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Author Notes:

Correspondence: H. M. Soeters, Division of Bacterial Diseases, National Centers for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS C-25, Atlanta, GA 30329; hmsoeters@cdc.gov

The authors are grateful to the following individuals for their contributions to the establishment and maintenance of the ABCs system. California Emerging Infections Program: Susan Brooks and Hallie Randel; Colorado Emerging Infections Program: Benjamin White, Deborah Aragon, Meghan Barnes, and Jennifer Sadlowski; Connecticut Emerging Infections Program: Matt Cartter, Carmen Marquez, and Michelle Wilson; Georgia Emerging Infections Program: Stephanie Thomas, Amy Tunali, and Wendy Baughman; Maryland Emerging Infections Program: Joanne Benton, Terresa Carter, Rosemary Hollick, Kim Holmes, and Andrea Riner; Minnesota Emerging Infections Program: Kathryn Como-Sabetti, Lori Triden, Corinne Holtzman, Richard Danila, and Kerry MacInnes; New Mexico Emerging Infections Program: Kathy Angeles, Joseph Bareta, Lisa Butler, Sarah Khanlian, Robert Mansmann, and Megin Nichols; New York Emerging Infections Program: Kari Burlaff, Suzanne McGuire, Glenda Smith, and Nancy Spina; Oregon Emerging Infections Program: Mark Schmidt, Jamie Thompson, and Tasha Poissant; Tennessee Emerging Infections Program: Brenda Barnes, Karen Leib, Katie Dyer, and Lura McKnight; Centers for Disease Control and Prevention (CDC): Karrie-Ann Toews, Emily Weston, Londell McGlone, Gayle Langley, Melissa Arvay, Olivia Almendares, Huong Pham, and the Bacterial Meningitis Laboratory.


Research Funding:

This work was supported by a cooperative agreement with the Emerging Infections Program of the CDC (CDC-RFA-CK12–120205CONT16).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Microbiology
  • Haemophilus influenzae
  • invasive disease
  • surveillance
  • epidemiology

Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease-United States, 2009-2015

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Journal Title:

Clinical Infectious Diseases


Volume 67, Number 6


, Pages 881-889

Type of Work:

Article | Post-print: After Peer Review


Background. Following Haemophilus influenzae serotype b (Hib) conjugate vaccine introduction in the 1980s, Hib disease in young children dramatically decreased, and epidemiology of invasive H. influenzae changed. Methods. Active surveillance for invasive H. influenzae disease was conducted through Active Bacterial Core surveillance sites. Incidence rates were directly standardized to the age and race distribution of the US population. Results. During 2009-2015, the estimated mean annual incidence of invasive H. influenzae disease was 1.70 cases per 100 000 population. Incidence was highest among adults aged =65 years (6.30) and children aged <1 year (8.45); many cases in infants aged <1 year occurred during the first month of life in preterm or low-birth-weight infants. Among children aged <5 years (incidence: 2.84), incidence was substantially higher in American Indian and Alaska Natives AI/AN (15.19) than in all other races (2.62). Overall, 14.5% of cases were fatal; case fatality was highest among adults aged =65 years (20%). Nontypeable H. influenzae had the highest incidence (1.22) and case fatality (16%), as compared with Hib (0.03; 4%) and non-b encapsulated serotypes (0.45; 11%). Compared with 2002-2008, the estimated incidence of invasive H. influenzae disease increased by 16%, driven by increases in disease caused by serotype a and nontypeable strains. Conclusions. Invasive H. influenzae disease has increased, particularly due to nontypeable strains and serotype a. A considerable burden of invasive H. influenzae disease affects the oldest and youngest age groups, particularly AI/AN children. These data can inform prevention strategies, including vaccine development.

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© The Author(s) 2018.

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