in 1991 (P<.0001 ² for trend). The incidence for H influenzae meningitis declined from 59 per 100 000 children in 1986 to 6 per 100 000 in 1991 (P<.0001, ² for trend).

Conclusions.
—The decrease in H influenzae invasive diseases closely follows the dates of H influenzae type b vaccine licensure for use in progressively younger age groups. Some age groups, however, experienced a decline in disease rates even before becoming eligible for vaccination.

(JAMA. 1993;269:227-231)

Author Affiliations
From the Division of Preventive Medicine, Department of Advanced Preventive Medicine Studies, Walter Reed Army Institute of Research, Washington, DC. Dr Broadhurst is now Epidemiology Consultant, 7th Medical Command, 10th Medical Laboratory, Landstuhl, Germany, and Dr Erickson is now Command Preventive Medicine Officer, Special Operations Command, Ft Bragg, NC.

Footnotes
The opinions or assertions contained herein are the private views of the authors and are not necessarily to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100 (Dr Kelley).

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